Rabies - Treatment

Any animal bite should be treated first with standard cleansing procedures. The wound should be washed thoroughly with medical soap and water. Antibiotics and tetanus injections (see tetanus entry) are usually given as well. These injections protect against bacterial infections.

The most important aspect of treatment is deciding whether a rabies immunization should be given. In some cases, the bite may have come from a domestic animal, such as a dog or a cat. If the animal is caught, it is placed in seclusion and observed. If the animal shows no signs of rabies in four to seven days, it is probably not rabid (not infected with rabies). The person who was bitten does not need a rabies immunization. If there is doubt as to whether the animal is rabid, it is killed. Its brain can then be examined to see if the rabies virus is present.

Sometimes the animal is not caught. In that case, a doctor has to decide whether to give the person who was bitten an immunization. That decision is usually based on how common rabies is in the area. If the disease is very rare, an immunization may not be necessary. If rabies is fairly common, an immunization will probably be given.

A rabies immunization usually consists of two parts. One part consists of injecting the patient with rabies antibodies taken from a person who has already been immunized. These antibodies will be of some help in destroying the rabies virus in the infected person's body. This part of the immunization process is given once, at the beginning of the treatment.

The second part of the immunization consists of injecting the patient with dead rabies viruses. These viruses will cause the patient's body to start manufacturing antibodies of its own without causing infection because they are dead. This part of the rabies immunization is given in a series of five injections, usually given one, three, seven, fourteen, and twenty-eight days after the animal bite. If successful, the antibodies from these two different sources will fight off the rabies infection.

Until the 1970s the rabies vaccination was a painful and frightening procedure that consisted of between fourteen and twenty-one shots that had to be given in the abdomen. Today the vaccine is given in the arm muscle, like a flu or tetanus shot.

Sometimes it may be too late to start immunizations. In that case, the main goal of treatment is to relieve the symptoms of the disease. For example, pain relievers can be given for painful muscle spasms. Other forms of medication can prevent seizures and relieve a person's anxiety. In the late stages of the disease, a patient may need mechanical devices to aid with breathing and heart function. Survival in such cases is rare but not unheard of.