RABIES INFECTION

Although rabies infections in people are rare, they can cause serious health problems. So it's a good idea to know how to recognize the signs that your child has been bitten by a rabid animal and what to do about it.

Rabies is a virus that is usually transmitted by a bite from a wild infected animal, such as a bat, raccoon, skunk, or fox. If a rabid animal bite goes untreated, an infection can develop and lead to brain damage or even death.

But if you recognize the warning signs of a rabies infection early, and get medical help, your child can make a full recovery. After a bite by a rabid animal, a child may develop a fever, headache, and general malaise. A twitching around the animal bite, a trademark symptom of rabies, may appear, in addition to a fever above 105 degrees Fahrenheit (40.5 degrees Celsius), agitation, and hallucinations.

If you suspect that your child has been bitten by a rabid animal, even if there are no rabies symptoms, it is important to take your child to the emergency department immediately.

Any animal bites - even those that don't involve rabies - can lead to infections and other medical problems. As a precaution, you may want to call your child's doctor any time your child has been bitten.

How Is Rabies Transmitted?
Raccoons are the most common carrier of rabies in the United States, but bats are most likely to infect people. Almost three quarters of rabies cases came from contact with bats between 1990 and 2001.

Approximately 7,000 cases of rabies in animals are reported each year to the U.S. Centers for Disease Control.

Skunks and foxes also tend to carry rabies, and a few cases have been reported in wolves, coyotes, bobcats, and ferrets.

Small rodents, such as hamsters, squirrels, chipmunks, mice, and rabbits, do not typically carry rabies. Because of widespread vaccination programs in the United States, transmission from dogs to people is very rare. Outside the United States, exposure to rabid dogs is the most common cause of transmission to humans.

An infected animal carries the rabies virus in the saliva and can transmit it to a person by biting him or her. In rarer cases, an animal can spread the virus to a person when its saliva touches a person's mucous membranes (moist skin surfaces, like the mouth or inner eyelids) or contacts broken skin such as a cut, scratch, bruise, or open wound.

Once the infected animal bites a person, the rabies virus can spread into the surrounding muscle, then travel up a nearby nerve to the brain. Once the virus infects the brain, it can cause severe, possibly permanent injury.

Signs and Symptoms of Rabies
The symptoms of rabies typically appear at least 4 days after the bite occurs. But in rare cases, symptoms don't show up for more than a year.

One of the most distinctive signs of a rabies infection is a tingling or twitching sensation around the area of the animal bite. It is often accompanied by a fever, headache, muscle aches, loss of appetite, nausea, and fatigue.

As the infection progresses, a child infected with rabies may develop any of the following symptoms:

• irritability
• excessive movements or agitation
• confusion
• hallucinations
• aggressiveness
• bizarre or abnormal thoughts
• muscle spasms
• abnormal postures
• seizures (convulsions)
• weakness or paralysis (when a person cannot move some part of the body)
• extreme sensitivity to bright lights, sounds, or touch
• increased production of saliva or tears
• difficulty speaking

In the advanced stage of the infection, as it spreads to other parts of the nervous system, other symptoms may develop:

• double vision
• problems moving facial muscles
• abnormal movements of the diaphragm and muscles that control breathing
• difficulty swallowing and increased production of saliva, causing the "foaming at the mouth" usually associated with a rabies infection

What to Do if Your Child Is Bitten by a Rabid Animal
If your child has an animal bite and shows any symptoms of a rabies infection, see a doctor immediately.

If your child has been bitten by a rabid animal but shows no symptoms, take the following steps right away:

• Wash the bite area with soap and water for 10 minutes and cover the bite with a clean bandage.
• Immediately call your doctor and go to a nearby emergency department. Anyone with a rabies infection must be treated in a hospital.
• Call local animal-control authorities to help find the animal that caused the bite. The animal may need to be detained and observed for signs of rabies.
• If you know the owner of the rabid animal that has bitten your child, get all the information about the animal, including vaccination status and the owner's name and address. Notify your local health department, particularly if the animal hasn't been vaccinated.
• If you suspect that your child has been bitten by an unknown dog, bat, rat, or other animal, contact your child's doctor immediately, or take your child to the emergency department.
• Vaccinate your pets: Cats, dogs, and ferrets can be infected by rabies.