Rabies
What is rabies?
Rabies is a viral infection that affects the central nervous system. Vaccination and preventative care soon after potential exposure can prevent the onset of symptoms. Once symptoms of infection appear, there is no cure and it is fatal.
Worldwide, the rabies virus causes tens of thousands of deaths each year.
At a glance
- Rabies is a infection that can spread from infected animals to humans, usually through a bite or scratch. After infection, if symptoms appear, it is almost always fatal.
- Rabies is rare in Europe. The EU/EEA recorded 1 human case of rabies in 2023 – the first since 2019 when 5 cases were reported (in 3 of those cases, the infection occurred while traveling outside Europe). Worldwide, 99% of human cases are linked to dogs.
- Rabies can be prevented by getting vaccinated.
What are the symptoms of rabies?
After exposure, it can take weeks or even months for symptoms to appear. Once symptoms begin, the disease progresses through a number of stages:
- Tingling and/or numbness around the skin of the bite or scratch that caused the infection
- Muscle pain
- Nausea and vomiting
- Hydrophobia (distress when seeing or contacting liquids) and aerophobia (distress when experiencing ventilation, such as open windows or doors) once the disease has set in
After the initial onset of symptoms, rabies will either progress through a furious or paralytic phase, with much more severe symptoms and always ending with death of the patient. The symptoms of these phases are:
Furious:
- Extreme agitation or aggression
- Restlessness
- Seizures
- Hallucinations
- Delirium
- Racing heartbeat
- Muscle twitching
- Facial paralysis
- Excessive salivation
Paralytic:
- Weakness that starts from the area that was bitten and spreads to the whole body
- Tingling and other sensations
- Paralysis
- Coma
How is rabies spread?
Rabies can spread to humans through exposure to saliva from an infected animal, for instance through a bite or scratch or through an animal licking someone around the eyes, mouth or open wound. Virtually all human rabies cases around the world are transmitted by infected dogs, but bats have also been responsible for infecting humans.
Who is at risk of rabies?
In the EU/EEA, people are unlikely to come into contact with an infected animal. However, people who travel outside the EU/EEA, or those who work closely with mammals that are potential transmitters are at higher risk.
How can rabies be prevented?
Vaccination can protect against rabies. The rabies vaccine can also be given following exposure and before the onset of symptoms, reducing the likelihood of becoming sick. Where available, administration of immunoglobulins might also be considered, particularly to people who have not been vaccinated prior to exposure.
People travelling to areas where the risk of exposure is significant should make sure they are vaccinated before travel.
Bite injuries must be thoroughly cleaned with soap for 15 minutes and subsequently disinfected.
How is rabies treated?
There is no cure for rabies once symptoms appear. However, after exposure, the rabies vaccine can be given to patients to teach the body to fight off the infection before it reaches the brain. People who were not previously vaccinated will need more doses.
People who have not been vaccinated before exposure can also be given antibodies (so-called human rabies immunoglobins) that help fight the infection.