Rabies

Overview

The rabies virus is spread to people from the saliva of infected animals, i.e. through a bite or a scratch. The disease causes restlessness, muscle cramps, paralysis and, finally, death. Vaccination is recommended for professionals at risk and travellers. In rabies areas, contact with dogs and wild animals should be avoided, and a doctor should be consulted immediately if you think you may have the infection.

Symptoms

• Incubation period: usually 3-8 weeks

Initial stage

• Headaches
• Fever
• Exhaustion
• Bite/scratch
  • Itching
  • Pain
  • Sensory disturbances

Phase of cerebral inflammation

• Restlessness, confusion, panic attacks
• Irritability, temper tantrums
• Swallowing problems (pharyngeal spasms)
  • Limited food intake
  • Typical fear of water
  • Frothing at the mouth
• Increase in salivation
• Breathing and muscle spasms

Stage of paralysis

• Patient goes quiet
• Growing paralysis
• Loss of consciousness
• Respiratory paralysis
• Death (practically always)

Causes and treatment

Causes

• Pathogen: rabies virus
• Contagion
  • Being bitten or scratched by a rabid animal
  • Saliva contains the virus
  • Risk depends on the location and severity of the injury
• Carriers
  • Dogs (in 99% of cases affecting humans)
  • Foxes, monkeys, bats, etc.
• Found in
  • Africa, South and East Asia, South America
  • Eradicated in Central and Western Europe

Further treatment by your doctor / in hospital

Possible tests

• Identification of pathogen
  • Saliva
  • Cornea of the eye
  • Cerebrospinal fluid (lumbar puncture)
  • Skin biopsy at the neck

Possible therapies

• Crucial: quick, correct wound treatment
  • Wound cleaning
  • Disinfection
  • Cutting away of wound edges
• Fast active and possibly passive immunisation (vaccination)

What can I do myself?

• Reaction to injury (bite, scratch) by an animal
  • Immediately and thoroughly wash the wound with a soap solution (several minutes)
  • Immediately disinfect the wound
  • Go to the doctor immediately
• Wash skin thoroughly after contact with animal saliva
• Avoid contact with wild animals, don’t touch or threaten them
  • Be careful if animals are unnaturally tame or aggressive
  • Be careful of stray dogs
• Medical advice for travellers (before travelling to the tropics/developing countries)
• Vaccination
  • Professional risk: forestry workers, hunters, veterinarians and veterinary nurses, laboratory staff
  • Travelling and staying in risk countries (depending on the style and duration of travel)
  • Pets should be vaccinated (vaccination certificate)

When to see a doctor?

• Immediately when injured by a possibly infected animal
  • Wild animal or pet (in particular dogs)
  • Especially if the animal was unnaturally tame or aggressive
  • Especially if the animal salivated noticeably

Further information

Federal Office of Public Health, FOPH (Bundesamt für Gesundheit, BAG)
www.bag.admin.ch

Federal Food Safety and Veterinary Office, FSVO (Bundesamt für Lebensmittelsicherheit und Veterinärwesen, BLV)
www.blv.admin.ch

Synonyms

rabies, hydrophobia, lyssa, canine madness