Rabies

Overview

Rabies is a viral infection that attacks the nervous system. Once symptoms develop, it is often fatal. But a rabies vaccine, or a series of vaccines, given soon after contact with an animal infected with rabies can prevent the illness.

Causes

The rabies virus enters the body through a cut, scratch, or bite, or through the mouth or eyes. It travels to the central nervous system. Once the virus reaches the brain, it travels into the nerves and grows in different organs.

The rabies virus is spread through an infected animal's saliva. It can pass between animals through biting. It can also pass through scratching, as many animals lick their claws.

A child may get rabies if he or she is bitten or scratched by an animal with rabies. The virus can also be spread if a child has scratches or sores that are licked by an infected animal. Rabies can also spread if a child touches his or her mouth or eyes with hands that have saliva of an infected animal.

Risk Factors

A child is more at risk for rabies if he or she lives in an area where rabies is known to be present.

In the U.S., rabies is mainly found in skunks, raccoons, foxes, coyotes, and bats. In some areas, these wild animals may infect pet cats, dogs, and livestock such as horses. In the U.S., cats are more likely than dogs to have rabies.

Each state keeps information about animals that may carry rabies. You can contact your state’s department of public health to learn more.

Symptoms

Symptoms can start 5 days to more than a year after contact with the rabies virus. The average time is about 2 months. These are the most common symptoms of rabies:

The symptoms of rabies can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

Diagnosis

An animal that has bitten or scratched your child can be tested for rabies. This test is called direct fluorescent antibody test (dFA). Test results are usually known within a few hours. If the animal does not have rabies, your child may not need rabies vaccine shots. 

No single test can show if a child has rabies. Your child may need several kinds of tests. Tests are done on samples of blood, saliva, spinal fluid, and skin biopsy taken from the nape of the neck.

Treatment

Vaccines that give immunity to rabies must be given soon after contact with the rabies virus. Once symptoms occur, there is no known treatment for rabies.

Treatment for suspected contact with rabies is done with one dose of immune globulin and a series of shots of rabies vaccine over a 2-week period.

A pre-exposure rabies vaccine may also be used to protect children at high risk for exposure. Talk with your child’s healthcare provider to learn more.

Complications

Once symptoms of rabies start, rabies most often leads to death.

Prevention

Being safe around animals, even pets, can help reduce the risk for animal bites. Some general guidelines for preventing animal bites and rabies include:

• Keep pets in a fenced yard or on a leash when out in public.
• Select family pets carefully.
• Never leave a young child alone with a pet.
• Have your pets vaccinated against rabies, and keep all shots current.
• Watch pets so they don’t come into contact with wild animals. Call your local animal control agency to remove any stray animals.

Teaching your child about animal safety can also help to prevent animal bites. This includes:

• Don’t try to separate fighting animals.
• Stay away from strange or sick animals.
• Leave animals alone when they are eating.
• Don’t approach or play with wild animals of any kind.

When to Call a Healthcare Provider

Call the healthcare provider if your child has:

• Been bitten or scratched by any animal
• Had contact with any animal that appears sick

Each state keeps information about animals that may carry rabies. You can contact your state’s department of public health to learn more.

Tell the healthcare provider:

• Where the bite or scratch happened, such as a back yard or forest
• Type of animal, such as pet or wild animal
• Type of exposure, such as cut, scratch, or licking of open wound
• Part of the body involved, such as hand, leg, or face
• Number of exposures to the animal
• If the animal has been vaccinated against rabies (if known) 
• If the animal seemed to be ill
• If the animal is available for testing or quarantine

Don't attempt to capture a wild or sick animal that has bitten your child. Tell animal control officers.

Key Points

• Rabies is a viral infection that attacks the nervous system.
• Once symptoms develop, it is often fatal. But a rabies vaccine given soon after contact can prevent the illness.
• A child may get rabies if he or she is bitten or scratched by an animal with rabies. The virus can also be spread if a child has scratches or sores that are licked by an infected animal. Rabies can also spread if a child touches his or her mouth or eyes with hands that have saliva of an infected animal.
• Symptoms can start 5 days to more than a year after contact with the rabies virus. The average time is about 2 months.
• Vaccines that give immunity to rabies must be given soon after contact with the rabies virus. Once symptoms occur, there is no known treatment for rabies.
• Being safe around animals, even pets, can help reduce the risk of animal bites.

Next Steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.