Dr. Mitch Shulman: Rabies — What you need to know

Rabies is a contagious and deadly disease caused by a virus that attacks the nervous system. The virus is transmitted through infected saliva that gets into an open cut or through the mucous membranes (eye, nose, mouth). It doesn’t spread through the air.

Once symptoms start, the disease is fatal, but it is preventable with appropriate action before that happens.

Symptoms of rabies in a person usually take about three to eight weeks to develop but it can be more rapid depending on where the virus entered the body (faster the closer it is to the head or the spinal cord); how severe the exposure was (for example, a deep bite); and the amount of virus present. The virus has to reach nerve cells and then travel along the nerves to the spinal cord and the brain.

It’s never a good idea to wait to see what develops. If you’re in contact with a potentially infected animal, wash the area with soap and water for 10 to 15 minutes and call 811 (24 hours a day) to report the situation and to be directed to the right resources. If the contact is significant, you’ll be treated with an injection of an immune globulin to provide immediate protection and at the same time, a vaccination program (consisting of a total of four shots) will be started. The vaccination series against rabies that we use now is much shorter and easier than in the past.

If you come upon a dead, disoriented or aggressive bat, raccoon, skunk or fox, report it to the Quebec Rabies Hotline at 1 -877-346-6763 (Monday to Friday, 8:30 a.m. to 4:30 p.m.) or online (the Gouvernement du Québec surveillance portal at any time). Don’t touch it. Assume that a dead animal could contain the virus.

An infected animal (including pets) may show behavioural changes. A normally nocturnal animal might be active during the day; the animal may bite its own limbs; attack inanimate objects, other animals or humans; the animal may lose its usual fear of humans; and it may also salivate and make strange noises. Rabid bats, because of paralysis, may be found on the ground unable to fly or they can seem to be disoriented, colliding with obstacles, flying during the day rather than at night. In pets, rabies usually causes death within 10 days. If a pet has symptoms, it must be isolated and kept away from people and a veterinarian should assess the situation as soon as possible. The rabies vaccine to prevent disease in cats and dogs works, but it must be kept up to date.

The key is to prevent contact in the first place. Outdoor garbage containers should be tough enough to stand up to the sharp claws of a raccoon. Explain to your children not to touch or approach an animal that they don’t know (even dogs and cats) or one that’s dead. All wild animals should best be admired from a distance and otherwise left alone.

Dr. Mitch Shulman is an Associate Professor in the Department of Emergency Medicine at McGill Medical School as well as an Attending Physician in the Emergency Department of the McGill University Health Centre. He’s also the CJAD AM 800 Medical Consultant.