Rabies

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Diagnosis

Though the behavioral symptoms of rabies are classic, a diagnosis based solely on the symptoms can be difficult because they are similar to other diseases, conditions, and complications. The inability to swallow, for example, could be caused by an object lodged in the throat. Many factors can trigger aggressive, strange behavior and many animals are easily provoked when injured.

The only way to be 100% sure that an animal is rabid is to perform a direct fluorescent antibody test (dFA) on the brain tissue, which requires that the animal be euthanized. This is the most rapid and reliable test for rabies and it has been used for more than 40 years.

The dFA test is based on the principle that infected animals have rabies virus antigen (a protein) in brain tissue that reacts to antirabies antibodies (proteins produced by the immune system to fight disease and infection). The test involves inserting fluorescently labeled antirabies antibody molecules into the brain tissue, which bind to the rabies virus antigens and give off a bright glow when viewed through a special fluorescent microscope. A dFA test can also detect the presence of rabies antigens in the skin.

Tests that do not require euthanasia can be used to examine serum, spinal fluid, and saliva, but none of them can rule out rabies with 100% certainty. These tests are used only in humans and animals that cannot be euthanized.

Pets suspected of having rabies must be diagnosed as early as possible, especially if people have been exposed to the animal. Rabies is a fatal disease. Humans who have been exposed can be treated with safe postexposure prophylaxis, but only if it is administered before the person begins showing symptoms.

Treatment

If a rabid animal bites an unvaccinated cat or dog, the cat or dog must be quarantined immediately. Local health officers determine the length of time and conditions of the quarantine.

If a rabid animal bites a vaccinated cat or dog, the cat or dog should be immediately revaccinated and observed for up to 60 days, depending on local regulations.

If a vaccinated cat or dog bites a person, the animal should be quarantined for 10 days, to be observed for signs of rabies. If it shows signs of rabies within 10 days, it should be euthanized and submitted for rabies testing. If the animal remains healthy for 10 days, it may not have been infected when it bit the person. If the animal shows behavioral symptoms of rabies within those 10 days, the virus was present in the saliva when the animal bit the person.

If a stray or unvaccinated cat, dog, or other animal bites a person, the animal should be immediately euthanized and submitted for rabies testing. Unvaccinated people should receive postexposure treatment within 48 hours. Each year in the United States, 40,000 people receive postexposure treatment, which involves immediate cleansing of the wound and injection of human rabies immune globulin into the wound site and one other site (e.g., the buttocks). At the same time, a series of five injections of vaccine are administered. The local public health official should also be notified.

Prevention

The most effective way to prevent rabies in pets is through vaccination. Safe, effective vaccines are available for dogs, cats, horses, cattle, and sheep. All dogs and cats should be vaccinated after 12 weeks of age, one year later, and then every 3 years. Vaccinated cats and dogs should wear rabies tags, and their owners should keep their rabies certificates. Rabies shots should be administered by a licensed veterinarian.

Pet owners in the Northeastern United States, where rabies is epidemic among raccoons, should be especially diligent in vaccinating all cats and dogs. Any unvaccinated pet that comes into contact with a rabid animal is at risk for rabies.

Rabies poses a serious health threat to humans. People who have frequent contact with animals (e.g., pet groomers, zookeepers) should get a pre-exposure rabies vaccination. Do not keep skunks, foxes, raccoons, or bats as pets; they cannot be vaccinated and are susceptible to rabies. Avoid animals that seem to be behaving abnormally, especially wild animals that seem too friendly.

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