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Indiana State Department of Health

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RABIES

 Rabies Quick Facts

Rabies and Camping

Animal Bite Investigation Workshop Materials

What is rabies?

Rabies is a viral disease that infects the central nervous system (brain and spinal cord) of mammals. It is almost always fatal.

How is rabies transmitted?

Rabies is usually transmitted by the bite of a rabid animal. The virus multiplies at the site of the bite and after a few days moves up the nerves to the brain. After reaching the brain, the rabies virus moves to the salivary gland. The presence of rabies virus in saliva enables the virus to infect another animal or person. Rabies virus usually produces behavioral changes in animals that make them more disposed to bite. This facilitates transmission to another animal. Rabies can also be transmitted when infected saliva comes in contact with an open wound, the eye, or the mouth. There have been occasional transmissions between humans through cornea or organ transplants. A scratch from a rabid animal could transmit the disease because there might be virus on its nails. Petting a rabid animal has never been shown to transmit rabies to humans.

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Which animals can transmit rabies?

Indiana animals considered to be at highest risk of transmitting rabies to humans include bats, skunks, foxes, raccoons, and coyotes. Dogs and cats can also transmit rabies that they have acquired from wildlife, but pets are rarely found rabid in Indiana. Reptiles and birds never get rabies. Theoretically, rats, mice, rabbits, squirrels, chipmunks, etc. can transmit rabies, but bites from these animals are not considered a rabies risk in Indiana at this time. Your local health department can help you evaluate the risk of rabies following an animal bite.

Until the early 1960's, most of the rabies cases in Indiana were dogs, cats, and animals bitten by dogs and cats. After pet vaccination increased and animal control programs were established, dog and cat rabies decreased rapidly. From the 1960s to 1988 skunks were the most commonly found rabid animals in Indiana. After 1988 bats became the most common rabid animal. Rabid bats have been found somewhere in the state every year since 1965. Rabies in skunks has been restricted to counties in far south central Indiana, where rabies in skunks continues to be transmitted at a very low level.

The chart below lists (as of December 2013) the number of each species found rabid in Indiana since 1962 and the last year in which a rabies case in that species occurred.

SPECIES
LAST YEAR POSITIVE
NUMBER POSITIVE
SINCE 1962
BAT
2013
>500
DOG
1989
182
CAT
1984
47
COW
1986
79
FOX
1990
99
GOAT
1967
1
GROUND HOG
1983
2
HORSE
2002
16
OPOSSUM
1968
1
PIG
1967
4
RACCOON
1979
4
SHEEP
1982
1
SKUNK
2004
824
HUMAN
2009
2

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What are the symptoms of rabies in animals?

One of the first signs of rabies in an animal is a change in behavior. A usually calm animal may become aggressive or a very active animal may seem depressed. Rabid wild animals can lose their fear of humans, and nocturnal animals might be seen during daylight hours.

In addition to changed behavior, rabid animals can exhibit furious and/or paralytic ("dumb") rabies. Animals with furious rabies are aggressive and may attack other animals and even inanimate objects. The furious stage does not occur in all rabid animals. An animal with paralytic rabies seems uncoordinated and weak and has a "dull" or "vacant" expression. Weakness eventually leads to paralysis and death. In some rabid animals, paralysis of the muscles used for swallowing causes saliva to accumulate with possible drooling and foaming. In all cases, death is due to respiratory paralysis.

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What are the symptoms of rabies in humans?

Rabies in humans is very similar to that in animals. The first sign in humans often consists of a general feeling of apprehension and itching or tingling at the site of the bite. Other signs of rabies in humans include headache, weakness, paralysis, and death. Because swallowing is often impossible due to paralysis of the throat muscles, humans with rabies often show extreme agitation and panic when offered water to drink. This is the origin of the term, hydrophobia.

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Can rabies exposure be prevented?

You can avoid being exposed to rabies by doing the following:

  • don't attempt to pet animals unknown to you
  • don't approach animals that are sleeping, injured, eating or caring for young
  • avoid contact with wild animals; enjoy them from a distance
  • exclude wildlife access to your house, garage, etc.
  • don't leave pet food out where it will attract wildlife
  • keep garbage containers closed and secure
  • HAVE YOUR PETS VACCINATED AGAINST RABIES – a vaccinated pet is a barrier between you and rabid wildlife

Can rabies be cured?

Once symptoms appear in humans, rabies can not be cured. There have been only a few human rabies survivors, and almost all suffered permanent neurological damage. Therefore, efforts are focused on preventing exposure or providing immunity that will prevent disease in those exposed.

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Can rabies disease be prevented?

Immunity can be provided prior to the exposure (preexposure) or after an exposure (postexposure). The methods to provide immunity are as follows:

Individuals who are in high-risk occupations (veterinarians, wildlife workers/rehabilitators, animal control personnel, and rabies laboratory workers) should be immunized with rabies vaccine prior to exposure. In some circumstances, international travelers should also be immunized against rabies prior to travel.

The second way rabies can be prevented is by vaccination after an exposure has occurred but before symptoms develop (post-exposure prophylaxis). It consists of 1 shot of immune serum given the first day of treatment and 5 shots of vaccine given over a period of 1 month. The serum is infiltrated around the wound, and the vaccine is given in the arm. Post-exposure prophylaxis, when given properly, has been extremely effective in preventing rabies in humans bitten by known rabid animals.

Pre-exposure Immunizations

Pre-exposure immunization does not eliminate the need for additional therapy in the event of an exposure to a rabid animal; however, it does simplify the post exposure therapy by eliminating the need for immune globulin and reduces the number of rabies vaccine doses required. It may provide protection in the event that an unapparent exposure occurs.

Pre-exposure immunization consists of three doses of vaccine. The first is given on day 0, the second on day 7, and the third on day 21 or day 28. Generally, booster doses are not needed until a known exposure occurs. Individuals in certain high-risk occupations in high-risk geographical areas may need to have their rabies protection (antibody) level checked periodically and receive a rabies vaccine booster when indicated. Individuals who have questions about the need to booster their rabies immunization should contact their physician or state health department.

International travelers who need both rabies vaccine and anti-malarial medication should complete rabies immunization in advance of starting anti-malarial medication to prevent interference with development of rabies immunity.

Post Exposure Immunizations

Rabies post exposure prophylaxis is given after an animal bite or other exposure to a rabid animal or one thought to have the potential to have transmitted rabies. Treatment is based on providing both passive immunity and active immunity for those who have not previously been immunized against rabies.

Passive immunity is provided by human rabies immune globulin. Human rabies immune globulin (HRIG) is obtained from human plasma donors who have been hyper-immunized. It is heat treated to kill blood-borne pathogens, filtered, and concentrated. HRIG is given at the time post exposure prophylaxis is initiated. HRIG is injected around the bite wound to neutralize any rabies virus that may be present. If all the calculated dosage cannot be injected at the bite site, the remaining amount is to be given in the gluteal area.

Rabies vaccine is used to provide active immunity, and in a post exposure setting, five doses of vaccine are given over a one-month period. The first dose is given on the day post exposure prophylaxis is initiated (called day 0) and additional doses are given on days 3, 7, and 14 following the initial dose.

Individuals who have received rabies vaccine in a pre-exposure series should receive two doses of vaccine. The first dose should be given on day 0 (day post-exposure prophylaxis is initiated) and the second on day 3. Individuals who have received vaccine in a pre-exposure series should not receive HRIG.

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What should I do if an animal bites me?

If an animal bites you, there are a few simple steps you can take:

  • Wash the wound with lots of soap and running water.
  • Go to a physician or emergency room immediately if the bite is severe or bleeding.
  • In any case, notify your physician that an animal bit you.
  • Make sure that you are up to date on your tetanus vaccination.
  • Take antibiotics if your physician prescribes them.
  • If possible and without causing further injury, try to identify or capture the biting animal.
  • Notify your county health department or animal control agency. The biting animal might need to be observed or tested to make sure that you were not exposed to rabies. If the biting animal is a dog, cat or ferret, it can be observed for 10 days after the bite. If it is not ill after that time, you were not exposed to rabies. Alternatively, dogs, cats and ferrets can be euthanized and tested immediately. High-risk wild animals should be killed and tested immediately. For other exposures, consult your local health department. Testing for rabies in Indiana is only done at the Indiana State Department of Health Disease Control Laboratory.

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Where can I get more information?

  • Your local health department is an excellent source of information on rabies in general, on the occurrence of rabies in your county, the risk of rabies following an animal bite, and options for observation or testing of biting animals.
  • Your veterinarian can advise you on how to protect your pets from rabies.
  • For additional information on rabies from the Centers for Disease Control and Prevention go to http://www.cdc.gov/ncidod/diseases/submenus/sub_rabies.htm
  • What Pet Owners Need to Know About Rabies