Children are the victims of about 60% of all dog bites in the United States. Fortunately, a relatively small number of these bites spread the very serious rabies infection. Rabies is a rare disease in the United States, with 1 to 2 deaths reported each year.
Rabies is caused by a virus that is present in animals infected with it. The virus can spread to humans through direct contact with the saliva of an infected animal, usually from bites or scratches. The greatest risk comes from wild animals, especially bats, but also raccoons, skunks, foxes and coyotes. Domestic pets such as dogs and cats are usually immunized against rabies.
Signs & symptoms of rabies
When the rabies virus enters the body, it can move along the nerve pathways to the brain. It causes serious symptoms beginning with pain, tingling, and numbness at the site of the bite or scratch. It can then progress rapidly to other symptoms including:
Anxiety, restlessness and aggressiveness
Swallowing difficulties, particularly water (hydrophobia)
Muscle spasms
Drooling
Seizures
Paralysis
Coma and death
How long does it take to show signs of rabies in people?
The incubation period for rabies in humans may last weeks to months. However, it can be shorter with bites on the face. It can also be much longer in some cases of bites on the feet or legs (extending more than a year sometimes).
What to do if your child is bitten by an animal
If your child has been bitten by an animal, thoroughly flush the wound with water and wash it with soap and water.
If possible, it is important that the animal be captured so a veterinarian can check if it has a rabies infection. Unless proper equipment is available, though, don't attempt to capture a possibly rabid animal. Captured animals are killed and their brains are examined for rabies immediately. Pets who appear well and have been immunized can be watched for symptoms of the disease. This observation period should extend for 10 days. If the animal develops symptoms, it must be killed and the brain examined.
When to call your pediatrician
Any time that your child is bitten by an animal, contact your pediatrician. All animal bites should be reported to health officials who will be able to tell you whether the bite presents a risk of rabies. Any bite by a wild animal should be considered a risk for rabies until proven otherwise.
If the animal is a domestic and healthy pet, your pediatrician may ask that the animal be observed, under the supervision of a veterinarian. The pediatrician will start the shots only if the animal shows signs of rabies.
If a bat is found in a room where your child has been sleeping or playing, report it immediately to your pediatrician, even if you don't find a bite mark. Your child should start preventive treatment for rabies unless the bat can be tested for rabies and is negative.
How is rabies diagnosed?
Your pediatrician will examine your child. If rabies is suspected, several tests will be done on saliva, blood, skin, and spinal fluid to look for evidence of the virus.
Treatment & prognosis for rabies
There is no specific treatment for rabies once the infection develops in a child. Rabies infection is nearly always fatal once symptoms start; there have been very few survivors. Death is usually caused by respiratory or heart failure within days after the appearance of symptoms.
However, prompt and proper treatment of bites can prevent or control the infection before it involves the brain and produces serious symptoms. Therefore, prevention is extremely important.
How to prevent rabies infection
Rabies vaccine
Following a bite, if your pediatrician determines that the animal has a high risk of having rabies and is not available to be tested or observed, they will immunize your child right away with rabies immune globulin and the first of 4 doses of rabies vaccine. The rabies immune globulin, disease-battling antibodies, is injected into the skin around the bite. The rabies vaccine will be injected into the arm or thigh, depending on the age of your child.
Once your child receives the vaccine, it will stimulate their body to make its own antibodies against rabies infection. Your child will be given 3 more doses of rabies vaccine on days 3, 7 and 14 after the bite.
What else can families do to protect against rabies?
Stray or wild animals
Teach your child to avoid contact with any stray or wild animals. Your child should not tease or bother an animal. Also, they should not examine or play with a dead animal that they may find.
You can reduce the presence of wild animals in the area of your home by tightly closing garbage can lids. Chimney covers can prevent bats from getting into the home.
Pets
Make sure your own family pet receives animal rabies shots according to your veterinarian's recommendations.
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