Rabies Symptoms and Prevention: What You Need to Know
Introduction
Rabies is a neurotropic viral infection that primarily affects the central nervous system of mammals, including humans, resulting in encephalitis and, if left untreated, is invariably fatal. Despite being entirely preventable, rabies continues to cause thousands of deaths each year, particularly in parts of Asia and Africa. Understanding how the disease spreads, recognizing its symptoms, and knowing how to prevent infection are essential steps in controlling and eventually eliminating this global health threat.
What Is Rabies?
Rabies is a transmissible viral illness triggered by a neurotropic virus classified under the genus Lyssavirus, which primarily targets the nervous system. The virus typically spreads when the saliva of an infected animal enters the body through skin breaches, most commonly as a result of bites or, in some cases, scratches. Human infection typically occurs through a bite or scratch from an animal carrying the virus. Once the virus enters the body, it travels through the nervous system to the brain.
How Is Rabies Transmitted?
The most common way rabies spreads to humans is through bites from infected animals. In many countries, particularly in developing regions, domestic dogs are the main source of transmission. Rabies can also be transmitted by wild animals, with common carriers including:
- Bats
- Raccoons
- Skunks
- Foxes
Although rare, the virus can also be transmitted if infected saliva comes into contact with broken skin or mucous membranes, such as the eyes, nose, or mouth.
Symptoms of Rabies
Rabies has a variable incubation period, usually ranging from one to three months, though it can be shorter or longer depending on the location of the bite and the amount of virus introduced.
Early symptoms may include:
- Fever
- Headache
- Fatigue
- Muscle pain
- Pain, or prickling sensation at the site of the bite wound
Advanced Neurological Symptoms
As the disease progresses, symptoms become more severe in nature.
- Confusion and agitation
- Muscle spasms
- Hypersalivation
- Difficulty swallowing
- Fear of water (hydrophobia)
- Delirium
- Seizures
- Hallucinations
- Paralysis
- Coma and eventual death
Diagnosis and Treatment
Rabies diagnosis in humans, especially before death (antemortem), is complex and requires multiple tests, as no single test is sufficient. The following samples are typically tested:
- Saliva: RT-PCR is used to detect rabies virus RNA.
- Serum: Serum from patient is used to detect rabies-specific antibodies (IgM and IgG).
- Cerebrospinal Fluid (CSF): CSF is tested for the presence of rabies antibodies.
- Nuchal Skin Biopsy: Nuchal skin biopsy is extracted from the back of the neck to detect rabies virus antigen in nerve endings using immunofluorescence or PCR.
A combination of these tests increases the accuracy of diagnosis in suspected human cases.
Post-Exposure Prophylaxis (PEP) involves:
- Cleaning the wound immediately with soap and water is recommended.
- Administration of rabies immunoglobulin (if recommended)
- A multi-dose rabies vaccination regimen administered over a period of few weeks
If given before symptoms begin, PEP is almost 100% effective in preventing rabies
Preventing Rabies
For individuals:
- Vaccinate pets, especially dogs and cats
- Avoid approaching wild or unfamiliar animals
- Teach children to report animal bites immediately
For communities and governments:
- Organize mass dog vaccination campaigns
- Control stray animal populations
- Raise public awareness through education programs
For travelers:
People visiting high-risk areas, especially those who may work with animals or stay in rural regions, should consider pre-exposure vaccination.
Rabies in India: Current Situation and Public Health Challenges
Rabies remains a major public health concern in India, which accounts for approximately 36% of the world’s rabies deaths, according to the World Health Organization (WHO). Despite being a 100% vaccine-preventable disease, rabies continues to claim thousands of lives annually in the country, with the majority of cases resulting from bites by infected dogs, particularly stray or unvaccinated animals.
Epidemiological Overview
- Estimated deaths: Annually, rabies leads to over 20,000 fatalities in India.
- High-risk population: Children under 15 years of age are disproportionately affected, representing nearly 40% of all reported cases.
- Transmission: Over 90–95% of human rabies cases in India are caused by dog bites, often from free-roaming or stray animals in urban and rural areas.
Key Challenges
- High population of stray dogs: India has an estimated 30–35 million stray dogs, many of which are not vaccinated, increasing the risk of transmission.
- Limited access to Post-Exposure Prophylaxis (PEP): In many rural and underserved areas, access to timely and complete PEP, including vaccines and rabies immunoglobulin, is inadequate.
- Lack of awareness: There is insufficient public knowledge about the urgency of rabies prevention and treatment following animal bites.
- Underreporting: Rabies cases, particularly in rural areas, are often misdiagnosed or go unreported due to a lack of surveillance infrastructure.
Government and Public Health Initiatives
- National Rabies Control Programme (NRCP): Implemented by the Ministry of Health and Family Welfare, this program focuses on animal bite management, rabies surveillance, and public education.
- Animal Birth Control (ABC) and vaccination programs: These are being carried out in various urban centers to reduce the stray dog population and improve vaccination coverage.
- One Health approach: India is increasingly adopting the One Health framework, promoting coordination between human, animal, and environmental health sectors to address rabies comprehensively.
Government and Public Health Initiatives
India has committed to the global goal of zero human deaths from dog-mediated rabies by 2030, in alignment with WHO, OIE, FAO, and GARC initiatives. Achieving this goal will require:
- Strengthened intersectoral collaboration
- Expanded vaccine and immunoglobulin availability
- Increased public awareness campaigns
- Enhanced surveillance and reporting systems
Conclusion
Rabies is one of the deadliest diseases known to medicine, but also one of the most preventable. With immediate and proper treatment after exposure, lives can be saved. Public awareness, responsible pet ownership, timely access to vaccines, and global cooperation are key to ending the tragedy of rabies. Through informed action, we can move toward a world free from this fatal but preventable disease.
- Medicine and Diseases
- 28 August 2025
- 11:00
Reviewed by Dr Aarti Nehra (MBBS, MMST)
