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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP

Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Rabies facts
• What is rabies?
• What are rabies symptoms and signs in humans?
• What is the history of rabies, and what is the cause of rabies?
• How is rabies transmitted?
• How soon after an exposure should a person seek medical attention?
• How is a rabies infection diagnosed?
• What is the treatment for rabies in humans?
• Should people get a preexposure vaccination before traveling outside the U.S.?
• Can rabies be prevented?
• What is the prognosis for people with rabies?
• Rabies Index

After the first exposure (in most people, an animal bite), the symptoms of itching or discomfort like pins or needles pricking the skin occur at the bite area. In addition, the person may develop fever and a headache. Investigators suggest these symptoms may last from about two days to weeks. This is the acute phase or the acute incubation phase of the disease. Unfortunately, there is another incubation period before the next set of signs and symptoms develop. The National Institutes of Health (NIH) suggests that the average latent incubation period is about three to seven weeks, although they do report a range from seven days to 10 years, with the longer time periods occurring infrequently.

The symptoms and signs of rabies in humans may consist of some or many of the following according to the CDC and NIH:

• Anxiety, stress, and tension
• Delirium
• Drooling
• Convulsions
• Exaggerated sensation at the bite site
• Excitability or combativeness
• Hallucinations
• Loss of feeling in an area of the body
• Loss of muscle function
• Low-grade fever (102 F or lower)
• Muscle spasms
• Numbness and tingling
• Pain at the site of the bite
• Restlessness, insomnia
• Swallowing difficulty (drinking causes throat spasms and the person may become hydrophobic)

When these symptoms develop, the person will likely die from the disease. Less than 10 people have survived after developing such clinical rabies symptoms, and most of the few survivors had some previous level of treatment. When people develop clinical rabies, the best treatment is supportive care.

Figure 1: Muscle spasms and delirium in a person with clinical rabies; note the need for restraints. SOURCE: CDC