Table of ContentsView AllTable of ContentsWhen Is Rabies Fatal?Incubation PeriodProdromal PeriodAcute Neurologic PeriodWhen to See a ProviderDiagnosisNext in Rabies GuideHow Rabies Is Diagnosed
Table of ContentsView All
View All
Table of Contents
When Is Rabies Fatal?
Incubation Period
Prodromal Period
Acute Neurologic Period
When to See a Provider
Diagnosis
Next in Rabies Guide
Once the symptoms ofrabiesbegin to appear in a person who has been exposed to the virus, the infection is almost always fatal, with death occurring as few as four days later.
Rabies can be treated, but only if it is treated immediately after exposure. That is why it’s critical to seek treatment right away if you think you’ve been exposed to rabies.
This article explains what symptoms occur during each stage of infection with rabies, how it is diagnosed and treated, and when to see a healthcare provider.
The rabies virus, a member of theLyssavirusgenus,moves through the network of nerve cells, causing progressive symptoms as it gradually infiltrates the brain and central nervous system.
It’s rare for people in the United States to get rabies. Only one to three rabies cases are reported each year. In the decade from 2009 to 2018, the U.S. had 25 cases of human rabies, and seven of those infections were acquired outside of the U.S. and its territories.
Despite being rare in the U.S., rabies remains a frightening prospect: Once symptoms start to appear, death can occur within four to 20 days.
Early rabies symptoms may only include mild fever and headache. As it progresses, severe symptoms like confusion, excessive salivation, seizures, paralysis, delirium, and coma occur. Once this happens, death is almost inevitable.
The following is a timeline of the three stages of rabies: incubation, prodromal, and acute.
© Verywell, 2018
Incubation Period for Rabies
The incubation period is the time between exposure to the virus and the first appearance of symptoms. The period can run anywhere 30 to 90 days on average but may be shorter or longer based on the host and viral factors.
How Many Years Later Can Rabies Take Effect?Incubation periods longer than one year are exceptionally rare, but it can happen. There have been reports of rabies symptoms beginning years after exposure, including a case of a girl in Ghana who developed symptoms more than five years after a dog bite.
How Many Years Later Can Rabies Take Effect?
Incubation periods longer than one year are exceptionally rare, but it can happen. There have been reports of rabies symptoms beginning years after exposure, including a case of a girl in Ghana who developed symptoms more than five years after a dog bite.
The prodromal period is when symptoms first appear. This is when the virus first enters the central nervous system and begins to cause damage.
The prodromal phase tends to run from two to 10 days on average and may cause such symptoms as:
The acute neurologic period lasts anywhere from two to 10 days and will almost invariably end in death. The types and characteristics of symptoms can vary, depending largely on how severe or mild the initial exposure was.
Atypical rabiesis a type most often associated with bat bites. It may involve symptoms from both furious and paralytic forms of the disease. The variations in symptoms and severity can often make it hard to recognize a case as rabies.
Symptoms of rabies occurring during the acute neurologic period may include:
These symptoms will soon lead to a coma as the rabies infection causes massive brain inflammation.Without intensive supportive care, death will usually occur within hours or days.
Why Are Rabies Patients Afraid of Water?Hydrophobia results from intense pain and muscle spasms in the throat that make it difficult for a person with rabies to swallow. This may cause avoidance of water, and even the sight or sound of water may trigger spasms.
Why Are Rabies Patients Afraid of Water?
Hydrophobia results from intense pain and muscle spasms in the throat that make it difficult for a person with rabies to swallow. This may cause avoidance of water, and even the sight or sound of water may trigger spasms.
When to See a Healthcare Provider
Whatever the circumstance, if there is a genuine suspicion of exposure,treatmentshould be started without delay.
While rabies can only be transmitted through saliva or brain/nerve tissues, any potential exposure, however small, should be taken seriously. If anything, it may provide the impetus to get the rabies vaccine and reduce your future risk.
What Are the Signs of a Rabid Animal?
The Rabies VaccineEven if you’ve been previouslyvaccinated for rabies, you should still have your wound looked at as soon as possible.The rabies vaccine can prevent rabies after you’ve been exposed—but only early on, before symptoms appear. Once you start showing symptoms, the vaccine can no longer prevent you from getting rabies.
The Rabies Vaccine
Even if you’ve been previouslyvaccinated for rabies, you should still have your wound looked at as soon as possible.The rabies vaccine can prevent rabies after you’ve been exposed—but only early on, before symptoms appear. Once you start showing symptoms, the vaccine can no longer prevent you from getting rabies.
Even if you’ve been previouslyvaccinated for rabies, you should still have your wound looked at as soon as possible.
The rabies vaccine can prevent rabies after you’ve been exposed—but only early on, before symptoms appear. Once you start showing symptoms, the vaccine can no longer prevent you from getting rabies.
Rabies Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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Diagnosing Rabies
Be prepared to provide a healthcare provider with as much information about the animal and the circumstances of the attack as possible.
In the case of a wild, potentially rabid animal that has been caught, a definitive diagnosis requires that the animal be euthanized, after which tissue from different parts of the brain will be removed and analyzed.
It is not necessary to euthanize and test all animals that bite, however. For animals with a low probability of rabies such as dogs, cats, and ferrets, observation periods (10 days) may be sufficient to rule out the risk of potential human rabies exposure.
Several tests are necessary to diagnose rabies in humans, including those performed on samples of saliva, serum, spinal fluid, and skin biopsies of hair follicles at the nape of the neck. Skin biopsy specimens are examined for rabies antigen in the cutaneous nerves at the base of hair follicles.
Your healthcare provider will decide if you need postexposure prophylaxis. The decision will be based on whether you were bitten or exposed otherwise, which animal you were exposed to, and whether the animal is available for testing.
Summary
While rabies is extremely rare in the United States, it is a lethal disease once symptoms are evident. Symptoms progress through three stages: incubation, prodromal, and acute. Rabies can be diagnosed using brain tissue samples in an animal that is suspected to be infected. Rabies in humans can be diagnosed using samples of saliva, spinal fluid, and skin biopsies.
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Rabies.Fooks A, Cliquet F, Finke S, et al.Rabies.Nat Rev Dis Primers. 2017;3:17091. doi:10.1038/nrdp.2017.91Centers for Disease Control and Prevention.Rabies in the United States: Protecting public health.Amoako YA, El-Duah P, Sylverken AA, et al.Rabies is still a fatal but neglected disease: a case report.J Med Case Reports.2021;15(1):575. doi:10.1186/s13256-021-03164-yJackson AC.Rabies: a medical perspective.Rev Sci Tech. 2018;37(2):569-580. doi:10.20506/rst.37.2.2825Amoako YA, El-Duah P, Sylverken AA, et al.Rabies is still a fatal but neglected disease: a case report.J Med Case Rep. 2021;15(1):575. doi:10.1186/s13256-021-03164-yMahadevan A, Suja MS, Mani RS, Shankar SK.Perspectives in diagnosis and treatment of rabies viral encephalitis: Insights from pathogenesis.Neurotherapeutics. 2016;13(3):477-92. doi:10.1007/s13311-016-0452-4Bokade CM, Gajimwar VS, Meshram R, Wathore SB.Survival of atypical rabies encephalitis.Ann Indian Acad Neurol. 2019;22(3):319-321. doi:10.4103/aian.AIAN_202_18Centers for Disease Control and Prevention.Information for veterinarians.Centers for Disease Control and Prevention.Rabies vaccine: what you need to know.Centers for Disease Control and Prevention.Information for diagnostic laboratories.Centers for Disease Control and Prevention.When to seek medical care for rabies.Centers for Disease Control and Prevention.Rabies post-exposure prophylaxis (PEP).
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.World Health Organization.Rabies.Fooks A, Cliquet F, Finke S, et al.Rabies.Nat Rev Dis Primers. 2017;3:17091. doi:10.1038/nrdp.2017.91Centers for Disease Control and Prevention.Rabies in the United States: Protecting public health.Amoako YA, El-Duah P, Sylverken AA, et al.Rabies is still a fatal but neglected disease: a case report.J Med Case Reports.2021;15(1):575. doi:10.1186/s13256-021-03164-yJackson AC.Rabies: a medical perspective.Rev Sci Tech. 2018;37(2):569-580. doi:10.20506/rst.37.2.2825Amoako YA, El-Duah P, Sylverken AA, et al.Rabies is still a fatal but neglected disease: a case report.J Med Case Rep. 2021;15(1):575. doi:10.1186/s13256-021-03164-yMahadevan A, Suja MS, Mani RS, Shankar SK.Perspectives in diagnosis and treatment of rabies viral encephalitis: Insights from pathogenesis.Neurotherapeutics. 2016;13(3):477-92. doi:10.1007/s13311-016-0452-4Bokade CM, Gajimwar VS, Meshram R, Wathore SB.Survival of atypical rabies encephalitis.Ann Indian Acad Neurol. 2019;22(3):319-321. doi:10.4103/aian.AIAN_202_18Centers for Disease Control and Prevention.Information for veterinarians.Centers for Disease Control and Prevention.Rabies vaccine: what you need to know.Centers for Disease Control and Prevention.Information for diagnostic laboratories.Centers for Disease Control and Prevention.When to seek medical care for rabies.Centers for Disease Control and Prevention.Rabies post-exposure prophylaxis (PEP).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
World Health Organization.Rabies.Fooks A, Cliquet F, Finke S, et al.Rabies.Nat Rev Dis Primers. 2017;3:17091. doi:10.1038/nrdp.2017.91Centers for Disease Control and Prevention.Rabies in the United States: Protecting public health.Amoako YA, El-Duah P, Sylverken AA, et al.Rabies is still a fatal but neglected disease: a case report.J Med Case Reports.2021;15(1):575. doi:10.1186/s13256-021-03164-yJackson AC.Rabies: a medical perspective.Rev Sci Tech. 2018;37(2):569-580. doi:10.20506/rst.37.2.2825Amoako YA, El-Duah P, Sylverken AA, et al.Rabies is still a fatal but neglected disease: a case report.J Med Case Rep. 2021;15(1):575. doi:10.1186/s13256-021-03164-yMahadevan A, Suja MS, Mani RS, Shankar SK.Perspectives in diagnosis and treatment of rabies viral encephalitis: Insights from pathogenesis.Neurotherapeutics. 2016;13(3):477-92. doi:10.1007/s13311-016-0452-4Bokade CM, Gajimwar VS, Meshram R, Wathore SB.Survival of atypical rabies encephalitis.Ann Indian Acad Neurol. 2019;22(3):319-321. doi:10.4103/aian.AIAN_202_18Centers for Disease Control and Prevention.Information for veterinarians.Centers for Disease Control and Prevention.Rabies vaccine: what you need to know.Centers for Disease Control and Prevention.Information for diagnostic laboratories.Centers for Disease Control and Prevention.When to seek medical care for rabies.Centers for Disease Control and Prevention.Rabies post-exposure prophylaxis (PEP).
World Health Organization.Rabies.
Fooks A, Cliquet F, Finke S, et al.Rabies.Nat Rev Dis Primers. 2017;3:17091. doi:10.1038/nrdp.2017.91
Centers for Disease Control and Prevention.Rabies in the United States: Protecting public health.
Amoako YA, El-Duah P, Sylverken AA, et al.Rabies is still a fatal but neglected disease: a case report.J Med Case Reports.2021;15(1):575. doi:10.1186/s13256-021-03164-y
Jackson AC.Rabies: a medical perspective.Rev Sci Tech. 2018;37(2):569-580. doi:10.20506/rst.37.2.2825
Amoako YA, El-Duah P, Sylverken AA, et al.Rabies is still a fatal but neglected disease: a case report.J Med Case Rep. 2021;15(1):575. doi:10.1186/s13256-021-03164-y
Mahadevan A, Suja MS, Mani RS, Shankar SK.Perspectives in diagnosis and treatment of rabies viral encephalitis: Insights from pathogenesis.Neurotherapeutics. 2016;13(3):477-92. doi:10.1007/s13311-016-0452-4
Bokade CM, Gajimwar VS, Meshram R, Wathore SB.Survival of atypical rabies encephalitis.Ann Indian Acad Neurol. 2019;22(3):319-321. doi:10.4103/aian.AIAN_202_18
Centers for Disease Control and Prevention.Information for veterinarians.
Centers for Disease Control and Prevention.Rabies vaccine: what you need to know.
Centers for Disease Control and Prevention.Information for diagnostic laboratories.
Centers for Disease Control and Prevention.When to seek medical care for rabies.
Centers for Disease Control and Prevention.Rabies post-exposure prophylaxis (PEP).
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