Hey Doc,

My grandson was bit by another camper’s dog last weekend. The bite is only superficial and appears to not be infected. Do we need to worry about rabies?

—Foaming at the mouth in Virginia

————————————————————-

Luckily, the threat of rabies disease is very rare in North America. Since 1995, the CDC reports only a handful of U.S. cases every year. Most rabies cases initially occur outside the U.S. Rabies is caused by a virus transmitted by the nerves and saliva of its victims. Petting or handling an infected animal will not lead to transmission of the virus. Bites are the most common method of virus transmission.

The most common infected animals in the U.S. are bats and raccoons. Rabies-infected animals may appear normal, especially after the initial infection. As the disease advances, the animal will start to exhibit odd behaviors. The furious stage, shown in horror writer Steven King’s movie Cujo, leads to abnormal aggressive behavior. The paralytic stage can occur after the furious stage or shortly follow the initial infection. Both wild and domestic animals may show lack of appetite, excessive saliva production, and frequent imbalance during the paralytic stage. Wild animals may appear docile, which is why you should never approach unusually friendly wild animals. Total time following infection until death in most animals is 7-10 days.

If not treated early, the disease is nearly 100% fatal. In most areas of the U.S., all animal bites must be reported to their local health agency. If a domestic animal bites a person and the suspicion of rabies is low, then the animal can be observed for 10 days. If the animal remains asymptomatic, then no rabies prophylaxis is needed. When the bite occurs from an animal that can’t be observed, the local health department may recommend a series of injections. They aren’t fun.