Wild animals are the natural reservoir of rabies and responsible for the spread of the disease. Any mammal can get rabies. The most common wild reservoirs of rabies are raccoons, skunks, bats, and foxes. Domestic mammals can also get rabies such cats, cattle, and dogs.
Feral, semi-restricted and restricted dogs are responsible for more than 99% of all human rabies cases in India; 17.4 million people were bitten by animals in 2002 and every 20 seconds a person undergoes post-exposure treatment. Elimination of rabies in humans requires control of rabies in dogs. Dogs can be infectious to others for as much as two weeks before symptoms appear. Estimates suggest that by preventing rabies in a single dog, 211,000 additional infections can be avoided. Elimination of rabies in humans requires control of rabies in dogs.
People usually get rabies from the bite of a rabid animal. Rabies is a disease of young people, mostly affecting the 5-15 age class, as dog bites to the face, head, neck and upper extremities carry the greatest risk of infection. Although very rare, it is also possible to face non-bite exposure, if eyes, nose, mouth, open wounds, scratches, abrasions or mucous membranes come into contact with contaminated saliva or other potentially infectious materials (such as brain tissue).
Inhalation of aerosolized rabies virus is also a potential non-bite route of exposure, but other than laboratory workers, most people are unlikely to encounter an aerosol of rabies virus. Contact such as petting a rabid animal does not constitute an exposure.
The only documented cases of rabies caused by human-to-human transmission occurred among 8 recipients of transplanted corneas, and among three recipients of solid organs. Casual contact, such as touching a person with rabies or contact with non-infectious fluid or tissue (urine, blood, and faeces) does not constitute an exposure and does not require treatment.
Medical assistance should be obtained as soon as possible after an exposure. One of the most effective methods to decrease the chances for infection involves thorough washing of the wound with soap and water.
For post-exposure treatment, a regimen of one dose of immune globulin and five doses of rabies vaccine over a 28-day period is required. Rabies immune globulin and the first dose of rabies vaccine should be administered as soon as possible after exposure. Additional doses or rabies vaccine should be given on days 3, 7, 14, and 28 after the first vaccination. It is important that the proscribed schedule of shots is accurately followed. Current modern vaccines are relatively painless and are given in your arm, like a flu or tetanus vaccine.
A pre-exposure vaccination does not eliminate the need for additional therapy after a rabies exposure. It simplifies therapy by eliminating the need for human rabies immune globulin (HRIG) and decreasing the number of doses needed. A pre-exposure vaccination is important for people at high risk of being exposed to rabies in areas where immunizing products may not be readily available resulting in delayed treatment.
Further information:
Centers for Disease Control & Prevention (CDC) rabies vaccine publication:
