Diseases & Conditions, Health

Understanding Rabies

Camille Platt
Todd Rudolph, MD
Micah Woods, DVM
Lukisha Willett
July 26, 2024

How to Protect Yourself and Your Pets

An animal bite can be worrisome, especially if it’s not just a nip from an overly excited pet. While it’s important not to panic, you do want to take precautions against a rabies infection. Here, we shed light on the reality of rabies and hear from local experts about how prevention is key.

Rabies is a virus that affects the central nervous system and spreads to humans from the saliva of an infected animal, typically through a bite. Untreated rabies in humans can cause serious and eventually life-threatening symptoms, but cases are thankfully very rare, with only 1 to 3 reported annually in the United States. The majority of medical intervention is instead a preventative response to any potential exposure to the virus.

Rabies in Wildlife & Domestic Animals

Five thousand animals are diagnosed with rabies each year in the United States, and 9 out of 10 of these cases are reported in wildlife. Bats are the primary cause of animal-to-human transmission of rabies in the U.S., accounting for about 70% of human rabies cases. According to the CDC, most bats actually do not have rabies, but it is impossible to tell which ones do simply by sight. Even if you find a bat in your home and do not believe you have been bitten, you should call a public health professional to catch the animal for testing.

Bat bites are small and difficult to detect, so any contact with a bat should be taken seriously. Other wild animals to be wary of include foxes, raccoons, coyotes, beavers, and skunks.

Veterinarians report that dogs, cats, ferrets, and some farm animals can also carry the rabies virus. This risk is higher abroad: 25% of all human rabies cases in the United States since 1960 were contracted by dog bites that happened during travels outside the country.

Symptoms of Rabid Animals

When an animal becomes rabid, it is because it has been bitten by another animal with the rabies virus. The incubation period – the time before symptoms appear in an infected animal – can last a few weeks or a few months. Warning signs of rabies to watch out for include excessive salivation, loss of coordination, weakness, partial paralysis, abnormal behavior, and aggression. For bats, unusual behavior – such as daytime flying or entering a home – may also be a red flag for infection.

Reporting Rabies

Ultimately, you want to report any bite by an animal to your local health department. They are the experts on trends in rabies in your area and what risk different species carry. A healthy animal that bites a human should be confined and under observation for 10 days to make sure rabid symptoms do not develop. Public health authorities should be alerted to the quarantine. According to the CDC, out of all the animals tested annually in the United States for rabies, only 6% receive a positive diagnosis. This is why the observation period is best practice when it comes to first steps.

Treatment for Rabies

Post-exposure prophylaxis (PEP) is the standard treatment for rabies exposure and is nearly 100% effective at preventing rabies infection in humans. PEP consists of a rabies immune globulin shot near the site of the bite, which prevents the virus from infecting you, and a rabies vaccine. You can return to normal activities after receiving this treatment and will typically receive three follow-up injections over the course of two weeks.

In the event that you have been bitten by an animal, your physician may start you on PEP to prevent infection. However, there is likely no need to be alarmed. At times, this is simply the preferred procedure. If the animal that bit you (or may have bitten you) cannot be caught and quarantined, PEP may be recommended for peace of mind. Otherwise, the animal’s 10-day quarantine will dictate whether you receive treatment.

Rabies Prevention

Rabies prevention takes two forms: prevention of infection in your domestic pets and prevention of infection in yourself.

It is important to keep all family pets up to date on vaccinations and keep them close to home. A dog or cat contained to a yard and home is less likely to be bitten by another animal, risking infection. In addition, if your neighborhood includes a population of stray animals, contact local animal control authorities. Stray animals may be unvaccinated and risk passing disease to the neighborhood pets.

To prevent personal exposure to rabies, always use caution with wildlife and stray animals. Keep a safe distance, and do not attempt to approach or interact with an unknown animal. If you get bit or are worried about possible rabies exposure, contact your physician as soon as possible for advice on whether treatment will be necessary.

What to do if you’ve been bit:

Wash the area with soap and warm water.
Call animal control.
Document the animal’s behavior before the bite.
If a domestic animal, have someone locate the animal’s owner and ask for vaccination records.
Contact your physician and report the bite to public health officials.

Experts Weigh In

Q. What should the public know about rabies and the medical protocol in place to prevent it?

A. Although rare in the U.S., rabies is still a significant public health concern due to the fact that rabies can be fatal if left untreated. The first concern is a bite or scratch wound from an animal. While the majority of infections are caused by the bite of a bat, other animals can include skunks, raccoons, foxes, coyotes, and even domestic animals. The important thing for the public to know is to clean the wound with soap and water, contact local animal control, and contact the animal owner for vet records if appropriate. When there is suspected rabies exposure or if exposure cannot be completely ruled out, PEP is recommended. When an animal in question is able to be quarantined and observed for 10 days, some may choose to wait.

Todd Rudolph, MD Medical Director, AFC Urgent Care

Q. How can I keep myself and my pets safe from rabies infection?

A. The most important thing you can do to protect yourself and your pets from rabies is to maintain an annual rabies vaccine on all of your animals. Do your best to keep wild animals from coming onto your property or having contact with your pets. Frequent visitors or feral animals should be reported to animal control. Keep yourself and children at a safe distance from wild animals and never, ever try to touch them. Always seek medical attention immediately for any bite/scratch wounds from unknown animals regardless of its severity. Report the incident to your health department (the ER or urgent care should do this for you). There is a chance that post-rabies exposure vaccination protocols may be required. Ideally, the rabid-suspected animal is then trapped and tested for rabies by the health department.

Micah Woods, DVM Veterinarian, Ooltewah Veterinary Hospital

Q. What should I do if I get bit by an animal?

A. If you’ve been bitten by an animal, you should visit urgent care. Dog and cat bites are common complaints and can be effectively treated in most cases. The provider will ask about the source animal to assess rabies risk. Due to vaccination efforts, rabies transmission from pets has decreased, but wildlife like bats, raccoons, and skunks pose a higher risk. For these bites, rabies assessment is essential, with treatment available at the ER or health department. Bite wounds can quickly become infected, often requiring antibiotics. Tetanus status will be updated if needed. Treatment includes infection prevention, pain control, wound care, and discharge instructions. A follow-up visit with your primary care physician is also recommended.