Rabies is a virus that is transmitted from animals to humans (or other animals) through saliva, central nervous system tissue (brain, spinal cord), and brain/spinal cord fluid. The fluid or tissue containing the virus enters the system via fresh bites or scratches or through contacting the eyes, nose, and mouth. Rabies affects mammals and is often found in bats, skunks, raccoons, foxes, cats (feral), dogs, and livestock. Bites by some animals, such as bats, can inflict minor injury and can sometimes be difficult to detect. It is therefore important to understand the disease, be able to recognize an exposure, and know how to protect yourself after an exposure has occurred. 

Symptoms 

The onset of symptoms of rabies in humans may be similar to the flu and include fever, headache, and loss of energy or distress. Once the disease advances, more severe symptoms emerge which may include trouble sleeping, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, increase in saliva, difficulty swallowing, and fear of water. As symptoms progress, respiratory problems, heart deterioration and coma is experienced. Death usually occurs within 2-10 days of the onset of these symptoms.

If rabies is not treated, the disease is fatal. It is a preventable viral disease if treated soon after exposure, which is why it is very important to know what an exposure to rabies may be in addition to understanding the disease and how it is transmitted.  

Exposure

Exposures to bats are increasing as bat populations are growing in metropolitan areas.  Bats like dark spaces. Their favorite spots include the under-side of bridges, parking garages, and eaves of buildings. If you find a bat in a room or in an area out of their norm, do not touch it. Try to cover it and call skilled responders (generally animal control) for removal, regardless of whether the bat is dead or alive. You always want to submit bats for rabies testing if there is ANY chance that a person or pet had contact with the bat.

It can take weeks or months for an animal to show signs of rabies. The typical first sign of rabies in an animal is a change in behavior. They’ll usually stop eating and drinking, might become vicious or extremely docile, and then have paralysis after the initial behavior change. As a general rule, biting animals should be isolated and observed for 10 days to determine if the animal has rabies. If the biting animal was rabid at the time of the bite, it will begin to show signs of rabies within the 10-day observation period. 

If any of the following occur, consider this a potential exposure and contact your local or state health authority to have an investigation started:

• Bat found in same room as sleeping person
• Bat found in same room as unobserved child
• Bat found in same room as mentally impaired or intoxicated person
• Unsure of type of contact with bat (flew by, potential scratch)
• Handling of dead bat 
• Bites or scratches from any animal – vaccinated or not
• Contact with any saliva, central nervous system tissue, or brain/spinal fluid of any animal with unusual behavior

What to do

If you have been in contact with an animal that may have rabies, get medical care as soon as possible. If you have been bitten or scratched, the first step is to wash the wound with soap and water for 10-15 minutes. You will then receive Human Rabies Immune Globulin (HRIG) that is injected in and around the bite site or into a large muscle. You’ll also receive a rabies vaccine to prevent the spread of the disease in your body. This requires getting a series of four to five doses of medication on days 0, 3, 7, and 14.  If you have immune system issues, you will likely receive a fifth dose on day 28. The treatment that is available now has proven to be almost 100 percent successful. Again, the sooner after exposure you get seen by your medical care provider, the better!

While our natural curiosity can prompt us to approach animals that seem harmless, be aware of the animals in your area that have a high rate of rabies or those that are not behaving normally. Rabies is a very serious disease but can be prevented with common sense, vaccination of domestic animals, and prompt response to an exposure.

Additional resources
Texas Department of State Health Services—Zoonosis Division
Rabies—Centers for Disease Control and Prevention