Preventing Rabies and Tetanus

Rabies is a preventable viral disease that affects the central nervous systems; tetanus is a serious and potentially fatal disease caused by a neurotoxin.

| August/September 2004

Preventing Rabies

Rabies is a preventable viral disease that affects the central nervous systems of humans and other mammals. According to Linda J. Demma, an epidemiologist with the Centers for Disease Control and Prevention (CDC), public health costs associated with rabies prevention and treatment exceed $300 million a year, “so the disease is still a common concern.”

People and animals get the rabies virus from the bite of an animal infected with the disease. In the United States, the most common hosts are wild skunks, raccoons, bats, foxes and coyotes. Domesticated mammals also can get rabies, especially nonvaccinated cats and dogs.

In humans, most potential rabies exposures are caused by bites from domesticated animals, simply because people have less contact with wild animals. But, almost all cases of human deaths from rabies reported to the CDC in the past 23 years have been caused by bites from bats: From 1980 to 2003, 30 of 34 human deaths from rabies were associated with bats, Demma says. In only three of those cases, the patients reported a known bite. Most victims didn’t realize they had been bitten (a bat’s teeth are very small and bite marks can go unnoticed). To reduce your exposure to bats, seal off openings in your home larger than a quarter-inch by half-inch, through which bats can enter. Check with your physician when bitten by a bat or any other animal.

Symptoms and Treatments

Symptoms of rabies, which appear within two to eight weeks after the bite, include fever, headache and general discomfort. Severe symptoms occur in the following two to 10 days and include insomnia, anxiety, confusion, slight or partial paralysis, difficulty swallowing, overly excited behavior, hallucinations, agitation, salivation and fear of water. Death usually occurs within days of the onset of the severe symptoms.

There are two types of vaccine against rabies — given before a bite (pre-exposure), or just after exposure (post-exposure). The CDC advises people who are at a higher risk of contracting rabies, such as veterinarians or animal handlers, to undergo pre-exposure treatment. It does not eliminate the need for post-exposure shots but can simplify treatment if the person is bitten. The number of human deaths from rabies has declined from more than 100 per year at the turn of the 20th century to one or two per year. The number of rabies cases in domestic animals also has decreased, from 4,000 in 1955 to less than 1,000 in 2000.

If an animal bites you, wash with soap and water and do not delay in seeking medical attention, Demma says. Call animal control or a wildlife conservation agency for assistance with capturing the animal. If professional assistance is unavailable, use precautions to catch the animal safely and submit it for testing to local authorities.

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