Overview

Rabies is a deadly virus spread to people from the saliva of infected animals. The rabies virus is usually transmitted through a bite.

Animals most likely to transmit rabies in the United States include bats, coyotes, foxes, raccoons and skunks. In developing countries, stray dogs are the most likely to spread rabies to people.

Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. For this reason, anyone who may have a risk of contracting rabies should receive rabies vaccinations for protection.

Mayo Clinic Minute: What you should know about bats and rabies

Learn more about the risk of rabies from bats and how to prevent rabies.

Jason Howland: The most dangerous threat of rabies in the U.S. is flying overhead.

Gregory Poland, M.D., Vaccine Research Group Mayo Clinic: "It used to be thought, well, it's a rabid dog. But the more common way of getting rabies is from the silver-haired bat."

Jason Howland: The deadly virus is transmitted from the saliva of infected animals to humans, usually through a bite.

Dr. Poland: "… The bat doesn't always bite. Sometimes the saliva will drool onto you, and you could have a minor open cut. Or sometimes a bat will lick on the skin and, again, transmit the virus that way."

Jason Howland: Dr. Poland says that's why if you wake up and find a bat in the room, you should get the rabies vaccine.

Dr. Poland: "People think, 'Well, the bat's in the house. We woke up with it, doesn't look like it bit anybody.' Doesn't matter. Rabies is such a severe disease with no cure, no treatment for it, that the safer thing to do is to give rabies vaccine."

Jason Howland: That includes an immune globulin and multidose rabies series which is not cheap. A typical series of rabies vaccines cost anywhere from three to seven thousand dollars.

For the Mayo Clinic News Network, I'm Jason Howland.


Symptoms

The first symptoms of rabies may be very similar to those of the flu and may last for days.

Later signs and symptoms may include:

  • Fever
  • Headache
  • Nausea
  • Vomiting
  • Agitation
  • Anxiety
  • Confusion
  • Hyperactivity
  • Difficulty swallowing
  • Excessive salivation
  • Fear brought on by attempts to drink fluids because of difficulty swallowing water
  • Fear brought on by air blown on the face
  • Hallucinations
  • Insomnia
  • Partial paralysis

When to see a doctor

Seek immediate medical care if you're bitten by any animal, or exposed to an animal suspected of having rabies. Based on your injuries and the situation in which the exposure happened, you and your doctor can decide whether you should receive treatment to prevent rabies.

Even if you aren't sure whether you've been bitten, seek medical attention. For instance, a bat that flies into your room while you're sleeping may bite you without waking you. If you awake to find a bat in your room, assume you've been bitten. Also, if you find a bat near a person who can't report a bite, such as a small child or a person with a disability, assume that person has been bitten.


Causes

The rabies virus causes a rabies infection. The virus spreads through the saliva of infected animals. Infected animals can spread the virus by biting another animal or a person.

In rare cases, rabies can be spread when infected saliva gets into an open wound or the mucous membranes, such as the mouth or eyes. This could happen if an infected animal licked an open cut on your skin.

Animals that can transmit the rabies virus

Any mammal (an animal that suckles its young) can spread the rabies virus. The animals most likely to spread the rabies virus to people include:

Pets and farm animals
  • Cats
  • Cows
  • Dogs
  • Ferrets
  • Goats
  • Horses
Wild animals
  • Bats
  • Beavers
  • Coyotes
  • Foxes
  • Monkeys
  • Raccoons
  • Skunks
  • Woodchucks

In very rare cases, the virus has been spread to tissue and organ transplant recipients from an infected organ.


Risk factors

Factors that can increase your risk of rabies include:

  • Traveling or living in developing countries where rabies is more common
  • Activities that are likely to put you in contact with wild animals that may have rabies, such as exploring caves where bats live or camping without taking precautions to keep wild animals away from your campsite
  • Working as a veterinarian
  • Working in a laboratory with the rabies virus
  • Wounds to the head or neck, which may help the rabies virus travel to your brain more quickly

Prevention

To reduce your risk of coming in contact with rabid animals:

  • Vaccinate your pets. Cats, dogs and ferrets can be vaccinated against rabies. Ask your veterinarian how often your pets should be vaccinated.
  • Keep your pets confined. Keep your pets inside and supervise them when outside. This will help keep your pets from coming in contact with wild animals.
  • Protect small pets from predators. Keep rabbits and other small pets, such as guinea pigs, inside or in protected cages so that they are safe from wild animals. These small pets can't be vaccinated against rabies.
  • Report stray animals to local authorities. Call your local animal control officials or other local law enforcement to report stray dogs and cats.
  • Don't approach wild animals. Wild animals with rabies may seem unafraid of people. It's not normal for a wild animal to be friendly with people, so stay away from any animal that seems unafraid.
  • Keep bats out of your home. Seal any cracks and gaps where bats can enter your home. If you know you have bats in your home, work with a local expert to find ways to keep bats out.
  • Consider the rabies vaccine if you're traveling or often around animals that may have rabies. If you're traveling to a country where rabies is common and you'll be there for an extended period of time, ask your doctor whether you should receive the rabies vaccine. This includes traveling to remote areas where medical care is difficult to find.

If you work as a veterinarian or work in a lab with the rabies virus, get the rabies vaccine.


Nov 02, 2021

  1. Rabies. Centers for Disease Control and Prevention. https://www.cdc.gov/rabies/. Accessed Aug. 10, 2021.
  2. AskMayoExpert. Rabies. Mayo Clinic; 2021.
  3. Rabies. Elsevier Point of Care. https://www.clinicalkey.com. Accessed Aug. 10, 2021.
  4. Rabies vaccine information statements. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/hcp/vis/vis-statements/rabies.html. Accessed Aug. 10, 2021.
  5. Bennett JE, et al. Rabies (Rhabdoviruses). In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Aug. 10, 2021.
  6. Jameson JL, et al., eds. Rabies and other rhabdovirus infections. In: Harrison's Principles of Internal Medicine. 20th ed. McGraw Hill; 2018. https://accessmedicine.mhmedical.com. Accessed Aug. 10, 2021.

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