Rabies

This article is about rabies in humans. For rabies in animals, see Rabies in animals. For other uses, see Rabies (disambiguation).
"Rabid" redirects here. For other uses, see Rabid (disambiguation).

Rabies
A man suffering from rabies tied to a hospital bed.
A man with rabies, 1958
SpecialtyInfectious disease
SymptomsFever, extreme aversion to water, confusion, excessive salivary secretion, hallucinations, disrupted sleep, paralysis, coma,[1][2] hyperactivity, headache, nausea, vomiting, anxiety[3]
CausesRabies virus, Australian bat lyssavirus[4]
PreventionRabies vaccine, animal control, rabies immunoglobulin[1]
TreatmentSupportive care
MedicationIncurable[5]
Prognosis~100% fatal after onset of symptoms[1]
Deaths59,000 per year worldwide[6]

Rabies is a viral disease that causes encephalitis in humans and other mammals.[1] It was historically referred to as hydrophobia ("fear of water") because its victims would panic when offered liquids to drink. Early symptoms can include fever and abnormal sensations at the site of exposure.[1] These symptoms are followed by one or more of the following symptoms: nausea, vomiting, violent movements, uncontrolled excitement, fear of water, an inability to move parts of the body, confusion, and loss of consciousness.[1][7][8][9] Once symptoms appear, the result is virtually always death.[1] The time period between contracting the disease and the start of symptoms is usually one to three months but can vary from less than one week to more than one year.[1] The time depends on the distance the virus must travel along peripheral nerves to reach the central nervous system.[10]

Rabies is caused by lyssaviruses, including the rabies virus and Australian bat lyssavirus.[4] It is spread when an infected animal bites or scratches a human or other animals.[1] Saliva from an infected animal can also transmit rabies if the saliva comes into contact with the eyes, mouth, or nose.[1] Globally, dogs are the most common animal involved.[1] In countries where dogs commonly have the disease, more than 99% of rabies cases in humans are the direct result of dog bites.[11] In the Americas, bat bites are the most common source of rabies infections in humans, and less than 5% of cases are from dogs.[1][11] Rodents are very rarely infected with rabies.[11] The disease can be diagnosed only after the start of symptoms.[1]

Animal control and vaccination programs have decreased the risk of rabies from dogs in a number of regions of the world.[1] Immunizing people before they are exposed is recommended for those at high risk, including those who work with bats or who spend prolonged periods in areas of the world where rabies is common.[1] In people who have been exposed to rabies, the rabies vaccine and sometimes rabies immunoglobulin are effective in preventing the disease if the person receives the treatment before the start of rabies symptoms.[1] Washing bites and scratches for 15 minutes with soap and water, povidone-iodine, or detergent may reduce the number of viral particles and may be somewhat effective at preventing transmission.[1][12] As of 2016, only fourteen people were documented to have survived a rabies infection after showing symptoms.[13][14] However, research conducted in 2010 among a population of people in Peru with a self-reported history of one or more bites from vampire bats (commonly infected with rabies), found that out of 73 individuals reporting previous bat bites, seven people had rabies virus-neutralizing antibodies (rVNA).[15] Since only one member of this group reported prior vaccination for rabies, the findings of the research suggest previously undocumented cases of infection and viral replication followed by an abortive infection. This could indicate that people may have an exposure to the virus without treatment and develop natural antibodies as a result.

Rabies causes about 59,000 deaths worldwide per year,[6] about 40% of which are in children under the age of 15.[16] More than 95% of human deaths from rabies occur in Africa and Asia.[1] Rabies is present in more than 150 countries and on all continents but Antarctica.[1] More than 3 billion people live in regions of the world where rabies occurs.[1] A number of countries, including Australia and Japan, as well as much of Western Europe, do not have rabies among dogs.[17][18] Many Pacific islands do not have rabies at all.[18] It is classified as a neglected tropical disease.[19]

The global cost of rabies is estimated to be around US$8.6 billion per year including lost lives and livelihoods, medical care and associated costs, as well as uncalculated psychological trauma.[20]

  1. ^ a b c d e f g h i j k l m n o p q r s t "Rabies Fact Sheet N°99". World Health Organization. July 2013. Archived from the original on 1 April 2014. Retrieved 28 February 2014.
  2. ^ "Rabies – Symptoms and causes". Mayo Clinic. Retrieved 9 April 2018.
  3. ^ "Rabies". Mayo Clinic. Retrieved 5 October 2023.
  4. ^ a b "Rabies, Australian bat lyssavirus and other lyssaviruses". The Department of Health. December 2013. Archived from the original on 4 March 2014. Retrieved 1 March 2014.
  5. ^ "Rabies diagnosis and treatment". Mayo clinic. 27 June 2023.
  6. ^ a b "Rabies". CDC. 29 July 2020. Retrieved 31 January 2021.
  7. ^ "Rabies, Symptoms, Causes, Treatment". Medical News Today. 15 November 2017.
  8. ^ "Rabies, Symptoms and causes". Mayo Clinic.
  9. ^ "Animal bites and rabies". Johns Hopkins Medicine. 27 February 2020.
  10. ^ Cotran RS, Kumar V, Fausto N (2005). Robbins and Cotran Pathologic Basis of Disease (7th ed.). Elsevier/Saunders. p. 1375. ISBN 978-0-7216-0187-8.
  11. ^ a b c Tintinalli JE (2010). Emergency Medicine: A Comprehensive Study Guide (Emergency Medicine (Tintinalli)). McGraw-Hill. pp. Chapter 152. ISBN 978-0-07-148480-0.
  12. ^ Wunner WH (2010). Rabies: Scientific Basis of the Disease and Its Management. Academic Press. p. 556. ISBN 978-0-08-055009-1.
  13. ^ Manoj S, Mukherjee A, Johri S, Kumar KV (2016). "Recovery from rabies, a universally fatal disease". Military Medical Research. 3 (1): 21. doi:10.1186/s40779-016-0089-y. ISSN 2054-9369. PMC 4947331. PMID 27429788.
  14. ^ Weyer J, Msimang-Dermaux V, Paweska JT, Blumberg LH, Le Roux K, Govender P, et al. (9 June 2016). "A case of human survival of rabies, South Africa". Southern African Journal of Infectious Diseases. 31 (2): 66–68. doi:10.1080/23120053.2016.1128151. hdl:2263/59121. ISSN 2312-0053.
  15. ^ Gilbert AT, Petersen BW, Recuenco S, Niezgoda M, Gómez J, Laguna-Torres VA, Rupprecht C (August 2012). "Evidence of rabies virus exposure among humans in the Peruvian Amazon". The American Journal of Tropical Medicine and Hygiene. 87 (2): 206–215. doi:10.4269/ajtmh.2012.11-0689. PMC 3414554. PMID 22855749.
  16. ^ "Rabies: The Facts" (PDF). World Health Organization. Archived (PDF) from the original on 24 February 2017. Retrieved 24 February 2017.
  17. ^ WHO Expert Consultation on Rabies : second report (PDF) (2nd ed.). Geneva: WHO. 2013. p. 3. ISBN 978-92-4-120982-3. Archived (PDF) from the original on 20 October 2014.
  18. ^ a b "Rabies-Free Countries and Political Units". CDC. Archived from the original on 5 March 2014. Retrieved 8 May 2019.
  19. ^ "Neglected Tropical Diseases". cdc.gov. 6 June 2011. Archived from the original on 4 December 2014. Retrieved 28 November 2014.
  20. ^ "Rabies". www.who.int. Retrieved 13 August 2024.