How to treat a human suspected of having rabies

What medical care will I receive if I may have been exposed to rabies?

Postexposure prophylaxis (PEP) consists of a dose of human rabies immune globulin (HRIG) and rabies vaccine given on the day of the rabies exposure, and then a dose of vaccine given again on days 3, 7, and 14. For people who have never been vaccinated against rabies previously, postexposure prophylaxis (PEP) should always include administration of both HRIG and rabies vaccine. The combination of HRIG and vaccine is recommended for both bite and non-bite exposures, regardless of the interval between exposure and initiation of treatment.

People who have been previously vaccinated or are receiving preexposure vaccination for rabies should receive only vaccine.

Adverse reactions to rabies vaccine and immune globulin are not common. Newer vaccines in use today cause fewer adverse reactions than previously available vaccines. Mild, local reactions to the rabies vaccine, such as pain, redness, swelling, or itching at the injection site, have been reported. Rarely, symptoms such as headache, nausea, abdominal pain, muscle aches, and dizziness have been reported. Local pain and low-grade fever may follow injection of rabies immune globulin.

The vaccine should be given at recommended intervals for best results. Talk to your doctor or state or local public health officials if you will not be able to have your shots at the recommended interval. Rabies prevention is a serious matter and changes should not be made in the schedule of doses. Patient assistance programs that provide medications to uninsured or underinsured patients are available for rabies vaccine and immune globulin.

People cannot transmit rabies to other people unless they themselves are sick with rabies. PEP will protect you from developing rabies, and therefore you cannot expose other people to rabies. You can continue to participate in your normal activities.

Information for Clinicians

See our information on rabies biologics for information on dosing and administration route. You can also consult with local or state health officials for recommendations for assistance with risk assessments and PEP recommendations.

Regardless of the risk for rabies, bite wounds can cause serious injury such as nerve or tendon laceration and infection. Your doctor will determine the best way to care for your wound, and will also consider how to treat the wound for the best possible cosmetic results.

For many types of bite wounds, immediate gentle irrigation with water or a dilute water povidone-iodine solution has been shown to markedly decrease the risk of bacterial infection.

Wound cleansing is especially important in rabies prevention since, in animal studies, thorough wound cleansing alone without other postexposure prophylaxis has been shown to markedly reduce the likelihood of rabies.

You should receive a tetanus shot if you have not been immunized in ten years. Decisions regarding the use of antibiotics, and primary wound closure should be decided together with your doctor.

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Human cases of rabies are very rare in the United States, with only 23 cases reported from 2008 to 2017. Still, it’s important to understand the treatment protocol for rabies, a lethal viral infection that triggers inflammation of the brain and spinal cord. As the World Health Organization (WHO) notes, effective treatment soon after exposure to rabies can prevent the onset of symptoms, and ultimately save your life.

If you are bitten by an animal, seek medical attention immediately. The healthcare provider will provide wound care and prescribe medications if there is a risk for infection.

Wound Care

Swift action is essential when it comes to treating rabies. In addition to seeking medical attention right after an animal bite (especially from a bat, fox, or skunk), the wound should be cleaned immediately and thoroughly.

Wound Washing is Crucial

For post-bite first aid, the WHO recommends flushing and washing the wound for a minimum of 15 minutes. This cleaning should include use of soap and water, detergent, and/or a povidone-iodine solution.

According to the Centers for Disease Control and Prevention (CDC), animal-based research has shown that thorough wound cleansing alone may significantly reduce the likelihood of developing rabies. Once symptoms set in, however, death from respiratory failure usually occurs within seven days—even if treatment is given.

It should be noted that infection by bats is now the most common source of rabies-related human deaths in the United States.   The rabies virus may also be spread by such animals as foxes, skunks, and raccoons. Across the globe, over 90 percent of human rabies cases result from virus transmission by domestic dogs.  

Keep in mind that, regardless of rabies risk, animal bites can cause serious damage when the wound is severe. For example, bites may lead to local and/or systemic infection, as well as laceration of the nerves or tendons. Therefore, it’s always important to seek medical treatment after suffering any type of animal bite.

Post-Exposure Prophylaxis

Post-exposure prophylaxis (PEP) is the only treatment strategy known to prevent rabies-related deaths. This treatment includes extensive washing and local treatment of the wound followed by a course of a potent and effective rabies vaccine.

When given in time, PEP can stop the rabies virus from entering the central nervous system and, in turn, prevent the onset of rabies symptoms. To date, no one in the United States has developed rabies when given the vaccine promptly and appropriately, according to the National Institutes of Health.

In addition to PEP, your healthcare provider may prescribe antibiotics. You may require a tetanus shot depending on the date of your last tetanus shot.

The Rabies Vaccine

How to treat a human suspected of having rabies

Like all vaccines, rabies vaccines contain a weakened form of the virus that is incapable of causing disease or reproducing. In response to the vaccine, your body produces antibodies that target and kill the rabies virus.

Because all human rabies vaccines are inactivated, it’s impossible to develop rabies from receiving the vaccine. Each vaccine undergoes a series of rigorous quality-control tests, which include tests of potency, toxicity, safety, and sterility.

Dosing

Typically given in a set schedule of four doses over the course of 14 days (beginning with the day of exposure), the rabies vaccine is administered by injection.   In addition, most people also receive a treatment called human rabies immunoglobulin (HRIG) unless they have been previously vaccinated or are receiving pre-exposure rabies vaccines. Also administered by injection, HRIG is given the day the animal bite occurred.  

Side Effects

Although adverse reactions to rabies vaccine and HRIG aren’t common, they may trigger certain minor reactions at the injection site. These include:

  • Pain
  • Redness
  • Swelling
  • Itching

In rare cases, patients may experience symptoms like headache, nausea, abdominal pain, muscle aches, and dizziness.

Before receiving the rabies vaccine, let your healthcare provider if you’ve ever had a serious allergic reaction to a dose of rabies vaccine. You should also tell your healthcare provider if you have any severe allergies, or if you have a weakened immune system due to a chronic condition or use of certain medication (such as steroids).

Rabies Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.

How to treat a human suspected of having rabies

Frequently Asked Questions

Probably not, based on updated guidelines for rabies treatment released by the World Health Organization (WHO) in 2018. The guidelines identify three categories of rabies exposure. The first category is defined as “touching or feeding animals, licks on intact skin,” but post-exposure prophylaxis (PEP) is recommended only for category 2 and category 3 exposure.

The vaccine given to prevent rabies after exposure to the virus is safe and effective for most people, with side effects that are similar to those of any vaccine:

  • Symptoms at the injection site such as soreness, redness, swelling, or itching
  • Systemic side effects including headache, nausea, stomach pain, muscle aches, or dizziness

After booster shots, some people develop hives, joint pain, or fever. There are few known long-term complications associated with the rabies vaccine, although there have been rare reports of Guillain-Barre syndrome following the vaccine.

The American Veterinary Medication Association recommends parents and pets:

A diagnosis of rabies can be made after detection of rabies virus from any part of the affected brain, but in order to rule out rabies, the test must include tissue from at least two locations in the brain, preferably the brain stem and cerebellum.

The test requires that the animal be euthanized. The test itself takes about 2 hours, but it takes time to remove the brain samples from an animal suspected of having rabies and to ship these samples to a state public health or veterinary diagnostic laboratory for diagnosis.

In the United States, the results of a rabies test are typically available within 24 to 72 hours after an animal is collected and euthanized. Because rabies exposure to suspect animals is a medical urgency, but not an emergency, testing within this period is more than adequate for determining if a person was exposed to a rabid animal, and requires rabies postexposure vaccinations.

Approximately 120,000 animals or more are tested for rabies each year in the United States, and approximately 6% are found to be rabid. The proportion of positive animals depends largely on the species of animal and ranges from <1% in domestic animals to >10% of wildlife species.

Based on routine public health surveillance and pathogenesis studies, we have learned that it is not necessary to euthanize and test all animals that bite or otherwise potentially expose a person to rabies. For animals with a low probability of rabies such as dogs, cats, and ferrets, observation periods (10 days) may be appropriate to rule out the risk of potential human rabies exposure.

Consultation with a local or state health official following a potential exposure can help determine the best course of action based on current public health recommendations.

Diagnosis in humans

Several tests are necessary to diagnose rabies ante-mortem (before death) in humans; no single test is sufficient. Tests are performed on samples of saliva, serum, spinal fluid, and skin biopsies of hair follicles at the nape of the neck. Saliva can be tested by virus isolation or reverse transcription followed by polymerase chain reaction (RT-PCR). Serum and spinal fluid are tested for antibodies to rabies virus. Skin biopsy specimens are examined for rabies antigen in the cutaneous nerves at the base of hair follicles.

After a bite or other rabies exposure, the rabies virus has to travel through the body to the brain before it can cause symptoms. This time between the exposure and the appearance of symptoms is called the incubation period, and it may last for weeks to months. The incubation period may vary based on the location of the exposure site (how far away it is from the brain), the type of rabies virus, and any existing immunity.

The first symptoms of rabies may be very similar to those of the flu including general weakness or discomfort, fever, or headache. These symptoms may last for days.

There may be also discomfort or a prickling or itching sensation at the site of the bite, progressing within days to acute symptoms of cerebral dysfunction, anxiety, confusion, and agitation. As the disease progresses, the person may experience delirium, abnormal behavior, hallucinations, hydrophobia (fear of water), and insomnia. The acute period of disease typically ends after 2 to 10 days. Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive. To date less than 20 cases of human survival from clinical rabies have been documented, and only a few survivors had no history of pre- or postexposure prophylaxis.

The signs, symptoms, and outcome of rabies in animals can vary, but are often similar to those in humans, including early nonspecific symptoms, acute neurologic symptoms, and ultimately death.

Rabies virus can be excreted in the saliva of infected dogs, cats, and ferrets during illness and/or for a few days before illness or death. A healthy dog, cat, or ferret that bites a person should be confined and observed daily for 10 days. Confinement should be performed in coordination with public health authorities. To avoid mistaking the signs of rabies for possible side effects of vaccination, administration of rabies vaccine to the animal is not recommended during the observation period.

If the confined animal develops any signs of illness, it should be evaluated by a veterinarian. Any illness in the animal should be reported immediately to the local health department. If the animal develops signs suggestive of rabies, it should be euthanized by an animal health professional and the head submitted to a diagnostic laboratory for testing.

Any stray or unwanted dog, cat, or ferret that bites a person may be euthanized immediately by an animal health professional and the head should be submitted for rabies testing.

Other Animals

Other biting animals that might have exposed a person to rabies should be reported immediately to the local health department. Management of biting animals other than dogs, cats, and ferrets depends on:

  • The species
  • The circumstances of the bite
  • The epidemiology of rabies in the area
  • The biting animal’s history and current health status
  • The animal’s potential for exposure to rabies

Previous rabies vaccination of these animals might not preclude the necessity for euthanasia and testing.

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How to treat a human suspected of having rabies

A deadly virus is responsible for causing the rabies infection, which affects the spinal cord (the central nervous system) and the brain of humans and other mammals. If not treated early, the virus can be fatal. The rabies-infected animals can spread the disease through their saliva or contact with brain tissue.

Types of Rabies

Furious Rabies – If a person is infected by a rabies dog and develops furious rabies, then the person will be excitable and hyperactive with erratic behavior. A person may also show symptoms like anxiety, insomnia, confusion, agitation, hallucination, excess salivation, problems in swallowing, fear of water.

Paralytic Rabies – This type of rabies takes a very long time to develop. This type shows extreme effects. Infected people develop paralysis gradually and ultimately slip into the coma and die.

Causes and Symptoms

Rabies is transmitted to humans and other animals through close contact with the saliva from infected animals, such as scratches, bites, licks on broken skin, and mucous membranes. The most common way that humans contract rabies is when a rabid animal bites them. Since dogs in many countries are required to get rabies vaccines, bats are primarily the most guilty offenders that spread rabies to humans.

Other animals that have the most chances to pass on the rabies infection are skunks, raccoons, coyotes, and foxes. Small mammals, like squirrels, are typically not a threat for spreading rabies infection to humans. There are times the rabies virus can infect domesticated animals, such as cats, ferrets, and dogs. However, getting vaccinations and staying indoors cuts down on the number of pets that contract the virus.

Animals showing the signs of a rabies infection may foam at the mouth, suffer paralysis or drool. Pets with rabies do not act normal. For instance, a rabid dog may act shy when she or he usually is friendly. Rabies infected wild animals will not fear for humans.

What are the first symptoms of rabies in humans?

The first symptoms of rabies may last for days. These symptoms can be very similar to influenza, including general weakness or discomfort, fever, or headaches. A human with rabies may experience a cough, fever, or sore throat. As the virus progresses, symptoms become more severe and can include hallucinations, restlessness, and seizures. Falling into a coma and dying is inevitable for untreated cases of rabies in humans.

Preventive health maintenance is very important. Many diseases often have no advance symptoms. So even if you feel well you can identify them before they become advanced.
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Can you survive rabies?

There’s no effective treatment for rabies. The disease usually causes death. A small number of people have survived rabies without treatment

Rabies has an incubation period of two weeks to three months. They are very dangerous and kills within a week of the first symptoms showing up. The immune therapies and vaccine series are useless when the symptoms showing up and at this point, they can increase and speed up the severity of the symptoms.

Immune therapies and antiviral drugs have been tried, but they haven’t been shown to be lifesaving. Steroids, poly IC and disease-fighting interferon-alpha haven’t

Rabies Home Remedies

A human infected with the rabies virus should receive treatment – an assortment of shots known as PEP (post-exposure prophylaxis). The medicinal compounds in the shots will aid the immune system in removing the disease when it is in the primary stages. When you take the PEP treatment before symptoms develop, you can usually avoid infection and have a higher chance of making a complete recovery. However, you can prevent infection with the following home remedies for rabies until you see a doctor.

a) Soap and Water:

One of the first things you should do when coming in contact with a suspected rabid animal is to wash the bite, scratch, and open sore with water and soap. And you should immediately contact the local health department and your doctor.

b) Vitamin C:

If you are infected with rabies, take a vitamin C supplement or eat foods high in the vitamin that help fight the infection. Food suggestions include red peppers, guavas, fresh herbs, kiwi, cauliflower, and oranges.

c) Vitamin B:

Taking vitamin B will help generate antibodies, which will help tackle the infection. While you may receive a supplement, you can also consume foods rich in vitamin B, including tomatoes, cabbage, celery raspberries, watermelon, tangerines, spinach, pineapple.

d) Walnut:

In some regions, walnut is known to help counter the poison of a rabid dog bite. To use this remedy, grind equal amounts of onion, walnut, salt. You can also add honey to this preparation. Dress the wound with this concoction until you can get to a medical practitioner.

e) Chinese Herbs:

Chinese medicine practitioners have used skullcap to cure rabies-related infections for hundreds of years.

f) Lavender:

Gardeners who plant multiple herbs in their garden will find plenty of herbal remedies for a wide range of medical problems. If you make a concoction out of lavender and apply it to a wound, it is believed to help it heal quickly.

g) Garlic:

The natural antibiotic properties can help treat the aftereffects of a rabid dog bite. Take a few cloves of garlic thrice daily to aid in wound curing.

h) Cumin Seeds:

Cumin seeds can counter the harmful effects of a bite from a rabid dog. Grind about two teaspoons of cumin seeds and 20 black peppercorns. Add the ingredients to water and then apply the remedy to a dog bite wound.

i) Echinacea Tea:

A tea brewed with Echinacea may help speed up the wound healing process of an infected bite, as well as give a boost to the immune system.

j) Aloe Vera & Neem leaves

Since ancient times, people have been using neem leaves to treat various wounds and cuts as it has antiseptic properties that help expedite the healing of the wound. All you need to do is take 15-20 drops of neem oil and mix it with 3-5 tablespoon of aloe vera, then apply the concoction over the wound. Neem helps in curing the wound, and aloe vera help in providing a cooling effect on it.

Henna is a wellness lifestyle writer. She loves sharing her thoughts and personal experiences related to natural remedies, Ayurvedic, yoga and fitness through her writing. She currently writes for How To Cure. She can connect with others experiencing health concerns and help them through their recovery journeys through natural remedies.

When you think of rabies, one of the first things you may envision is a beastly canine foaming at the mouth – like Stephen King’s ‘Cujo,’ but other animals, including humans can also become infected with the virus associated with the condition. There are different stages, but precautions and home remedies for rabies can help treat the initial wounds before a doctor confirms the diagnosis.

How to treat a human suspected of having rabies

Table of Contents

What is Rabies?

A virus is responsible for causing the rabies infection, which affects the brain and spinal cord (the central nervous system) of mammals, including humans. If not treated before symptoms arise, the infection is nearly always deadly. Animals that become infected with rabies can spread the disease through their saliva or through contact with brain tissue. It is rare for people living in the United States or Canada to get rabies, as it is more common in developing nations [1].

Causes and Symptoms

Rabies is transmitted to other animals and humans through close contact with the saliva from infected animals, such as scratches, bites, licks on broken skin, and mucous membranes [2]. The most common way that humans get rabies is when they are bitten by a rabid animal. Since dogs in the United States are required to get rabies vaccines, bats are typically the most guilty culprits that transmit rabies to humans.

In the U.S., other animals that have the most potential to pass on the rabies infection are raccoons, skunks, foxes and coyotes. Small mammals, such as squirrels, are typically not a threat for spreading the rabies infection to humans in the United States and Canada. There are times when the rabies virus can spread to pets, such as dogs, cats, and ferrets. However, staying indoors and getting vaccinations cuts down on the numbers of pets that contract the virus.

An animal showing the signs of a rabies infection may drool, foam at the mouth, or suffer paralysis. Pets with rabies do not act like themselves. For example, a rapid dog may act shy when he or she is normally friendly. Wild animals with rabies will show no fear for humans.

A human with rabies may experience a fever, cough or sore throat. As the virus progresses, symptoms become more serious and can include hallucinations, restlessness, and seizures. Falling into a coma and dying are inevitable for untreated cases of human rabies.

Rabies Home Remedies

A human infected with the rabies virus must receive treatment – an assortment of shots known as postexposure prophylaxis (or PEP). The medicine in the shots will assist the immune system in eliminating the disease when it is in the early stages. When you receive the PEP treatment before symptoms start to emerge, you can usually avoid an infection and have a better chance of making a full recovery. However, some people believe that you can ward off infection with the following home remedies for rabies until you have a chance to see a doctor:

a) Soap and Water:

One of the first things you should do when coming in contact with a suspected rabid animal is wash the scratch, bite, and open sore with soap and water. The next thing you should do is immediately call your doctor and local health department.

b) Vitamin C:

If you have an infection associated with rabies, taking a vitamin C supplement or eating foods high in the vitamin will help fight the infection. Food suggestions include guavas, red peppers, fresh herbs, kiwi, cauliflower, and oranges [3].

c) Vitamin B:

Taking vitamin B will help produce antibodies, which will help fight infection. While you can take a supplement, you can also consume foods high in vitamin B, including cabbage, tomatoes, raspberries, celery, tangerines, watermelon, pineapple, and spinach.

d) Walnut:

In some circles, walnut is believed to help neutralize the poison of a rabid dog bite. To follow this remedy, grind equal amounts of walnut, salt and onion. Some have added honey to this concoction. Dress the wound with this mixture until you can get to a doctor.

e) Chinese Herbs:

If you happen to have skullcap in your home, practitioners of Chinese medicine have used skullcap to treat rabies-related convulsions for centuries.

f) Lavender:

Gardeners who plant a variety of herbs in their yard will find plenty of herbal remedies for a wide range of medical concerns. If you make a compress out of lavender and apply to a wound, it is believed to help it heal faster.

g) Garlic:

The natural antibiotic properties may help treat the aftereffects of a rabid dog bite. Some people have taken a few cloves of garlic three times daily to assist in wound healing.

h) Cumin Seeds:

Some believe that cumin seeds possess the ability to counter the toxic effects of a bite from a rabid dog. Grind about two teaspoons of cumin seeds and 20 black peppercorns. Add the ingredients to water, and then apply the remedy to a dog bite wound.

i) Echinacea Tea:

A tea brewed with Echinacea may help speed up the wound healing process of an infected bite, as well as give a boost to the immune system.