What is Rabies? Transmission, Symptoms, Diagnosis, Treatment, and Complications

Rabies is a viral infection that primarily affects the central nervous system, causing severe inflammation of the brain and spinal cord. The rabies virus is a member of the Lyssavirus genus in the family Rhabdoviridae.

Rabies is zoonotic, which means that it can be transmitted from animals to human beings. It spreads via the saliva of infected animals. If an animal with rabies bites you, you are at serious risk of developing rabies yourself. In the majority of cases, animals infect humans by biting them.

The World Health Organization says the following regarding how deadly the virus is:

“Rabies is a vaccine-preventable, zoonotic, viral disease affecting the central nervous system.”

“Once clinical symptoms appear, rabies is virtually 100% fatal. In up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans.”

The virus is present worldwide, except for Antarctica. More than 95% of all deaths occur in Africa and Asia.

The word rabies is followed by a singular verb, as in ‘rabies is and NOT ‘rabies are.’

Transmission of rabies

All warm-blooded animals including humans can become infected. However, only mammals develop symptoms and become ill and die. If the virus infects a bird, it rarely shows any signs and symptoms and recovers completely. Researchers found some birds with rabies antibodies, which suggests they most likely fed on infected mammals.

Nearly all (99%) human infections come from domestic dogs. Other sources include cats, coyotes, wolves, cattle, skunks, foxes, monkeys, raccoons, and mongooses.

According to Wikipedia:

“Rabies may also spread through exposure to infected bears, domestic farm animals, groundhogs, weasels, and other wild carnivorans.”

The virus infects the peripheral nervous system at first, and then the brain. From there, it spreads to other organs, including the salivary glands. Your peripheral nervous system is the part of the nervous system locate outside your brain and spinal cord.

Signs and symptoms

Signs and symptoms are not the same. A sign is something the patient as well as the doctor and others observe or detect. A skin rash, for example, is a sign. A symptom, on the other hand, is something only the patient is aware of. A headache is an example of a symptom. If you don’t tell your doctor or friends, they will never know about your headache.

Early signs and symptoms of rabies include fever, fatigue, headache, and muscle ache – they are similar to those of flu. As the virus progresses, the signs and symptoms that appear depend on the type of infection. There are two main forms of rabies: furious and paralytic.

  • Furious form

This form is characterized by erratic behavior, hyperactivity, agitation, and fear of water (hydrophobia). The patient also finds it much harder to swallow due to painful throat muscle spasms.

Other symptoms include hallucinations and seizures before the patient falls into a coma and eventually dies.

  • Paralytic form

This form is much less common and progresses slowly. The patient experiences muscle weakness, loss of sensation, paralysis, and eventually respiratory failure, coma, and death.

Rabies virus image

Wikipedia image adapted by medicalvocab.com

Treatment for rabies

As soon as clinical symptoms appear, there is no specific treatment for rabies. The disease, if treatment starts at this point (after symptoms appear), is nearly always fatal.

However, if treatment starts soon after the patient is bitten, a PEP (post-exposure prophylaxis) is administered. The PEP prevents the onset of symptoms and the progression of the disease, i.e., it prevents the patient from getting sick.

PEP includes a series of vaccinations, and sometimes the administration of RIG (rabies immune globulin) to provide immediate passive immunity.

It is crucial to treat the patient as soon as possible after exposure, i.e., as soon as possible after being bitten.

In other words, if an animal bites you and you suspect it might have rabies, get treatment immediately.


Rabies has a fatality rate of almost 100% once the signs and symptoms appear. The most common complication is encephalitis (inflammation of the brain), followed by coma and death.

If the patient survives after symptoms appear, which is extremely rare, they will have severe, long-term neurological problems.


  • Vaccinate all dogs, cats, and other pet mammals. Make sure vaccinations are kept current.
  • Do not allow your pet mammals to roam unsupervised.
  • Avoid stray dogs and cats. Keep your pets away from them.
  • Make sure your property is unattractive to wild animals. There should be no access into your attic, basement, or down chimneys. Keep trash cans tightly closed and feed your pets indoors.
  •  According to the Washington US District Government website: “Do not keep wild animals as pets.  Even a raccoon or skunk born in captivity may be a rabies carrier. Local laws prohibit acquiring of keeping such animals as pets. There are no approved vaccines or known quarantine for wild animals.”
  • Animal handlers and veterinarians should have a pre-exposure shot.

If a potentially rabid animal bites you:

  • Thoroughly wash the wound straight away with soap and water for 15+ minutes.
  • Apply an antiseptic to the wound.
  • See a healthcare professional to determine whether you need PEP, and if so, get the treatment.
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