Rabies in Children
What is rabies?
Rabies is a viral infection that affects certain warm-blooded animals. It's caused
by a virus in the Rhabdoviridae family and attacks the nervous system. Once symptoms
develop, it is 100% fatal in animals if left untreated. A few people have survived
a rabies infection, but this is very rare.
In North America, rabies happens mainly in skunks, raccoons, foxes, coyotes, and bats.
In some areas, these wild animals infect domestic cats, dogs, and livestock. In the
United States, cats are more likely than dogs to be rabid.
Individual states maintain information about animals that may carry rabies. It is
best to check for region-specific information if you are unsure about a specific animal.
How does rabies happen?
The rabies virus enters the body through a cut or scratch, or through mucous membranes
(such as the lining of the mouth and eyes), and travels to the central nervous system.
Once the infection reaches the brain, the virus travels into the nerves and multiplies
in different organs.
The salivary glands are most important in the spread of rabies from one animal to
another. When an infected animal bites another animal, the rabies virus is transmitted
through the infected animal's saliva. Scratches by claws of rabid animals are also
dangerous because these animals lick their claws.
Humans with open scratches or sores may be exposed to rabies when these areas are
licked by an animal infected by rabies.
What are the symptoms of rabies?
The time of exposure to the onset of illness can range anywhere from 5 days to more
than a year. The average incubation period is about 2 months. The following are the
most common symptoms of rabies:
Rabies: Stage 1
Rabies: Stage 2
Initial period of vague symptoms, lasting 2 to 10 days
Vague symptoms may include:
Pain, itching, or numbness and tingling at the site of the wound may happen
Children often develop difficulty in swallowing (sometimes referred to as "foaming
at the mouth") due to the inability to swallow saliva. Even the sight of a glass of
water may terrify the child.
Some children become agitated and disoriented, while others become paralyzed.
Immediate death, or coma resulting in death from other complications, may result.
The symptoms of rabies may look like other conditions or medical problems. Always
talk with your child's healthcare provider for a diagnosis.
How is rabies diagnosed?
In animals, a test called direct fluorescent antibody test (dFA) is often used to
detect rabies. Test results are usually known within a few hours. Knowing these results
may save a child from undergoing treatment if the animal is not rabid.
In humans, a number of tests are needed to confirm or rule out rabies, as no single
test can be used to rule out the disease with certainty. Tests are done on samples
of serum, saliva, spinal fluid, and skin biopsies taken from the nape of the neck.
What is the treatment for rabies?
Your child's healthcare provider will determine specific treatment for rabies. Unfortunately,
there is no known, effective treatment for rabies once symptoms of the disease happen.
However, there are effective vaccines (HDCV, PCEC) that provide immunity to rabies
when given soon after an exposure. Treatment for suspected exposure to rabies includes
one dose of immune globulin and a series of shots of rabies vaccine over a 2-week
period. It may also be used for protection before an exposure happens, for people
such as veterinarians and animal handlers.
How can animal bites and rabies be prevented?
Being safe around animals, even your own pets, can help reduce the risk of animal
bites. Some general guidelines for avoiding animal bites and rabies include the following:
Keep pets in a fenced yard or on a leash when out in public.
Select family pets carefully.
Never leave a young child alone with a pet.
Have your pets immunized against rabies and all shots kept current.
Supervise pets so they do not come into contact with wild animals. Call your local
animal control agency to remove any stray animals.
Teaching your child about animal safety may also help to prevent animal bites. Some
things to remember include the following:
Do not try to separate fighting animals.
Avoid any strange or sick animals.
Leave animals alone when they are eating.
Do not approach or play with wild animals of any kind.
What facts need to be reported to your healthcare provider?
If you or someone you know has been bitten or scratched by an animal, remember to
report the following facts to your healthcare provider:
Location of the incident (such as backyard or forest)
Type of animal involved (domestic pet or wild animal)
Type of exposure (cut, scratch, or licking of open wound)
Part of the body involved (hand, leg, or face)
Number of exposures
Whether or not the animal has been immunized against rabies (if known)
Whether or not the animal is sick or well—if "sick," what symptoms were present in
Whether or not the animal is available for testing or quarantine
Do not attempt to capture a wild or sick-appearing animal that has bitten your child.
Notify animal control officers.