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Rabies

Alternative names: hydrophobia

Type of infection: viral

Incubation period: between 2 and 12 weeks (though both longer and shorter periods have been reported)

Mortality rate: 100% fatal if not treated

Vector:  various mammals

History

Rabies has been known to man for thousands of years. Ancient Mesopotamian writings describe these symptoms in dogs along with warnings about their bites. During the Middle Ages, it was quite a problem due to the half-feral dogs that often roamed through villages. It was believed then that the disease was easily transmitted, and people were often killed just on the suspicion that they had contact with a rabid animal.

Louis Pasteur developed the first vaccine treatment for rabies in 1885.

Catching Rabies

Though we tend to associate rabies with dogs, there are many other mammals that can carry it. In fact, in North America, the more common source of rabies are infected bats. Alternatively, it can be carried and spread by raccoons, foxes, skunks, coyotes, and even cats. Rodents and rabbits can not carry rabies. The animals don't necessarily need to look or act ill to be carriers, so don't use that as your only gauge of potential risk.

Rabies is spread via saliva, so bites are the most dangerous source of infection, though a good scratch can be enough. Technically, a human with advanced rabies could also transmit the disease if they happen to bite someone though is a pretty rare occurrence.

Signs and Symptoms

There are several stages of rabies, and the symptoms are fairly unique once they begin to develop. At first, it will seem like the flu, with fever, lethargy and headache. This can last a few days. It's during this phase that you need to seek treatment, even though you may not even recognize that you have rabies. Being very aware of animal bites or scratches is the key.

After that, there will be neurological symptoms, such as confusion, irrational anxiety, insomnia, anger and paranoia. Once these symptoms begin, rabies is almost certainly fatal. You can also expect delirium and hallucinations at this stage.

Towards the end of its run, rabies can cause another set of symptoms called "hydrophobia" (seen in about 80% of people who get the disease). There is a severe fear of water and drinking, and painful throat spasms when swallowing. In the other 20%, the disease presents with paralysis and muscle weakness instead.

In can also be very important to recognize the symptoms of rabies in afflicted animals, so that you can make extra effort to avoid them or to help you make a diagnosis if you are bitten/scratched. At first an animal will simply have a fever and loss of appetite. This is not likely to be very visible to you in a wild animal, but it is something you might notice with your own pet dog. After that, the more traditional symptoms will start to appear.

Animals will start to be extremely violent and will attack without provocation. There can by seizures, paralysis, disorientation and the stereotypical foaming at the mouth.

Treatment

If treated immediately, rabies is seldom fatal anymore. But it is not something that can adequately be treated at home with standard medications. So you would have to have access to proper medical care once you are bitten by a rabid animal. Unfortunately, this may not always be available.

The first immediate step is to wash out the wound and rinse with iodine or alcohol to stop the infection from taking hold in the first place.

After that comes the post-exposure vaccine. Even though you take it after being bitten, it is still considered a vaccine because its purpose is to prevent the disease not treat it. More specifically, the treatment is one shot of human rabies immune globulin (HRIG) and 4 doses of the usual vaccine. You get the HRIG and 1 shot of vaccine ASAP after the bite, then the rest of the shots at 3, 7 and 14 days afterward.

Prevention

There is a vaccine that can be administered before you are exposed to rabies, but it is not commonly available unless you work with wildlife. If you live in an area where rabies may be a problem, you can ask your doctor about getting vaccinated.

If you are unable to acquire the proper vaccination, you will need to protect yourself from animal bites and scratches.

Risk Assessment

In a post-disaster scenario, animal pests can be a bigger problem than currently, especially once dogs begin to run wild and could further spread the disease from other mammals. And considering it is one of the few diseases with a 100% fatality rate (when untreated), it should not be taken lightly. Thankfully, it is not contagious between people and is unlikely to spread in a typical pandemic fashion.




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