Today is World Rabies Day ❘ We have found all the truth about rabies for you!

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Many people know that rabies has a certain incubation period, but since when has the saying " rabies can remain latent for more than ten years " been circulated among the people? This has made many friends who have pets or have been bitten by pets feel disappointed.

So, can the incubation period of rabies really last for more than ten years?

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Let me first give you the answer: There is no scientific basis for this statement . Research data from the World Health Organization shows that 99% of rabies viruses will break out within one year , and you simply cannot wait for more than ten years.

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The length of the incubation period is related to factors such as the virulence of the virus and the nerve distribution at the site of invasion. The more viruses there are, the stronger the virulence, the richer the nerves at the site of invasion, and the closer to the central nervous system, the shorter the incubation period .

The incubation period of rabies virus is usually 1 to 3 months . In most cases, the time from infection to onset is 20 to 60 days. Very few cases are within a week or more than a year. Studies have shown that the longest incubation period of rabies can be up to 6 years [3].

What is rabies?

Rabies is an acute infectious disease that is transmitted between humans and animals and is caused by the rabies virus[1]. The disease is transmitted from animals to animals or from animals to humans through exposure to saliva or other substances containing the virus. Currently, the disease is preventable but not curable[2]. Once the disease occurs, there is no special treatment and the mortality rate is almost 100% . It seriously threatens the life safety of people injured by animals and social stability.

Almost all warm-blooded animals can be infected with the rabies virus . In Asia and Africa, dogs are the main source of infection, but cats can also transmit rabies[3].

What are the symptoms of rabies?

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The main symptoms of most patients with rabies are: a strange feeling in the wound, mania, fear of wind, water, and light . In the late stage, there will be dilated pupils, paralysis, coma, and death .

Clinically, rabies can manifest as either a manic form (approximately 2/3 of cases) or a paralytic form . Rabies transmitted by dogs generally manifests as a manic form. Manic patients are mostly characterized by confusion, fear convulsions, and autonomic dysfunction (such as dilated pupils and excessive salivation).

According to the course of the disease, the clinical manifestations of rabies can be divided into several stages: incubation period, prodromal period, acute neurological symptom period (excitement period), paralysis period, coma and death . But in fact, the onset of the disease is a continuous clinical process, not a simple series of independently separable manifestations.

The duration from onset of rabies to death usually does not exceed 5 days , and the cause of death is usually suffocation due to pharyngeal muscle spasm or respiratory and circulatory failure[4].

What is the process of rabies virus infection?

The rabies virus usually enters the human body through saliva after an infected animal bites a person. Once in the human body, it will stay in the muscle tissue for a period of time and replicate in small quantities.

It then moves along the nerve endings toward the spinal cord and brain, about a few centimeters a day.

Finally, the virus reaches the brain and replicates in large numbers, directly attacking the body's control center , causing symptoms such as fear of water and wind. At this point, the immune system is too late to provide protection .

Therefore, it usually only takes a few days from the onset of the disease to death.

Can I only be infected by a dog bite? Can I get rabies if I am licked by a pet?

Rabies virus has a wide range of sources. Although the word "dog" is not in its name, other warm-blooded animals such as cats, wolves, and foxes can also spread rabies . In South America, the main way people are infected with rabies is by being bitten by bats .

Different levels of exposure to rabies virus require different prevention strategies. Generally, if you are licked by a pet or touch a pet, and your skin is intact and has not come into contact with your own mucous membranes (such as your mouth), you do not need to treat it. If there are tooth marks or claw marks, but no bleeding, you should immediately treat the wound and get a rabies vaccine.

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Will a rabies patient bite someone? Will the bite transmit rabies?

There is indeed a theoretical risk of contracting rabies through contact with sick people.

Rabies is a disease caused by a viral infection. The virus itself does not cause the patient to bite people . However, during the manic phase of a rabies attack, the patient is more sensitive to some external stimuli, such as seeing or drinking water, and may become mentally ill, and may bite people at this time. If a rabies patient is in the acute phase of the disease, the bite may be contagious .

Is rabies fatal once it strikes?

The World Health Organization reported that rabies is prevalent throughout the world, killing 59,000 people worldwide each year [4], or one person every 10 minutes, with 99% of deaths resulting from infection caused by dog ​​bites.

my country is the second largest country with rabies in the world, with a peak of 3,300 rabies cases in 2007[5], and the epidemic situation is very serious. In addition, 10 million people in Asia and Africa have received rabies vaccinations after being bitten by dogs that may have rabies.

At the initiative of the International Alliance for Rabies Control, the World Health Organization, the World Organization for Animal Health and the US Centers for Disease Control and Prevention jointly launched the establishment of September 28th of each year as World Rabies Day .

Experts suggest that the government should take the lead, with local health departments coordinating with relevant departments such as public security, agriculture, and food and drug administration to raise public awareness of rabies prevention and control knowledge through centralized animal vaccination, popular science lectures, teaching seminars, media publicity, special programs in museums or zoos, academic conferences, and fundraising activities, so as to prevent rabies before it happens. [2]

What is the scientific way to deal with animal bites?

Step 1 : Clean the wound alternately with soapy water (or other weak alkaline detergent) and running water (or saline) for at least 15 minutes.

Step 2 : Go to the designated rabies vaccination clinic in time, conduct a graded diagnosis of the wound, complete the vaccination as soon as possible, and, if necessary, administer passive immunosuppressants (proteins).

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in conclusion

The incubation period of rabies varies in length, generally 1 to 3 months, but can be as short as a few days or as long as more than a year for some individuals. The longest incubation period currently recognized is 6 years. In addition, the mortality rate of rabies is almost 100%. It is recommended that you take preventive measures in your daily life and vaccinate your pet while interacting with it to minimize the risk. If you are bitten by an animal, go to the hospital for vaccination in time.

Author : Wang Fang, Chief Physician of Chaoyang District Center for Disease Control and Prevention, Beijing

Reviewer : Yang Liqing, Chief Physician, Chaoyang District Center for Disease Control and Prevention, Beijing

References :

[1] Li Yanrong, Zhu Liling, Zhu Wuyang, et al. Analysis of epidemiological characteristics of rabies in China in 2016. Chinese Journal of Epidemiology, 2018, 39(1): 40-43. DOI: 10.3760/cma.j.issn.0254-6450.2018.01.008.

[2] From: Vaccines, 6th edition

[3] From: Technical Guidelines for Rabies Prevention and Control (2016)

[4]Hampson K, Coudeville L, Lembo T, et al. Estimating the global burden of endemic canine rabies [J]. PLoS Negl Trop Dis, 2015, 9(4): e0003709. DOI: 10.1371/journal.pntd.0003709.

[5] Yin Wenwu, Wang Chuanlin, Chen Qiulan, et al. Expert consensus on rabies exposure prevention and treatment[J]. Chinese Journal of Preventive Medicine, 2019, 53(7): 668-679. DOI: 10.3760/cma.j.issn． 0253-9624.2019.07.004.

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