Frequently Asked Questions

Rabies is a viral disease transmitted from mammals to humans. There are two clinical manifestations of rabies: furious and paralytic. Furious rabies is the most common form of human rabies. Once symptoms of the disease develop, either form is almost always fatal.

When a person is bitten or scratched by an animal that has rabies, the virus can enter their body through the saliva of the infected animal. The virus can also infect a person if the animal licks an open wound, a cut, or the mucous membranes of the mouth and nose.

Rabies is transmitted by bite or scratch of mammals/ warm blooded animals. Dogs are responsible for up to 99% of human rabies cases, however the virus can be transmitted from the bite of any rabid animal. Human rabies cases have occurred because of bites from cats, Monkeys, mongooses, jackals, foxes, wolves and other carnivorous animals. Many animals will become aggressive and bite when they have rabies, including horses and donkeys. In animals where biting is not common, such as cattle and buffalo, transmission can still occur through exposure to saliva. Care should be taken while examining sick animals that are salivating.

There is no evidence suggesting that Rabies is being transmitted by bat exposure in India. 

The most common route of transmission is through the saliva of a rabid animal. However, the rabies virus has also been found, and could possibly be transmitted, through other bodily fluids such as tears, and nervous tissue. Rabies virus is not found in blood or faeces. There are no evidence-based reports of human rabies arising from consumption of milk, including breastmilk, or cooked meat. However, consuming the meat or milk of a rabid animal is strongly discouraged. Individuals or professionals who slaughter rabies-infected mammals and handle tissues of rabid animals may be at risk of contracting the virus through breaks in their skin. These individuals should use specialized personal protective equipment and consult infectious disease specialists if they suspect they have been exposed to rabies infected carcasses.

The risk of Human to human Rabies transfer is minimal and there are no well documented cases, other than very rare cases resulting from infected organ transplant. However, caregivers should be vigilant when looking after patients with rabies and avoid contact with their saliva and other excretions. Hand washing and good personal hygiene are of upmost importance when caring for patients with rabies. As per National Guideline people who have been exposed closely to the secretions of a patient with rabies may be offered PEP as a precautionary measure. 

Yes. Organs transplanted from rabid organ donors can transmit rabies to the organ recipient. Individuals with symptoms of encephalitis (inflammation of the brain) before death should therefore be excluded as organ donors. Human-to-human transmission has never been confirmed outside the organ transplantation situation

If a person is bitten by an animal, the following measures should be taken

• Wash wounds and scratches immediately with soap or detergent and flush them thoroughly up to  15 minutes with copious amounts of running  water. If soap is not available, flush with water alone. Wound washing is the most effective first-aid treatment against rabies. 
• Apply an iodine-containing or anti-viral medication preparation on top of the wound 15 minutes after it has been washed and flushed. 
•  Take the person to a health care facility for further assessment and treatment by a healthcare professional as soon as possible.
  
  

Rabies PEP (Post Exposure Prophylaxis) is the emergency treatment given to a person who may have been exposed to rabies virus through a bite or scratch from an infected animal. Rabies PEP consists of the following steps: 

Wound treatment: The wound should be washed and flushed with soap and water for at least 15 minutes and disinfected with an antiseptic as soon as possible after the exposure.

Rabies immunoglobulin: This is a human or animal-derived product that contains antibodies against rabies virus. It is given by injection around the wound site to prevent the virus from spreading to the nervous system. It should be given as soon as possible, preferably within 24 hours of exposure, and no later than 7 days after the first dose of vaccine.

Rabies vaccine: This is a safe and effective vaccine that stimulates the body’s immune system to produce its own antibodies against rabies virus. It is given by injection in the arm or leg, usually in a series of four/ five doses on days 0, 3, 7, 14 and 28 after exposure depending on route of administration. 

Rabies PEP is very effective in preventing rabies if given correctly and promptly. All three steps of equally importasant.

There is no laboratory or epidemiological evidence to show that rabies is transmitted via the consumption of milk or milk products. Therefore, PEP is not required for consuming any milk or milk products from rabies infected animals.

Consuming the meat from a rabid animal is strongly discouraged. Although no human cases have been documented following the consumption of uncooked meat from a rabid animal, butchering or eating a rabid animal may potentially transmit rabies. If an exposure occurs, PEP should be initiated. Cooked meat does not transmit rabies; however, it is not advisable to butcher or consume meat of any kind from an infected animal. The carcass should be buried or burned if possible, with advice from a veterinary professional.

Rabies is a potentially fatal disease and PEP is life-saving. Hence pregnancy is not considered a contraindication to post exposure prophylaxis. Studies have indicated no increased incidence of abortion, premature births, or foetal abnormalities associated with rabies vaccination.

After entering the human body e.g. through an animal bite, the rabies virus enters the peripheral nervous system and migrates to the central nervous system (spinal cord and brain). The infected person exhibits behavioral changes and clinical signs when the virus reaches the brain. Clinical signs typically appear 2-3 months after a person has been infected. In exceptional cases, clinical signs can develop after a few days, or after more than six months, following an exposure.