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Rabies--what you need to know

Posted by Dr. Claire McCarthy  July 23, 2012 04:42 PM

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When I read about a Spencer child being bitten by a rabid bat that someone picked up out of the water and showed some children, I thought: why would anyone pick up a bat and show it to a kid? Didn't he know that bats and raccoons are the animals most likely to have rabies? 

And then I thought: I bet he didn't. And I bet he's not the only one who doesn't know this and other important facts about this deadly disease. So--here's what you need to know about rabies.

Rabies is caused by a virus that infects the brain. The virus can be found in the saliva of infected animals. Bites are the most common way it's transmitted, but someone could theoretically get it if the saliva got into their mouths, eyes, lungs, or into a scratch.

It's essentially always fatal once the symptoms start. So you need to take it really seriously. The good news is that if treatment (called post-exposure prophylaxis) is given early enough, rabies can be prevented. Because of this, human cases of rabies are very rare.

The most common infected animals are raccoons, skunks, bats, foxes, and coyotes. Cats, dogs, and cattle are the most common domesticated animals to get rabies. It's not very common in squirrels, rats, mice, hamsters and other small rodents.

Bat-proofing your house is a good idea to lower your family's risk. Because the teeth of a bat are small, it's possible that a person could be bit and not realize it. The Massachusetts Department of Public Health has information not only on how to do this, but on how to know if there are bats in your house, how to get them out, and how to capture a bat safely if you find one in your home.

If someone is bit by an animal that might be rabid, the first thing to do is to wash the wound out really well with lots of water and soap. Then call your doctor for advice. 

If the animal that bit can be caught, treatment may not be necessary. Treatment (more on that below) is a bunch of shots. Before starting them, it's nice to be sure they are necessary--either by testing the animal for rabies (which is done on brain tissue after the animal is dead) or quarantining it for 10 days to watch for any signs of rabies. If the testing is negative or the animal is fine after 10 days, no shots are needed! It's okay to wait the 10 days.
  • If your child is bitten by a dog (or other pet) you don't know, talk to the animal's owner (if possible). Find out if the pet has been vaccinated, and get the owner's name and number. I can't tell you how many times I've had to give rabies shots to a patient because we couldn't track down the animal or its owner.
  • Provoked bites--ones that happen because someone was trying to pet or otherwise touch an animal--worry us less than unprovoked ones (attacking for no reason is a sign of rabies)
Treatment is a series of shots. Human Rabies Immune Globulin (HRIG) is given along with the rabies vaccine on the first day of treatment (not necessarily the day of the bite), then the vaccine is given on days 3, 7, and 14. The shots are given in a muscle, usually the arm. They are 100 percent effective if given as recommended.

Don't touch animals, wild or otherwise, that you don't know. It's safer for all sorts of reasons. Teach children that too.

Pet owners can make a big difference in preventing rabies by:
  • Vaccinating their pets against rabies
  • Keeping their pets away from wildlife (as much as possible)
  • Spaying/neutering their pets, so there are fewer stray animals around 
You should always call your local Animal Control if you see any stray pets or animals that are acting strangely or seem sick. Better safe than sorry. And don't try to help the animals yourself.

For more information on rabies, visit the Centers for Disease Control's Rabies site, or the Rabies page on the Massachusetts Department of Public Health website.

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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