Recently, something startling is happening – rabies is cropping up in American children without any real warning. Why? Possibly because we’ve gotten so used to being safe and well that when animals bite our children, we don’t worry about it much.
In Indiana, a ten-year old girl died 26 days after a rabid bat bit her; her mother had forgotten that she’d been bitten. In California, an eleven-year-old boy died; his doctors and parents think he contracted rabies in the Philippines two years earlier, when a dog bit him.
Even in the later stages, rabies isn’t necessarily fatal. In 2004, a new experimental treatment called the Wisconsin Protocol, involving putting patients in an induced coma and giving them large antiviral drug doses, saved the life of a fifteen-year-old girl with advanced rabies. Even though doctors didn’t figure out the source of her illness for nearly a week, ribavirin was used to save her life. She was the first rabies patient whose life was saved with this treatment, and only the sixth human on record who recovered from rabies after onset of the symptoms.
The Wisconsin Protocol may save more lives in the future. But too save the lives of affected children, it is critical that the disease be recognized as early as possible. This means clinicians and parents need to know what to look for.
Rabies Indicators
Animal Bites: Rabies is always passed on through direct blood contact with an infected person or creature, and that almost always means a bite. The most common animal bites in the US that carry rabies are raccoons, bats, and dogs; in a couple of rare cases, rabies has also been spread from person to person via organ transplants, but this is nearly unheard of. There will likely be pain and exaggerated sensation at the site of the bite.
Brain inflammation: After a ten day to seven year incubation period, the virus causes swelling in the brain, which triggers all the other symptoms of the disease. In most people, the incubation period will be three to seven weeks.
Symptoms secondary to brain inflammation include: low-grade fever, difficulty swallowing that results in spasms of the throat (this makes it especially hard to swallow water, which is why rabies is also called hydrophobia), restlessness, excitability, muscular spasms and convulsions, numbness, tingling, loss of muscle function or feeling in an entire body area, drooling, anxiety, and stress.
By the time secondary symptoms show up, it is likely that the only possible treatment is the Wisconsin protocol, which is as yet relatively unproven. For this reason, it’s important that the victim seek treatment as soon as possible after an animal bite.
Modern early rabies treatment consists of a series of vaccinations given in the arm (not the stomach, as used to be the norm). Side effects can be moderately severe, but not permanent; they mostly make the recipient sick. This immunization, given within two days, almost always prevents rabies. After the secondary symptoms appear, hardly anyone survives more than seven days.
