Rabies

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Overview

Rabies is an acute viral disease that can be transmitted from wild animals to unvaccinated pets and livestock, as well as to humans. It is caused by the rabies virus, which is present in the saliva of infected animals, and is transmitted through infected secretions (usually through the bite of a rabid animal). Once infection occurs, the virus spreads to the central nervous system and causes inflammation in the brain (acute encephalitis). Rabies is almost always fatal.

Effective pet vaccinations, postexposure treatment for humans, and effective animal control have nearly eliminated rabies in dogs in the United States. In parts of the world where vaccinations and postexposure treatment are not available, rabies remains a serious health threat for animals and for humans. Rabies kills more than 35,000 people every year, mostly in Asia, Africa, and Latin America.

If you see a wild animal or a stray dog or cat, do not approach the animal and do not try to determine if the animal is sick on your own. Contact your local animal control agency or police department. If you are bitten or scratched by a wild animal or a stray, immediately wash the area with soap and water for at least 5 minutes, contact a qualified health care provider, and report the incident to your local health department.

Incidence
Rabies occurs worldwide, affecting pets and wildlife. Overall prevalence is low in most places, but in some areas, the virus poses a serious threat to animals and humans. In the Northeastern United States, rabies has been epidemic among raccoons since the late 1970s.

More than 50% of all rabies cases in the United States involve raccoons. Skunks (22.5%), foxes (6.5%), and insectivorous bats (10%) are other common carriers. Rabies is rarely found in smaller mammals such as rabbits, squirrels, rats, and opossums. Domestic animals account for less than 10% of all cases in the United States.

Rabies remains a serious problem among domestic animals in certain parts of Latin America, Africa, and Asia. Mongooses and vampire bats are common carriers in these areas.

There are rabies-free countries, where the disease has either never been recorded or has been eradicated through strict quarantines and prevention programs. These areas include the British Isles, Australia, New Zealand, Hawaii, Japan, and parts of Scandinavia. Dogs and cats entering rabies-free countries are usually required to be quarantined for about 6 months, allowing time to observe the animal for behavioral signs of rabies.

In the United States, rabies is rare, but probably under-diagnosed in humans. There were 32 laboratory-confirmed cases of rabies in humans between 1980 and 1996. It is believed that most of these cases occurred as a result of bat bites and dog bites that occurred in foreign countries. Human rabies is most prevalent in Asia, particularly India.

Cause
Rabies virus is in the Rhabdoviridae family. The virus cannot live outside its host's body for more than a couple of seconds, but live virus has been found in animals that have been dead as long as 48 hours.

Transmission
Rabies usually is transmitted through infected saliva as a result of a bite from an infected animal. Rarely, it is transmitted by viral contamination of a fresh wound, through a scratch, or through contamination of a mucous membrane (i.e., eyes, nose, mouth). There have been reports of rabies being transmitted through the air in bat-infested caves.

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