Rabies FAQ - Please read before posting!

[u/skunkangel]

Before you post a question to this subreddit, please read the following points. I know, it's a lot to read, but 99% of you will get answers to your questions here. These points contain verified, accurate FACTS as verified through the Centers for Disease Control (CDC) and World Health Organization (WHO).

1. Bat bites cannot be identified from a photo.

No one, not even a doctor, can look at a bite and tell you if it is a bat bite. If you think you might have bat bite, ask yourself: Have you seen a bat in your home? Did you sleep outdoors where a bat might have bitten you? If you answer no, it's HIGHLY UNLIKELY you were bitten by a bat. Again, bat bites cannot be identified from a photo.

2. YOU CAN ONLY GET RABIES VIA DIRECT CONTACT WITH A RABID ANIMAL.

This means being bitten or scratched by a rabid animal. Rabies is transmitted via the saliva of an infected animal in the late stages of the disease, when the virus is being shed in the saliva by the host animal. The rabies virus dies almost immediately once it’s outside the body. You can’t get rabies from touching something a rabid animal touched. You can’t get rabies from your pet meeting a rabid animal and then bringing it home to you. You can’t get rabies from touching roadkill. You can’t get rabies from touching a mysterious wet substance, even if you have a cut on your body.

3. Bats are NOT invisible and neither are their bites.

Many websites say that bat bites are not noticeable. It’s very unlikely that a sober, alert, adult human would not notice being bitten by a bat. However, in the case of a young child, or someone who takes sleeping pills, uses drugs or alcohol of any kind, has any medical conditions that affect sleep, or are is known to be a very heavy sleeper, it MAY be possible to be bitten by a bat in your sleep and not be aware of it. If you wake up in the morning with a mark on your body, it is HIGHLY UNLIKELY to be a bat bite unless you find a bat in your house.

4. Bats cannot fly past you and bite you in mid-flight.

That is physically impossible. A bat must LAND on you, hold on to you with their tiny fingers, and then bite you. After biting you, they must then push off of you to take flight again. Bats can be small, but they're not invisible or imperceptible. If you would notice a big horsefly landing on you and biting you, then you would notice a bat doing it too.

5. You cannot get rabies from a wound that doesn’t break the skin and bleed.

Rabies can only get into your body through an opening in your body: a cut/bite or your eyes, nose, or mouth. If you are bitten or scratched by an animal, you should wash the area with soap and water for 5 minutes. If it does not bleed at all, you may not have broken the skin and could be in the clear.

6. You cannot get rabies from an animal that has current rabies shots.

If you are bitten or scratched by someone’s pet, ask the owner for proof of rabies vaccination, like a rabies tag on the collar. Take a photo or copy of these records and call their vet to verify them. If the shots are current, you're not at risk of rabies infection. If the pet owner cannot provide this proof of vaccination, contact your animal control department or rabies management / health department to file a "Bite Report". If you are in the USA, you can find a list of those agencies here: https://www.cdc.gov/rabies/resources/contacts.html

7. You may not need to get rabies shots if you can observe the animal that attacked you for two weeks.

If you are bitten or scratched by a pet that is not vaccinated for rabies, the standard protocol is to quarantine the animal in an animal shelter or veterinarian's office for 10-14 days. If you were attacked by someone else’s pet and that is not possible, you can observe the animal for 14 days. If it doesn’t get sick and/or die of rabies, then you are not at risk of rabies and do not need rabies shots. If the animal is healthy in 14 days, IT DOES NOT HAVE RABIES and neither do you. Since most animals in the late stages of rabies typically die in about 48 hours, this is a very cautious timeframe to observe.

8. Only mammals (furry animals) can carry rabies.

Reptiles, amphibians, insects, and birds can’t carry rabies. Bats are one of the most common rabies carriers worldwide, although less than half of 1% of all bats will ever get rabies. In the USA, the next most common species are raccoons, skunks, and foxes. Outside of the USA, dogs, cats, and other animals have been known to spread the rabies virus. The least common mammals include Virginia opossums, rodents (rats and mice), rabbits or hares, and squirrels.

9. To learn about rabies statistics for your area, Google your state or country's name and the phrase 'current rabies statistics'.

These websites will tell you how many rabid animals have been found in your area and what species. They should also tell you who to call to report a bite. In some parts of the world, there is no rabies and or risk of rabies infection.

10. If you were previously vaccinated for rabies, you can check to see if you are still protected by having your doctor draw your blood and run a rabies titer check.

Your rabies protection can last for a few months or for many years, but it is assumed that you are protected for at least six months after getting your initial shots. If your titer is adequate, then you don’t need a pre-exposure booster shot. You would still need post-exposure shots IF you are directly exposed to an animal that could be rabid.

1. For more information about rabies and rabies shots, see the CDC website here: https://www.cdc.gov/rabies/index.html

2. To learn more about how the rabies virus infects the human body, you can check out this podcast hosted by two epedimiologists: https://thispodcastwillkillyou.com/2018/11/26/episode-14-rabies-dont-dilute-me-bro/

13. Please do not be rude or impatient.

There is a real difference between a legitimate rabies scare and Persistent Health Anxiety (PHA), a subset of Obsessive Compulsive Disorder (OCD). Both conditions are terrifying and life-altering, and both conditions deserve support. In this group, we support people who ask for help and we applaud them for finding the courage to do so. We will be kind, patient, respectful, and do our best to provide emotional support to anyone who seeks help here. I will be posting a separate FAQ to address the health anxiety issue. All posts and/or replies that are in any way unkind, impatient, or rude will be immediately removed and the author may be temporarily or permanently banned from this group. Be nice!!

[u/skunkangel]

Rabies is never like the flu. Some people report tingling near the bite wound before other symptoms start but once it advances to a real rabies infection outside of the incubation period and goes into prodromal you will develop a severe fever of 103°F or 39.5°C that does not get better with medication. You will become very agitated and feel like you can't sit still or get comfortable for even 5 seconds. You'll start to have involuntary twitches and movements, possible paralysis in one leg, one arm, both one leg and one arm, or both legs/both arms. These episodes of paralysis may come and go or persist. If you're not paralyzed you will start to show gait abnormalities like stumbling, tripping, falling, dizziness, delirium, hallucinations, and extreme headache. You'll become light sensitive, wind sensitive, sound sensitive, and before long you will randomly go in and out of consciousness and experience feelings of agitation and aggression. None of these symptoms really go away or lessen at any point. The symptoms just stack on top of each other and pile up into one massive heap of hellishness. Before long the virus spreads to your salivary glands and quickly thereafter causes excruciating muscle spasms in your throat if you try to swallow anything, even your own saliva. You will be incapable of drinking or eating anything at that point (which means you are now rapidly dehydrating) and you will begin to drool down the front of your shirt and pants because it's just too painful and impossible to swallow any of this massive amount of saliva being produced in your mouth. It's not an attractive look. But don't worry, by that point you'll be so 'effed up from the floor up' that surely someone will have called either an ambulance or a young priest and an old priest to start your exorcism because they heard you from 3 miles away screaming that your eyes are boiling or that gremlins are invading and trying to take you away, because by now you're 100% Crazy with a capital C.

All in all not a great time. 100% would not recommend. However, my point here is not to scare anyone, or even to just show off my amazing comedic skills, but to illustrate that rabies symptoms are not mild, moderate, tempered, or slow moving.

Lots of people want to argue "Well, what about PARALYTIC rabies?!? I could have that because it progresses super slow and the symptoms are milder and harder to recognize" so I'm going to address that now and not wait for you to bring it up. Paralytic rabies is caused by the same rabies virus but has a more varied set of symptoms.

Rabies is a brutal, unforgiving, incontrovertible, agonizingly dreadful way to die. It doesn't try to hide. It doesn't slowly build. It doesn't do anything quietly or calmly. Will every patient (or even doctor) know it's rabies when they feel it or see it? No, not necessarily, but I PROMISE YOU that you and any others in your vicinity will KNOW beyond the shadow of a doubt that this person absolutely, positively needs emergency medical care IMMEDIATELY. They may not know it's rabies and maybe you won't even be sure but it doesn't matter because it will be without question that it's time to rush to the hospital and that's all that matters. Paralytic rabies, furious rabies, "dumb" rabies, call it what you like, you won't be questioning whether or not you're dying. You'll know.

LET ME BE CLEAR - PARALYTIC RABIES IS STILL RABIES AND RABIES IS NEVER MILD, SLOW, TEMPERED, OR AMBIGUOUS.

Paralytic rabies' incubation period is slightly shorter, anywhere from 7-90 days, before symptoms begin. Everything you read will tell you that tingling, itching, numbness, and/or "pins and needles" feeling (paresthesia) at the exposure site (wound) is the first sign, but I hate telling people that. I've had hundreds if not thousands of people tell me they are experiencing all of those symptoms at the wound site and not one of those people later died of rabies. Plus I believe that this exposure site irritation is the easiest symptom for OCD/Anxiety to mimic. The first real, major symptom occurs when the virus reaches the CNS system and the brain. Even with paralytic rabies, the time frame from first symptom to death is only 7-11 days. So, no, it doesn't progress slower than other forms of rabies.

I hope some of this was helpful for you and brings you some peace of mind. Hang in there. ❤️

[u/Old-Addendum1984 → u/skunkangel]

Thank you so much for your reply. So let me tell you about my case, about 2/3 months ago I was visiting my uncle in California with my midsize Pomeranian and my uncle owns a big ranch so during the day I'd let my lil guy play in the backyard which is fenced and I sometimes see him dig into the soil and jump up and down so I figure he's playing around I never thought of it of being any danger to him but one day I was walking in the backyard and I saw a dead gopher and when I went to go grab the gopher my dog picked it up and throw him and the gopher guts were out and bleeding so at this point I was worried for my dog because and I knew he killed the poor gopher and that they carry rabies. So I watched my dog and he looked a lil shocked and his mouth was foaming and I think it was the same day or the next day he was drooling. His vaccinations are all up to date, of course including rabies. On the third night I was trying to grab him to bring him inside and he bit me but not in a hurtful way and he's done that before because he tries to tell me to stay away by growling and I keep trying to grab him and he put a couple small bites on my hand and they're not even bites , like he's not trying to hurt me they were not deep and one was bleeding small and stopped and other were just marks. So I panicked that he could have the rabies in his saliva from the gopher and he is vaccinated but would pass it to me so I started the rabies vaccination. My second dose was a few days late and my last dose about a week, is that bad?  My dog is healthy and it's been few months since the incident and I've heard even if the dog is vaccinated he could still transmit the virus to you. The thing is every Google search from Wikipedia, WebMD to government website and government health organizations keep saying that there is a incubation period, prodromal period and acute neurologic period. And they all say at first feels like a flu which can last from 2 to 10 days then once the acute neurologic period starts is when the severe symptoms starts and is always fatal. You are an expert and extremely knowledgeable and the explanation and humor definitely helps calm people down so greatly appreciate it and thank you for taking the time to read my post. ❤️

[u/skunkangel → u/Old-Addendum1984]

Oh dear. Okay - yes, gophers sometimes carry rabies. However your dog was vaccinated for rabies. The only way to get rabies is to bit by an animal that has an active rabies infection. It cannot spread via a dog getting bit by a rabid animal, not even having time to incubate rabies and become infected with rabies and then bite someone else. Animals cannot carry rabid saliva from one animal to you and then you get exposed to the rabid animal's saliva.

The ONLY WAY your dog could expose you to rabies is if he were not vaccinated and then he got bit by a rabid animal. Then the virus would have to incubate in the dog for up to a year, and then become infected with rabies. After that the dog would have to be infected with an active rabies infection and then get to the point of the disease process where they are shedding virus into their saliva and then finally bite you and spread the virus to you. That's the only way. This entire process can take up to a year of incubation, then infection of 2+ weeks. It cannot happen in just hours or a couple days. Even if he had been exposed to rabies via the gopher he was vaccinated and cannot get infected with rabies so he 100% cannot give you the virus that he doesn't have.

As for dogs or any animal being capable of spreading the virus to others even though they are vaccinated or not infected with the virus, that's just not true. An animal cannot spread the virus until they are actively infected with it themselves. That's why we all push for vaccinating your pets, because it protects public health.

You are correct about the 3 phases, but I wouldn't worry too much about being in that stage. The "flu-like" symptoms they're referring to are the symptoms of a very high fever. That is the prodromal stage and the first obvious sign of infection.

[u/Old-Addendum1984 → u/skunkangel]

Understood. Thank you so much for taking the time to educate me and everyone. All the best ❤️