Rabies is a deadly but vaccine-preventable viral disease, usually transmitted through the bite of a rabid animal. Dogs are the main source, contributing up to 99% of all rabies transmissions to humans.
The virus usually attacks the brain, causing several symptoms such as confusion, agitation, paralysis, and coma. Once symptoms begin, rabies is almost always fatal without urgent medical treatment.
However, timely intervention can prevent disease progression. Immediate washing of the wound with soap and water, followed by rabies immunoglobulin and a full rabies vaccine course, is critical.
Rabies prevention focuses on vaccinating dogs, avoiding bites, and educating communities, especially children, on safe behavior around animals. Pre-exposure rabies vaccination is recommended for high-risk individuals such as veterinarians, wildlife workers, and laboratory scientists.
Public awareness, responsible pet ownership, and accessible healthcare are key to reducing rabies cases and saving lives.
Overview
Key Facts
Causes
Symptoms
Risk factors
Diagnosis
Specialist to visit
Prevention
Treatment
Complications
FAQs
References
Frequently Asked Questions
The wound should be thoroughly washed with soap and running water as soon as possible. After that, the information about the type of animal, its vaccination status, and its overall health should be collected. Seek immediate medical attention for vaccination.
The rabies virus is a very fragile virus. As soon as the saliva dries, the virus is no longer infectious. The virus is easily killed by soaps, detergents, bleach, alcohol and ultraviolet light.
The rabid animal shows a change in personality or behavior. Pet animals may become aggressive. Often, the animals do not eat and can have fear of water. In later stages, paralysis may also occur.
Avoid applying irritants to the wound such as chili powder, plant juices, acids or alkalis. Wounds should not be covered with any dressings or bandages.
Yes, all currently available rabies vaccines and immunoglobulin are considered safe and effective for pregnant and lactating women. They do not affect fetal development or the health of the breastfeeding infant. However, as with any medical treatment, it is important to consult a healthcare provider to ensure the appropriate course of action based on individual circumstances.
In our relentless endeavour to keep improving our services, you are our eyes. Kindly take out sometime to guide us on how to serve your better.
Subscribe to stay informed
Subscribe to our carefully crafted informative emailers by Medical Experts and be the first to get the latest health news, tips and important updates.
Want to know more?We provide you with authentic, trustworthy and relevant information
Have issues with the content?
Disclaimer
Tata 1mg's sole intention is to ensure that its consumers get information that is expert-reviewed, accurate and trustworthy. However, the information contained herein should NOT be used as a substitute for the advice of a qualified physician. The information provided here is for informational purposes only. This may not cover all possible side effects, drug interactions or warnings or alerts. Please consult your doctor and discuss all your queries related to any disease or medicine. We intend to support, not replace, the doctor-patient relationship.
Rabies is caused by the rabies virus, which primarily spreads from infected animals to humans. The virus is present in the saliva, brain, and spinal cord of infected animals, making them the main source of transmission.
Rabies can affect various mammals, including dogs, cats, bats, monkeys, foxes, raccoons, skunks, jackals, and mongooses.
However, dogs are the most common source of rabies transmission to humans.
Transmission
When an infected animal bites, the rabies virus is transmitted through its saliva into the person’s body. Rabies can also spread through the following:
Bites from an infected animal
Scratches from the claws of an infected animal
Exposure to infected saliva through the nose, eyes, mouth, or broken skin
The rabies virus can also be transmitted from human to human through the transplantation of organs, such as the cornea. While this type of transmission is rare, it is possible. As a result, the corneas and other organs from a person who has died from rabies should not be used for transplantation.
Note: Rabies is not spread by petting or touching dried saliva, blood, urine, or feces of a rabid animal.
Symptoms Of Rabies
Symptoms of rabies can be divided into the following stages:
Stage 1 (Incubation): It is the period from exposure to the virus to the onset of symptoms and differs from person to person. This time is generally 2 to 3 months, but may range from 1 week to 1 year. It is dependent on factors such as the site of entry of the virus and the viral load
Stage 2 (Prodrome): This stage consists of nonspecific symptoms that mostly resemble the flu, with several gastrointestinal symptoms:
Pain, numbness, tingling, and itching at the wound site
Stage 3 (Neurological): In this stage, the virus reaches the central nervous system. It causes fatal inflammation of the brain and spinal cord, which can be experienced as the following symptoms:
Stage 4 (Coma): This stage usually develops within ten days of stage 3. Patients may have consistent hydrophobia and can develop paralysis.
Stage 5 (Death): Stage 4 can lead to death within 2 to 3 days without supportive care.
Risk Factors For Rabies
Low knowledge levels regarding rabies
Rabies is highly prevalent in areas where people have low knowledge regarding rabies and dog bites. The cases are especially seen in rural areas where people are unaware of the measures taken to prevent and manage rabies.
Exposure to unvaccinated dogs
Dogs are the main source of spreading rabies. Exposure to stray dogs or unvaccinated dogs can be a source of infection.
Living in rabies-endemic countries
People living in rabies-endemic countries with poor control of dogs and wildlife are more prone to rabies infection.
Age
Children are at high risk of catching the virus as they are more prone to being attacked by animals. Most cases of rabies are seen in children bitten by dogs, especially on their arms and faces.
Occupation or activities
Veterinarians, animal handlers, lab workers, and outdoor adventurers like campers or spelunkers are at higher risk of rabies due to close contact with potentially infected animals.
Delayed or inadequate post-exposure treatment
Not washing the wound immediately and not receiving timely and appropriate post-exposure prophylaxis (PEP) pose a high risk for rabies.
Protect Against Rabies—Explore 1mg for Vaccines and other healthcare needs
Diagnosis Of Rabies
Immediate medical attention
Immediate medical attention is crucial if a person is suspected of being bitten or scratched by an animal, as there is no definitive way to identify a rabid animal just by appearance.
Limitations of diagnostic testing
Although diagnostic tests can confirm rabies infection, they often take time. Relying solely on test results can delay treatment, which is dangerous since rabies is almost always fatal once symptoms appear.
Testing the animal
If the biting or scratching animal is available, it is typically tested for rabies. This can prevent unnecessary physical, emotional, and financial stress for the exposed individual if the animal is not found to be rabid.
Direct Fluorescent Antibody (DFA) Test: The DFA test is the gold standard for diagnosing rabies in animals. It detects rabies virus antigens in the brain tissue of an animal that has been humanely euthanized.
Observation period: If the animal (especially a dog or cat) is healthy and vaccinated, it is usually observed for 10 days. If the animal remains healthy during this time, no treatment may be necessary. Final decisions are typically made in consultation with the local health department.
Testing in humans
Rabies in humans is confirmed using various tests that detect the virus, its antigens, or genetic material in body tissues. Common diagnostic methods include:
Lumbar puncture: A sample of cerebrospinal fluid (CSF) is collected from the lower spine using a thin needle. This fluid is tested for the presence of the rabies virus.
Nuchal skin biopsy: This is the most reliable method during the first week of infection. A skin sample from the back of the neck is examined using immunofluorescent staining to detect rabies virus antigens in nerve fibers.
Real-time polymerase chain reaction (RT-PCR): Saliva samples are tested using RT-PCR to detect rabies RNA. This test amplifies the virus’s genetic material and is considered highly sensitive and confirmatory.
Blood tests
Blood tests are not typically used to detect active rabies infection, as virus-specific antibodies take time to appear. Instead, they are mainly used to:
Assess the body’s immune response to rabies vaccination.
Common antibody tests include:
Fluorescent Antibody Virus Neutralization (FAVN) Test
Rapid Fluorescent Focus Inhibition Test (RFFIT)
Imaging tests
Imaging is not used to confirm rabies but may help identify rabies-related encephalitis:
Computed tomography (CT) scan: Uses X-rays to create detailed images of the brain to detect inflammation or other abnormalities.
Need a Lab Test? Trusted Lab Testing Now Just a Click Away.
Specialist To Visit
Rabies is a medical emergency and can lead to fatal consequences if not treated promptly. Any bite or scratch from an unfamiliar or wild animal should never be ignored. Immediate action is crucial.
Doctors typically evaluate the wound and decide the course of treatment based on the severity of the animal attack. The following specialists are involved in the diagnosis and treatment of rabies:
General Physician
Infectious disease specialist
Neurologist
A general physician is typically the first point of contact for rabies exposure. They will assess the wound and determine the need for post-exposure prophylaxis (PEP).
If rabies exposure is suspected, an infectious disease specialist can provide more detailed guidance on the virus, including preventive treatment and further diagnostic tests.
If the disease progresses to neurological symptoms, a neurologist may be consulted for the management of complications affecting the brain and nervous system.
Seek advice from our world-class medical professionals.
Prevention Of Rabies
Eliminating rabies in animals
Rabies is a preventable disease through vaccination. It's crucial to keep your dogs, cats, ferrets, and certain livestock up to date with their rabies vaccinations. If your dog or cat is bitten or attacked by a wild animal, a booster shot is also recommended.
Pre-exposure rabies vaccination is given to individuals who are at high risk of being exposed to the rabies virus. These include:
Veterinarians and animal handlers
Veterinary students
Laboratory workers dealing with rabies or related viruses
Wildlife researchers or explorers
People traveling to rabies-endemic regions
Children in rabies-endemic areas
Vaccination schedule for pre-exposure:
Intramuscular (IM): Three doses on days 0, 7, and 21 or 28.
Intradermal (ID): Three doses on days 0, 7, and 21 or 28. (Note: The intradermal route is more common in India because it uses a lower vaccine volume and is cost-effective.)
Post-exposure rabies vaccination is a critical step for individuals who have been bitten, scratched, or otherwise exposed to the saliva of an animal suspected of having rabies. Immediate treatment after exposure can prevent the disease from progressing.
Vaccination schedule for post-exposure:
For individuals who have never been vaccinated:
Day 0: First dose (immediately after exposure)
Day 3: Second dose
Day 7: Third dose
Day 14: Fourth dose
Day 28: Fifth dose (optional, depending on the type of exposure)
For individuals previously vaccinated (pre-exposure):
Day 0: First dose
Day 3: Second dose
Rabies Immunoglobulin (RIG) may be administered alongside the vaccine if the individual has never been vaccinated previously. This provides immediate passive immunity and must be given as soon as possible after exposure, ideally within 24 hours.
Rabies Has No Cure. Prevention Starts with Vaccination.
Avoiding animal exposure
The best way to prevent rabies is to avoid contact with potentially infected animals. Follow these precautions:
Don’t touch injured or stray animals—report them to local authorities.
Avoid feeding, petting, or playing with unfamiliar animals, especially in high-risk areas.
Don’t allow your pets to roam freely.
Store garbage and pet food securely to avoid attracting wild or stray animals.
Don’t keep wild animals as pets.
Report any unusual behavior in your pets to a veterinarian immediately.
Teach children not to touch or feed stray animals and to report any bites or scratches.
Rabies awareness
Understanding the risk and severity of rabies is essential. Rabies is almost always fatal once symptoms appear, but it is completely preventable with timely medical care and vaccination.
Education plays a vital role in reducing rabies risk. Raising awareness in communities should include:
The importance of responsible pet ownership
How to prevent dog bites
First aid measures after a bite or scratch
The need for prompt medical care after exposure.
Teaching both adults and children about rabies prevention helps reduce exposure and saves lives.
If you have any questions about rabies and its vaccine, contact our expert team of doctors.
Treatment Of Rabies
Rabies is almost always fatal once clinical symptoms appear. However, immediate and appropriate medical treatment after exposure can effectively prevent the disease from progressing.
Immediate first aid: The first line of defense
If bitten or scratched by an animal suspected to be rabid:
Wash the wound immediately and thoroughly with soap and running water for at least 15 minutes. This helps reduce the viral load at the site.
Apply antiseptic (e.g., povidone-iodine, iodine solution, or alcohol) after washing.
Seek medical attention immediately.
Do not delay. Even minor scratches or licks on broken skin can transmit the rabies virus.
Post-exposure prophylaxis (PEP)
PEP is essential for preventing rabies after potential exposure. It consists of:
1. Rabies vaccine
Unvaccinated individuals:
5-dose schedule on days 0, 3, 7, 14, and 28
Previously vaccinated individuals:
Only 2 doses on days 0 and 3
No need for Rabies Immunoglobulin (RIG)
2. Rabies immunoglobulin (RIG)
Given only to unvaccinated individuals
Should be administered as soon as possible after exposure
Infiltrated into and around the wound site
No effective treatment after the onset of symptoms
Once symptoms (such as fever, anxiety, difficulty swallowing, hydrophobia, or confusion) appear, rabies is almost always fatal. At this stage:
Treatment becomes supportive only (palliative care)
Patients may receive sedation, ventilation, and comfort care
No antiviral drug or therapy has been proven effective
Prevention is the best treatment
Since there is no cure once symptoms begin, prevention through vaccination (pre- and post-exposure) and public awareness is crucial.
Complications Of Rabies
Once the rabies virus enters the body, it travels through the peripheral nervous system (PNS) toward the central nervous system (CNS), particularly the brain, where it causes severe and often irreversible neurological complications such as encephalomyelitis (inflammation of the brain and spinal cord).
As the virus spreads, it can lead to psychiatric and neurological symptoms, including:
Anxiety
Agitation
Delirium
After affecting the CNS, the virus can travel back to the peripheral nervous system, targeting peripheral organs, most notably the salivary glands, which facilitates the virus's transmission through saliva.
If not treated promptly, rabies can result in complete nervous system failure, often leading to death. The following complications may develop in infected individuals:
Seizures
Fasciculations (muscle twitching)
Psychosis
Aphasia (loss of ability to speak or understand language)
Autonomic instability (irregular heartbeat, temperature, and blood pressure regulation)
Paralysis, including paralysis of the lower limbs
Coma
Confusion
Difficulty swallowing (due to painful throat and laryngeal spasms)
Insomnia
Apnea (temporary cessation of breathing)
Cardiopulmonary complications, such as low blood pressure) and cardiac arrest
Multiple organ failure
Death.
Did you know?
Monkeys can also spread rabies, although they are not primary reservoirs of the virus like dogs or some other wild animals. Monkeys can become infected with rabies if they are bitten by a rabid animal. Once infected, they can transmit rabies to humans through bites, scratches, and saliva contact with broken skin or mucous membranes.
Did you know?
In rabies, the 'frothing' often portrayed in movies like Cujo and Old Yeller is caused by hypersalivation. This is due to painful throat spasms triggered by the sight, sound, or thought of water—a symptom known as hydrophobia.
Did You Know?
28th September is established as World Rabies Day by the Global Alliance for Rabies Control (GARC) and recognized by the World Health Organization (WHO). This date is chosen as on this date, back in 1895, the inventor of the rabies vaccine, Louis Pasteur, passed away. His discoveries are still saving countless lives.
