What is rabies? When to seek medical care, what to do if you’re concerned about exposure and more to know about the fatal disease

If the idea of rabies conjures up images of the scary, slobbering St. Bernard from Cujo, you're not alone. And with rabies-related stories popping up in the news — like the California teacher who died after a bat flew into her classroom and climate change possibly increasing our rabies risk, for example — you may be wondering just how worried you need to be about this fatal disease. The answer? It depends.

What is rabies?

“Rabies is a disease that mainly manifests as encephalitis, which is infection and inflammation of the brain,” Stanford University professor of medicine and infectious disease expert Dr. Dean Winslow tells Yahoo Life. “It’s caused by what is called a lyssavirus.”

The virus is contracted due to contact with an infected animal, typically via a bite. In the United States, bats are one of the major vectors of rabies, as are raccoons, skunks and foxes. Previously, dogs and cats were spreaders of rabies, however, thanks to successful vaccination campaigns in the U.S., there are low levels of rabies among these populations. On a global scale, however, the World Health Organization reports that dogs are the main source of human rabies deaths, contributing up to 99% of all rabies transmissions to humans.

Rabies is present in humans in two separate stages, Dr. Drake Matuska, family physician at Mayo Clinic Health System in La Crosse, Wis., tells Yahoo Life. “Rabies does have an early-disease stage in which people have a general sense of illness, with fever, chills, muscle weakness, muscle pain, fatigue, poor appetite, nausea and vomiting. This can last for up to one week. This eventually progresses to the full disease of rabies, which includes confusion or altered mental status, paralysis, hallucinations, excessive drooling, difficulty swallowing and eventually death.”

When to seek medical care

Winslow says there can be a “fairly long incubation period” before people who are infected with rabies see symptoms — typically several weeks to three months and, on occasion, up to a year. However, once rabies takes hold, the disease is almost 100% fatal. That’s why it is crucial that people don’t wait to seek medical attention after an interaction with an animal of unknown rabies status — even if you aren’t sure if the animal in question has rabies or not.

“Let’s say you are bitten by a skunk, or a domestic animal where you don't know the vaccination status — you need to immediately get medical attention and receive both a prophylactic medicine called rabies hyperimmune globulin, which is the antibody that can neutralize a rabies virus, along with starting a rabies immunization or vaccination series,” says Winslow.

Matuska adds, “The earlier you get the vaccinations, the less likely you are to pass away from the disease, should you get it.”

It's possible to be unaware that you've bitten by an animal — but if one has potentially been in contact with you, it’s important to get started on the regime, just in case.

For example, Matuska says, “If you have a bat that’s in the same room with you — let’s say, you wake up in the morning, and there’s a bat in the room — you can capture the bat and have it analyzed, because some of the bites can be unapparent. In the United States, the public health departments can really quickly do a histopathology on an animal's brain to determine whether it's infected with rabies or not.”

This rabies intervention is not always 100% successful, and may be less effective in immunocompromised individuals.

What to do if you’re concerned about exposure

Most of us don’t regularly interact with animals that may carry rabies, meaning that while rabies is certainly serious, it’s not exactly something you need to be worried about on a daily basis. People who do have more contact with animals, like veterinarians or animal control workers, can receive a pre-exposure rabies vaccination.

It also may be helpful to get a pre-exposure rabies vaccination if you are traveling somewhere with high levels of rabies in animals you may potentially come into contact with.

“In much of the rest of the world, particularly in low- and middle-income countries, dogs and cats are not vaccinated routinely,” Winslow says. “I recommend that if you’re traveling to a country where you’re going to be potentially exposed, to consider a prophylactic vaccination.”