Rabies or rabies is a fatal disease transmitted by infected animals such as dogs, cats, bats or foxes. Human-to-human contamination does not actually occur. People who go abroad or are bitten or scratched by a wild animal in their own country are at greatest risk of infection. Sometimes your own pet is infected. Rabies is not always immediately recognizable. The well-known foaming at the mouth is a symptom that only occurs towards the end of the disease course. It is then too late for treatment.
What is rabies?
We also know rabies as rabies or lyssa. This disease mainly occurs in dogs but can also be transmitted to humans. It is a serious viral disease that is fatal. The first symptoms do not occur immediately after infection, so it often appears that a person is not infected with the virus. It can sometimes take up to a year before the patient becomes ill and ultimately dies.
Humans can become infected with rabies through a dog, cat, fox, bat or deer. These animals are most often infected with rabies, but other mammals can also be infected. In Europe it is mainly wild animals that are infected, outside Europe it is mainly dogs that are infected. Infection is rare in the Netherlands and Belgium; the few cases involve contamination via imported animals or infection contracted abroad. Infection occurs through biting or scratching, but the virus is also transmitted through licking where infected saliva comes into contact with a wound. Human-to-human transmission is rare.
Someone infected by an animal with rabies does not immediately show symptoms. The incubation period is 14 days to more than 1 year. This partly depends on the place where the person was bitten or scratched and the amount of virus. The virus moves from the infection wound to the brain. The further away the infection is from the brain, the longer the incubation period. An infected animal cannot always be recognized because it may only develop the first symptoms later. Infected animals are sometimes very restless or even aggressive, while previously they were not. Infected wild animals can appear very tame. When approached, the wild animal may suddenly bite or scratch.
The first symptom is often a cold feeling on the wound where you have been bitten or scratched. Tingling also occurs. It is also referred to as itching, but itching also occurs during wound healing. It is therefore often difficult to find out where the itching comes from. The real symptoms occur when the virus has reached the central nervous system. Insomnia, muscle cramps and anxious feelings or visions occur. Behavioral changes manifest themselves in hyperactivity or in a state of paralysis. This is also often seen in animals. Hyperactivity is most common.
It is remarkable that swallowing becomes painful. Swallowing saliva hurts and is therefore no longer swallowed. The saliva appears as foam at the mouth. This is the point at which rabies is clearly recognizable in the animal. People have often visited the doctor before because of other complaints. Seeing water can be frightening. Drinking water can cramp the muscles in the esophagus and make breathing difficult. Eventually the patient will no longer want to drink at all.
After this, paralysis occurs that starts in the legs and creeps up through the legs. The paralysis ends at the head. The patient becomes delirious and has visions. After the first symptoms appear, it takes eight days for the patient to die. In animals this takes about ten days.
Only a few people worldwide have survived an infection with rabies. This was probably an infection with a weakened virus. In all other cases, treatment is not possible: the patient will certainly die. The same applies to animals: they will also certainly die. As a precaution, animals are immediately killed if infected, to prevent them from infecting other animals or people.
It is best to treat before the virus has a chance to reach the central nervous system. If you are bitten or scratched abroad, especially in subtropical countries, there is a risk of rabies. This risk also exists in the Netherlands and Belgium when one is attacked by a bat or a fox. Imported animals such as dogs and cats also pose a risk. It is best to vaccinate immediately after a bite or scratch. Immediately after an animal bite, an antiserum is administered around the wound. Subsequently, 5 more vaccines are administered, all within one month after the bite. It is not possible to test for rabies after a bite. Antibodies are only found in the blood when the virus has reached the central nervous system. It is then too late for treatment.
Dogs are not routinely vaccinated against rabies. When they go abroad, vaccination is recommended. Dogs that go to an animal boarding facility must also be vaccinated. People do not need to be vaccinated against rabies. This changes when one comes into professional contact with (wild) animals. People who go on holiday to certain countries and mainly go on cycling/or walking trips are also at increased risk. Vaccination is then recommended. A vaccination lasts an average of 1 year. A vaccination lasts 1 to 2 years. If a booster vaccination is administered within 1 year after vaccination, the basic vaccination provides protection for up to 5 years. A good vaccination consists of three doses of vaccine, only then is the person 100 percent protected against rabies.
- Delirium or febrile delirium