Rabies is a virus that is most commonly spread to humans via the bite of an infected animal. The animals most often afflicted with rabies in the United States are bats, skunks, coyotes and raccoons. In developing and Third World countries, a rabies-infected bite is most likely to come from stray dogs. The virus itself causes acute encephalitis in all mammals and, barring treatment, is almost always fatal.
Pre-Exposure Rabies Vaccination
First, it is important to note that the rabies vaccination is defined as a pre-exposure treatment. There are two types of vaccines available in the United States, and both are developed by using the inactive, or killed, form of the virus. Both types are considered equally safe and effective. The vaccine is most commonly given to those who are considered to be at higher risk for contracting the virus, such as veterinarians, international travelers, animal handlers and others whose activities frequently bring them into contact with potentially rabid animals. The pre-exposure vaccination consists of a series of three to five shots in the deltoid muscle of the arm. Even if you have been vaccinated, if you suspect you have been exposed to rabies you must seek immediate medical attention.
Post-Exposure Rabies Treatment
People who have received rabies vaccinations are not immune to the virus. They are still required to receive two additional doses of vaccine, one immediately after exposure to the virus and the second three days later. Those who have not been vaccinated prior to exposure are required to receive a dose of immune globulin and a dose of the vaccination as soon as possible after the suspected infection. Subsequent doses of the vaccination are then given on days three, seven, 14 and 28. Also, an important component of immediate post-exposure rabies treatment consists of the thorough cleansing of the wound with soap and water or, if available, a virucidal agent such as a solution of providine-iodine.
The Bottom Line
Do not hesitate to seek treatment if you suspect you have been infected with rabies. Although post-exposure treatment is considered a medical urgency, as opposed to a medical emergency, you should not delay the decision to seek out medical attention. Although the rabies virus can have a variable incubation period, anywhere from a few days to greater than a year, it is imperative to receive treatment prior to the development of symptoms, i.e., fever, headache, confusion, anxiety, difficulty swallowing, partial paralysis, insomnia and excessive salivation. Once symptoms have begun to develop, the prognosis for surviving rabies is very slim.
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