Materiały źródłowe

• #1

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Once the virus infects the central nervous system and clinical symptoms appear, rabies is fatal in 100% of cases. […] Rabies spreads to people and animals via saliva, usually through bites, scratches, or direct contact with mucosa (e.g. eyes, mouth, or open wounds). Once clinical symptoms appear, rabies is virtually 100% fatal. […] The incubation period for rabies is typically 2 to 3 months but may vary from one week to one year, depending on factors such as the location of virus entry and the viral load. Initial symptoms of rabies include generic signs like fever, pain and unusual or unexplained tingling, pricking, or burning sensations at the wound site. As the virus moves to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops. Clinical rabies in people can be managed but very rarely cured, and not without severe neurological deficits.

• #2 Rabies – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448076/

  Rabies virus infection often begins with symptoms similar to a febrile viral illness and vague neurological signs. Once symptoms manifest, the infection has an almost 100% fatality rate. In all but the rarest of cases, clinicians can only provide palliative care to minimize the patient’s pain and suffering before death. […] Following an incubation period ranging from a few days to a few years, rabies presents with a vague, febrile illness, frequently with pain and paresthesias at the wound site. Within 2 weeks, the neurological phase typically progresses into encephalitic or paralytic rabies, followed by coma. Death typically occurs within 2 to 3 days of coma onset. Once symptoms begin, treatment typically focuses on minimizing the patient’s pain and suffering. […] Nonspecific viral symptoms such as fever, malaise, myalgias, gastrointestinal symptoms, and headache, which are difficult to distinguish from other common viral illnesses, characterize the initial prodromal phase of rabies. Within 2 weeks, the neurological phase begins with anxiety, agitation, and delirium. Approximately 80% of patients develop encephalitis or furious rabies, with severe pharyngeal muscle spasms stimulated by the sight, sounds, or thought of water resulting in hydrophobia or aerophobia, hyperactivity, and spasms progressing to paralysis. The remaining 20% develop paralytic rabies, with ascending, progressive paralysis initially affecting the exposed limb. The coma stage of rabies typically begins within 10 days of the onset of neurological symptoms. Patients may have ongoing hydrophobia, prolonged apneic periods, and flaccid paralysis. Most patients die within 2 to 3 days of coma onset.

• #3

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Once the virus infects the central nervous system and clinical symptoms appear, rabies is fatal in 100% of cases. […] Rabies spreads to people and animals via saliva, usually through bites, scratches, or direct contact with mucosa (e.g. eyes, mouth, or open wounds). Once clinical symptoms appear, rabies is virtually 100% fatal. […] The incubation period for rabies is typically 2 to 3 months but may vary from one week to one year, depending on factors such as the location of virus entry and the viral load. Initial symptoms of rabies include generic signs like fever, pain and unusual or unexplained tingling, pricking, or burning sensations at the wound site. As the virus moves to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops. Clinical rabies in people can be managed but very rarely cured, and not without severe neurological deficits.

• #4 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The rabies virus is segregated from the immune system during the incubation period, and no antibody response is observed. The infected individual remains asymptomatic during this period. The average duration of incubation is 20-90 days. In more than 90% of cases, incubation is less than 1 year. A person whose inoculum occurs with a scratch on the hand may take longer to develop symptoms of rabies than a person who receives a bite to the head. The incubation period is less than 50 days if the patient is bitten on the head or neck or if a heavy inoculum is transferred through multiple bites, deep wounds, or large wounds. Infected patients may not recall exposure because of the prolonged incubation period. […] The virus enters the CNS. The duration of this period is 2-10 days. Nonspecific symptoms and signs develop, including fevers and flulike illness. Paresthesia, pain, or intense itching at the inoculation site is pathognomonic for rabies and occurs in 30% of canine-associated rabies cases and 70% of bat-associated rabies cases during this phase; this may be the individuals only presenting sign. Symptoms may include the following: Malaise, Anorexia, Headaches, Fever, Chills, Pharyngitis, Nausea, Emesis, Diarrhea, Anxiety, Agitation, Insomnia, Depression.

• #5 Clinical manifestations and diagnosis of rabies – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-rabies

  Rabies has the highest case fatality rate of any human infectious disease. […] The epidemiology, clinical manifestations, and diagnosis of rabies will be reviewed here. […] Viral tropism and dissemination — Lyssaviruses have a predilection for neural tissue and spread via peripheral nerves to the central nervous system (CNS). […] The mechanism by which rabies causes severe CNS disease is unclear. […] Rabies viruses then ascend rapidly up the spinal cord to the brain, initially infecting the diencephalon, hippocampus, and brainstem.

• #6 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  Rabies is a viral disease that causes encephalitis in humans and other mammals. Early symptoms can include fever and abnormal sensations at the site of exposure. These symptoms are followed by one or more of the following symptoms: nausea, vomiting, violent movements, uncontrolled excitement, fear of water, an inability to move parts of the body, confusion, and loss of consciousness. Once symptoms appear, the result is virtually always death. The time period between contracting the disease and the start of symptoms is usually one to three months but can vary from less than one week to more than one year. The time depends on the distance the virus must travel along peripheral nerves to reach the central nervous system. […] The period between infection and the first symptoms (incubation period) is typically one to three months in humans. This period may be as short as four days or longer than six years, depending on the location and severity of the wound and the amount of virus introduced. Initial symptoms of rabies are often nonspecific, such as fever and headache. As rabies progresses and causes inflammation of the brain and meninges, symptoms can include slight or partial paralysis, anxiety, insomnia, confusion, agitation, abnormal behavior, paranoia, terror, and hallucinations. The person may also have fear of water.

• #7 Rabies Symptoms and Specimen Collection | Rabies | CDC

  https://www.cdc.gov/rabies/hcp/suspected-human-rabies/index.html

  Rabies is a severe, acute disease that typically leads to death within four weeks of symptom onset. […] After a rabies exposure, the rabies virus must travel to the brain before it can cause symptoms. This time between exposure and the appearance of symptoms is the incubation period. It may last for weeks to months. […] The first symptoms of rabies, called prodrome, may be like the flu, including weakness, discomfort, fever, or headache. There also may be discomfort, prickling, or an itching sensation at the site of the bite. These symptoms may last for several days. […] Usually, severe disease appears within two weeks of the first symptoms, when the rabies virus causes brain dysfunction. Rabies symptoms in humans may include one or more of the following: Anxiety, Insomnia, Confusion, Agitation, Delirium, Hallucinations, Hydrophobia (fear of water), Hypersalivation, Seizures.

• #8 Rabies – Brain, Spinal Cord, and Nerve Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/brain-spinal-cord-and-nerve-disorders/brain-infections/rabies

  Rabies symptoms appear when the rabies virus reaches the brain or spinal cord, usually 30 to 50 days after a person is bitten. However, this interval can vary from 10 days to more than a year. The closer the bite to the brain (for example, on the face), the more quickly symptoms appear. […] Rabies may begin with a fever, headache, and a general feeling of illness (malaise). Most people become restless, confused, and uncontrollably excited. Their behavior may be bizarre. They may hallucinate and have insomnia. Saliva production greatly increases. Spasms of the muscles in the throat and larynx occur because rabies affects the area in the brain that controls swallowing, speaking, and breathing. The spasms can be excruciatingly painful. A slight breeze or an attempt to drink water can trigger the spasms. Thus, people with rabies cannot drink. For this reason, the disease is sometimes called hydrophobia (fear of water).

• #9 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The rabies virus is segregated from the immune system during the incubation period, and no antibody response is observed. The infected individual remains asymptomatic during this period. The average duration of incubation is 20-90 days. In more than 90% of cases, incubation is less than 1 year. A person whose inoculum occurs with a scratch on the hand may take longer to develop symptoms of rabies than a person who receives a bite to the head. The incubation period is less than 50 days if the patient is bitten on the head or neck or if a heavy inoculum is transferred through multiple bites, deep wounds, or large wounds. Infected patients may not recall exposure because of the prolonged incubation period. […] The virus enters the CNS. The duration of this period is 2-10 days. Nonspecific symptoms and signs develop, including fevers and flulike illness. Paresthesia, pain, or intense itching at the inoculation site is pathognomonic for rabies and occurs in 30% of canine-associated rabies cases and 70% of bat-associated rabies cases during this phase; this may be the individuals only presenting sign. Symptoms may include the following: Malaise, Anorexia, Headaches, Fever, Chills, Pharyngitis, Nausea, Emesis, Diarrhea, Anxiety, Agitation, Insomnia, Depression.

• #10 Signs of rabies | Rabies – Bulletin – Europe

  https://www.who-rabies-bulletin.org/site-page/signs-rabies

  The incubation period (the time the virus spreads from the peripheral nerves near the site of the bite via the spinal cord to the brain see transmission and pathogenesis) ranges in general between 2 and 3 month (2 weeks to 6 years are reported) depending on the site of infliction, the amount of virus and the virus strain. Due to its neurotropism all known lyssaviruses cause severe neurological symptoms as a result of an acute encephalitis. Therefore, clinical signs in humans and animals are very similar. […] The infection progresses in a predictable manner, from the initial prodormal phase to the manifest as furious or paralytic forms of rabies; the outcome is almost always fatal. […] After (bite) exposure with a rabid animal, initial symptoms of rabies are of non-specific nature and may be very similar to those of other infectious diseases including general weakness or discomfort, fever, or headache. A first specific clinical sign is neuropathic pain or a prickling or itching sensation at the site of the bite. Signs rapidly progress and include cerebral dysfunction, anxiety, confusion, agitation, delirium, abnormal behavior, hallucinations, and insomnia. Once clinical signs of rabies appear, without intensive care, death occurs within 2 weeks after onset of symptoms. There is no treatment available.

• #11

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Once the virus infects the central nervous system and clinical symptoms appear, rabies is fatal in 100% of cases. […] Rabies spreads to people and animals via saliva, usually through bites, scratches, or direct contact with mucosa (e.g. eyes, mouth, or open wounds). Once clinical symptoms appear, rabies is virtually 100% fatal. […] The incubation period for rabies is typically 2 to 3 months but may vary from one week to one year, depending on factors such as the location of virus entry and the viral load. Initial symptoms of rabies include generic signs like fever, pain and unusual or unexplained tingling, pricking, or burning sensations at the wound site. As the virus moves to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops. Clinical rabies in people can be managed but very rarely cured, and not without severe neurological deficits.

• #12 Rabies Symptoms and Specimen Collection | Rabies | CDC

  https://www.cdc.gov/rabies/hcp/suspected-human-rabies/index.html

  Rabies is a severe, acute disease that typically leads to death within four weeks of symptom onset. […] After a rabies exposure, the rabies virus must travel to the brain before it can cause symptoms. This time between exposure and the appearance of symptoms is the incubation period. It may last for weeks to months. […] The first symptoms of rabies, called prodrome, may be like the flu, including weakness, discomfort, fever, or headache. There also may be discomfort, prickling, or an itching sensation at the site of the bite. These symptoms may last for several days. […] Usually, severe disease appears within two weeks of the first symptoms, when the rabies virus causes brain dysfunction. Rabies symptoms in humans may include one or more of the following: Anxiety, Insomnia, Confusion, Agitation, Delirium, Hallucinations, Hydrophobia (fear of water), Hypersalivation, Seizures.

• #13 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  Rabies virus causes acute infection of the central nervous system. Five general stages are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death. The incubation period is exceptionally variable, ranging from fewer than 10 days to longer than 2 years, but is usually 13 months. […] Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery). The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness). More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paresthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies.

• #14 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The rabies virus is segregated from the immune system during the incubation period, and no antibody response is observed. The infected individual remains asymptomatic during this period. The average duration of incubation is 20-90 days. In more than 90% of cases, incubation is less than 1 year. A person whose inoculum occurs with a scratch on the hand may take longer to develop symptoms of rabies than a person who receives a bite to the head. The incubation period is less than 50 days if the patient is bitten on the head or neck or if a heavy inoculum is transferred through multiple bites, deep wounds, or large wounds. Infected patients may not recall exposure because of the prolonged incubation period. […] The virus enters the CNS. The duration of this period is 2-10 days. Nonspecific symptoms and signs develop, including fevers and flulike illness. Paresthesia, pain, or intense itching at the inoculation site is pathognomonic for rabies and occurs in 30% of canine-associated rabies cases and 70% of bat-associated rabies cases during this phase; this may be the individuals only presenting sign. Symptoms may include the following: Malaise, Anorexia, Headaches, Fever, Chills, Pharyngitis, Nausea, Emesis, Diarrhea, Anxiety, Agitation, Insomnia, Depression.

• #15 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  Rabies virus causes acute infection of the central nervous system. Five general stages are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death. The incubation period is exceptionally variable, ranging from fewer than 10 days to longer than 2 years, but is usually 13 months. […] Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery). The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness). More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paresthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies.

• #16 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  Rabies is a viral disease that causes encephalitis in humans and other mammals. Early symptoms can include fever and abnormal sensations at the site of exposure. These symptoms are followed by one or more of the following symptoms: nausea, vomiting, violent movements, uncontrolled excitement, fear of water, an inability to move parts of the body, confusion, and loss of consciousness. Once symptoms appear, the result is virtually always death. The time period between contracting the disease and the start of symptoms is usually one to three months but can vary from less than one week to more than one year. The time depends on the distance the virus must travel along peripheral nerves to reach the central nervous system. […] The period between infection and the first symptoms (incubation period) is typically one to three months in humans. This period may be as short as four days or longer than six years, depending on the location and severity of the wound and the amount of virus introduced. Initial symptoms of rabies are often nonspecific, such as fever and headache. As rabies progresses and causes inflammation of the brain and meninges, symptoms can include slight or partial paralysis, anxiety, insomnia, confusion, agitation, abnormal behavior, paranoia, terror, and hallucinations. The person may also have fear of water.

• #17 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  Rabies virus causes acute infection of the central nervous system. Five general stages are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death. The incubation period is exceptionally variable, ranging from fewer than 10 days to longer than 2 years, but is usually 13 months. […] Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery). The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness). More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paresthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies.

• #18

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #19 Rabies Symptoms and Stages of Infection

  https://www.verywellhealth.com/rabies-symptoms-1298793

  Once the symptoms of rabies begin to appear in a person who has been exposed to the virus, the infection is almost always fatal, with death occurring as few as four days later. […] Despite being rare in the U.S., rabies remains a frightening prospect: Once symptoms start to appear, death often occurs within three to 10 days. […] Early rabies symptoms may only include mild fever and headache. As it progresses, severe symptoms like confusion, excessive salivation, seizures, paralysis, delirium, and coma occur. Once this happens, death is almost inevitable. […] The prodromal phase usually lasts up to 10 days and may cause such symptoms as fever, itching (pruritus), tingling or burning sensation at the site of the exposure (known as paresthesia), fatigue, headache, anxiety, irritability, chills, insomnia, a general feeling of unwellness (malaise), loss of appetite (anorexia), and a sore, swollen throat (pharyngitis).

• #20 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  Rabies virus causes acute infection of the central nervous system. Five general stages are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death. The incubation period is exceptionally variable, ranging from fewer than 10 days to longer than 2 years, but is usually 13 months. […] Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery). The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness). More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paresthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies.

• #21 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #22 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #23

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #24 Rabies Symptoms and Stages of Infection

  https://www.verywellhealth.com/rabies-symptoms-1298793

  Once the symptoms of rabies begin to appear in a person who has been exposed to the virus, the infection is almost always fatal, with death occurring as few as four days later. […] Despite being rare in the U.S., rabies remains a frightening prospect: Once symptoms start to appear, death often occurs within three to 10 days. […] Early rabies symptoms may only include mild fever and headache. As it progresses, severe symptoms like confusion, excessive salivation, seizures, paralysis, delirium, and coma occur. Once this happens, death is almost inevitable. […] The prodromal phase usually lasts up to 10 days and may cause such symptoms as fever, itching (pruritus), tingling or burning sensation at the site of the exposure (known as paresthesia), fatigue, headache, anxiety, irritability, chills, insomnia, a general feeling of unwellness (malaise), loss of appetite (anorexia), and a sore, swollen throat (pharyngitis).

• #25 Rabies Symptoms and Stages of Infection

  https://www.verywellhealth.com/rabies-symptoms-1298793

  Once the symptoms of rabies begin to appear in a person who has been exposed to the virus, the infection is almost always fatal, with death occurring as few as four days later. […] Despite being rare in the U.S., rabies remains a frightening prospect: Once symptoms start to appear, death often occurs within three to 10 days. […] Early rabies symptoms may only include mild fever and headache. As it progresses, severe symptoms like confusion, excessive salivation, seizures, paralysis, delirium, and coma occur. Once this happens, death is almost inevitable. […] The prodromal phase usually lasts up to 10 days and may cause such symptoms as fever, itching (pruritus), tingling or burning sensation at the site of the exposure (known as paresthesia), fatigue, headache, anxiety, irritability, chills, insomnia, a general feeling of unwellness (malaise), loss of appetite (anorexia), and a sore, swollen throat (pharyngitis).

• #26 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  Rabies virus causes acute infection of the central nervous system. Five general stages are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death. The incubation period is exceptionally variable, ranging from fewer than 10 days to longer than 2 years, but is usually 13 months. […] Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery). The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness). More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paresthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies.

• #27 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  Rabies virus causes acute infection of the central nervous system. Five general stages are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death. The incubation period is exceptionally variable, ranging from fewer than 10 days to longer than 2 years, but is usually 13 months. […] Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery). The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness). More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paresthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies.

• #28 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  Rabies virus causes acute infection of the central nervous system. Five general stages are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death. The incubation period is exceptionally variable, ranging from fewer than 10 days to longer than 2 years, but is usually 13 months. […] Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery). The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness). More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paresthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies.

• #29

  http://web.stanford.edu/group/virus/rhabdo/2004bischoffchang/Rabies%20Profile.htm

  The incubation period for rabies virus is usually 1 to 2 months, but it can vary from a few days to a few years. […] Rabies infection follows a centripetal course from site of bite, where the virus initially replicates. An immune response comes only after replication and dissemination. […] There are three phases of clinical rabies: 1: prodromal period- 2-10 days, mild and nonspecific symptoms: general malaise, chills, fever, headache, photophobia, anorexia, nausea, vomiting, diarrhea, sore throat, cough, and musculoskeletal pain. Patient may also have abnormal sensation around the bite site such as itching, burning, numbness, or paresthesia. […] 2: acute neurologic phase: nervous system dysfunction: anxiety, agitation, dysphagia, hypersalivation, paralysis, and episodes of delirium; priapism and increased libido may occur.

• #30 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The rabies virus is segregated from the immune system during the incubation period, and no antibody response is observed. The infected individual remains asymptomatic during this period. The average duration of incubation is 20-90 days. In more than 90% of cases, incubation is less than 1 year. A person whose inoculum occurs with a scratch on the hand may take longer to develop symptoms of rabies than a person who receives a bite to the head. The incubation period is less than 50 days if the patient is bitten on the head or neck or if a heavy inoculum is transferred through multiple bites, deep wounds, or large wounds. Infected patients may not recall exposure because of the prolonged incubation period. […] The virus enters the CNS. The duration of this period is 2-10 days. Nonspecific symptoms and signs develop, including fevers and flulike illness. Paresthesia, pain, or intense itching at the inoculation site is pathognomonic for rabies and occurs in 30% of canine-associated rabies cases and 70% of bat-associated rabies cases during this phase; this may be the individuals only presenting sign. Symptoms may include the following: Malaise, Anorexia, Headaches, Fever, Chills, Pharyngitis, Nausea, Emesis, Diarrhea, Anxiety, Agitation, Insomnia, Depression.

• #31

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #32 Rabies Symptoms and Specimen Collection | Rabies | CDC

  https://www.cdc.gov/rabies/hcp/suspected-human-rabies/index.html

  Rabies is a severe, acute disease that typically leads to death within four weeks of symptom onset. […] After a rabies exposure, the rabies virus must travel to the brain before it can cause symptoms. This time between exposure and the appearance of symptoms is the incubation period. It may last for weeks to months. […] The first symptoms of rabies, called prodrome, may be like the flu, including weakness, discomfort, fever, or headache. There also may be discomfort, prickling, or an itching sensation at the site of the bite. These symptoms may last for several days. […] Usually, severe disease appears within two weeks of the first symptoms, when the rabies virus causes brain dysfunction. Rabies symptoms in humans may include one or more of the following: Anxiety, Insomnia, Confusion, Agitation, Delirium, Hallucinations, Hydrophobia (fear of water), Hypersalivation, Seizures.

• #33 Rabies Symptoms and Stages of Infection

  https://www.verywellhealth.com/rabies-symptoms-1298793

  Once the symptoms of rabies begin to appear in a person who has been exposed to the virus, the infection is almost always fatal, with death occurring as few as four days later. […] Despite being rare in the U.S., rabies remains a frightening prospect: Once symptoms start to appear, death often occurs within three to 10 days. […] Early rabies symptoms may only include mild fever and headache. As it progresses, severe symptoms like confusion, excessive salivation, seizures, paralysis, delirium, and coma occur. Once this happens, death is almost inevitable. […] The prodromal phase usually lasts up to 10 days and may cause such symptoms as fever, itching (pruritus), tingling or burning sensation at the site of the exposure (known as paresthesia), fatigue, headache, anxiety, irritability, chills, insomnia, a general feeling of unwellness (malaise), loss of appetite (anorexia), and a sore, swollen throat (pharyngitis).

• #34

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #35

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #36

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #37 Rabies Symptoms and Stages of Infection

  https://www.verywellhealth.com/rabies-symptoms-1298793

  Once the symptoms of rabies begin to appear in a person who has been exposed to the virus, the infection is almost always fatal, with death occurring as few as four days later. […] Despite being rare in the U.S., rabies remains a frightening prospect: Once symptoms start to appear, death often occurs within three to 10 days. […] Early rabies symptoms may only include mild fever and headache. As it progresses, severe symptoms like confusion, excessive salivation, seizures, paralysis, delirium, and coma occur. Once this happens, death is almost inevitable. […] The prodromal phase usually lasts up to 10 days and may cause such symptoms as fever, itching (pruritus), tingling or burning sensation at the site of the exposure (known as paresthesia), fatigue, headache, anxiety, irritability, chills, insomnia, a general feeling of unwellness (malaise), loss of appetite (anorexia), and a sore, swollen throat (pharyngitis).

• #38

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #39

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #40

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #41 Rabies | Yellow Book | CDC

  https://www.cdc.gov/yellow-book/hcp/travel-associated-infections-diseases/rabies.html

  Rabies is a fatal, acute, progressive encephalomyelitis caused by neurotropic viruses in the family Rhabdoviridae, genus Lyssavirus. […] After viral invasion of the PNS and then CNS, clinical illness in humans culminates in an acute, fatal encephalitis. After infection, the asymptomatic incubation period is variable, but signs and symptoms most commonly develop within several weeks to months after exposure. […] Pain and paresthesia at the site of exposure are often the first symptoms of disease. The disease then progresses rapidly from a prodromal phase (fever and non-specific symptoms) to a neurologic phase characterized by anxiety, paralysis, paresis, and other signs of encephalitis. […] Most rabies cases detected by healthcare systems are in people with classic encephalitic disease in which fever, hydrophobia, hyperactivity, or spasms eventually progress to paralysis and coma; this progression corresponds to „furious” rabies in animals. […] Once clinical signs appear, patients die quickly in the absence of intensive supportive care.

• #42 Rabies – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448076/

  Rabies virus infection often begins with symptoms similar to a febrile viral illness and vague neurological signs. Once symptoms manifest, the infection has an almost 100% fatality rate. In all but the rarest of cases, clinicians can only provide palliative care to minimize the patient’s pain and suffering before death. […] Following an incubation period ranging from a few days to a few years, rabies presents with a vague, febrile illness, frequently with pain and paresthesias at the wound site. Within 2 weeks, the neurological phase typically progresses into encephalitic or paralytic rabies, followed by coma. Death typically occurs within 2 to 3 days of coma onset. Once symptoms begin, treatment typically focuses on minimizing the patient’s pain and suffering. […] Nonspecific viral symptoms such as fever, malaise, myalgias, gastrointestinal symptoms, and headache, which are difficult to distinguish from other common viral illnesses, characterize the initial prodromal phase of rabies. Within 2 weeks, the neurological phase begins with anxiety, agitation, and delirium. Approximately 80% of patients develop encephalitis or furious rabies, with severe pharyngeal muscle spasms stimulated by the sight, sounds, or thought of water resulting in hydrophobia or aerophobia, hyperactivity, and spasms progressing to paralysis. The remaining 20% develop paralytic rabies, with ascending, progressive paralysis initially affecting the exposed limb. The coma stage of rabies typically begins within 10 days of the onset of neurological symptoms. Patients may have ongoing hydrophobia, prolonged apneic periods, and flaccid paralysis. Most patients die within 2 to 3 days of coma onset.

• #43 Rabies – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448076/

  Rabies virus infection often begins with symptoms similar to a febrile viral illness and vague neurological signs. Once symptoms manifest, the infection has an almost 100% fatality rate. In all but the rarest of cases, clinicians can only provide palliative care to minimize the patient’s pain and suffering before death. […] Following an incubation period ranging from a few days to a few years, rabies presents with a vague, febrile illness, frequently with pain and paresthesias at the wound site. Within 2 weeks, the neurological phase typically progresses into encephalitic or paralytic rabies, followed by coma. Death typically occurs within 2 to 3 days of coma onset. Once symptoms begin, treatment typically focuses on minimizing the patient’s pain and suffering. […] Nonspecific viral symptoms such as fever, malaise, myalgias, gastrointestinal symptoms, and headache, which are difficult to distinguish from other common viral illnesses, characterize the initial prodromal phase of rabies. Within 2 weeks, the neurological phase begins with anxiety, agitation, and delirium. Approximately 80% of patients develop encephalitis or furious rabies, with severe pharyngeal muscle spasms stimulated by the sight, sounds, or thought of water resulting in hydrophobia or aerophobia, hyperactivity, and spasms progressing to paralysis. The remaining 20% develop paralytic rabies, with ascending, progressive paralysis initially affecting the exposed limb. The coma stage of rabies typically begins within 10 days of the onset of neurological symptoms. Patients may have ongoing hydrophobia, prolonged apneic periods, and flaccid paralysis. Most patients die within 2 to 3 days of coma onset.

• #44 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  This period is associated with objective signs of developing CNS disease; however, consciousness remains unaffected until the onset of coma. The duration is 2-7 days. Symptoms include muscle fasciculations, priapism, and focal or generalized convulsions. Patients may die immediately or may progress to paralysis, which may be present only in the bitten limb at first but usually becomes diffuse. […] Two thirds of human rabies cases acquired from dogs manifest as „furious rabies.” Patients develop agitation, hyperactivity, restlessness, thrashing, biting, confusion, or hallucinations. After several hours to days, this becomes episodic and interspersed with calm, cooperative, lucid periods. Furious episodes last less than 5 minutes. Episodes may be triggered by visual, auditory, or tactile stimuli or may be spontaneous. Seizures may occur. This phase may end in cardiorespiratory arrest or may progress to paralysis.

• #45 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #46 Rabies: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13848-rabies

  In this phase, the rabies virus starts damaging your brain and spinal cord. About two-thirds of people have furious rabies, with symptoms like aggression, seizures and delirium. Others have paralytic rabies, with weakness and paralysis progressing from the bite wound to the rest of their body. […] Many people enter a coma in the final stages of a rabies infection. Rabies eventually leads to death. […] You usually have no symptoms of rabies for several weeks after it enters your body. When rabies makes it to your central nervous system (prodromal phase), you experience flu-like symptoms. In the final stages, you have neurological (brain) symptoms. […] Neurological symptoms of rabies are either furious or paralytic. […] Furious rabies symptoms may come and go with periods of calm in between (furious episodes).

• #47 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #48 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #49 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #50 Rabies: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13848-rabies

  In this phase, the rabies virus starts damaging your brain and spinal cord. About two-thirds of people have furious rabies, with symptoms like aggression, seizures and delirium. Others have paralytic rabies, with weakness and paralysis progressing from the bite wound to the rest of their body. […] Many people enter a coma in the final stages of a rabies infection. Rabies eventually leads to death. […] You usually have no symptoms of rabies for several weeks after it enters your body. When rabies makes it to your central nervous system (prodromal phase), you experience flu-like symptoms. In the final stages, you have neurological (brain) symptoms. […] Neurological symptoms of rabies are either furious or paralytic. […] Furious rabies symptoms may come and go with periods of calm in between (furious episodes).

• #51 Rabies: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13848-rabies

  In this phase, the rabies virus starts damaging your brain and spinal cord. About two-thirds of people have furious rabies, with symptoms like aggression, seizures and delirium. Others have paralytic rabies, with weakness and paralysis progressing from the bite wound to the rest of their body. […] Many people enter a coma in the final stages of a rabies infection. Rabies eventually leads to death. […] You usually have no symptoms of rabies for several weeks after it enters your body. When rabies makes it to your central nervous system (prodromal phase), you experience flu-like symptoms. In the final stages, you have neurological (brain) symptoms. […] Neurological symptoms of rabies are either furious or paralytic. […] Furious rabies symptoms may come and go with periods of calm in between (furious episodes).

• #52 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The remaining one third of patients with rabies develop paralytic rabies, also known as dumb rabies or apathetic rabies, because the patient is relatively quiet compared with a person with the furious form. Paralysis occurs from the outset, and fever and headache are prominent. Paralytic rabies may initially mimic Guillain-Barr syndrome (GBS) with ascending lowermotor-neuron weakness unpreceded by classic „mad” signs, and rabies should be considered in the differential diagnosis of GBS. […] This begins within 10 days of onset, and the duration varies. Without intensive supportive care, respiratory depression, arrest, and death occur shortly after coma. […] With furious rabies, patients present with episodic delirium, psychosis, restlessness, thrashing, muscular fasciculations, seizures, and aphasia. Hydrophobia and aerophobia are pathognomonic for rabies and occur in 50% of patients. Attempting to drink or having air blown in the face produces severe laryngeal or diaphragmatic spasms and a sensation of asphyxia. This may be related to a violent response of the airway irritant mechanisms. Even the suggestion of drinking may induce hydrophobic spasm.

• #53 Rabies – Brain, Spinal Cord, and Nerve Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/brain-spinal-cord-and-nerve-disorders/brain-infections/rabies

  Rabies symptoms appear when the rabies virus reaches the brain or spinal cord, usually 30 to 50 days after a person is bitten. However, this interval can vary from 10 days to more than a year. The closer the bite to the brain (for example, on the face), the more quickly symptoms appear. […] Rabies may begin with a fever, headache, and a general feeling of illness (malaise). Most people become restless, confused, and uncontrollably excited. Their behavior may be bizarre. They may hallucinate and have insomnia. Saliva production greatly increases. Spasms of the muscles in the throat and larynx occur because rabies affects the area in the brain that controls swallowing, speaking, and breathing. The spasms can be excruciatingly painful. A slight breeze or an attempt to drink water can trigger the spasms. Thus, people with rabies cannot drink. For this reason, the disease is sometimes called hydrophobia (fear of water).

• #54 Rabies: Symptoms, causes, vaccine, treatment, and prevention

  https://www.medicalnewstoday.com/articles/181980

  A person may enter a coma, and most people then die within 2 to 3 days. During the coma stage, even with supportive therapy, virtually no person survives rabies. […] People used to call rabies hydrophobia because it appears to cause a fear of water. The reason is that the infection causes intense spasms in the throat when a person tries to swallow. Even the thought of swallowing water can cause spasms, making it appear that the individual is afraid of water. […] Rabies is a deadly virus that infected animals spread through their saliva. It causes flu-like symptoms initially, which progress into a fever, muscle spasms, coma, and, eventually, death. […] Although there is no effective treatment once symptoms appear, rabies vaccines are usually successful in preventing infections. However, people must seek treatment immediately and not wait for any symptoms.

• #55

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Furious rabies results in hyperactivity, excitable behaviour, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest. […] Paralytic rabies accounts for about 20% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. Muscles gradually become paralysed, starting from the wound site. A coma slowly develops and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

• #56 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  The symptoms eventually progress to delirium and coma. Death usually occurs two to ten days after first symptoms. Survival is almost unknown once symptoms have presented, even with intensive care. […] Rabies has also occasionally been referred to as hydrophobia („fear of water”) throughout its history. It refers to a set of symptoms in the later stages of an infection in which the person has difficulty swallowing, shows panic when presented with liquids to drink, and cannot quench their thirst. Saliva production is greatly increased, and attempts to drink, or even the intention or suggestion of drinking, may cause excruciatingly painful spasms of the muscles in the throat and larynx. […] Hydrophobia is commonly associated with furious rabies, which affects 80% of rabies-infected people. This form of rabies causes irrational aggression in the host, which aids in the spreading of the virus through animal bites; a „foaming at the mouth” effect, caused by the accumulation of saliva, is also commonly associated with rabies in the public perception and in popular culture. The remaining 20% may experience a paralytic form of rabies that is marked by muscle weakness, loss of sensation, and paralysis; this form of rabies does not usually cause fear of water.

• #57 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  This period is associated with objective signs of developing CNS disease; however, consciousness remains unaffected until the onset of coma. The duration is 2-7 days. Symptoms include muscle fasciculations, priapism, and focal or generalized convulsions. Patients may die immediately or may progress to paralysis, which may be present only in the bitten limb at first but usually becomes diffuse. […] Two thirds of human rabies cases acquired from dogs manifest as „furious rabies.” Patients develop agitation, hyperactivity, restlessness, thrashing, biting, confusion, or hallucinations. After several hours to days, this becomes episodic and interspersed with calm, cooperative, lucid periods. Furious episodes last less than 5 minutes. Episodes may be triggered by visual, auditory, or tactile stimuli or may be spontaneous. Seizures may occur. This phase may end in cardiorespiratory arrest or may progress to paralysis.

• #58 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  The symptoms eventually progress to delirium and coma. Death usually occurs two to ten days after first symptoms. Survival is almost unknown once symptoms have presented, even with intensive care. […] Rabies has also occasionally been referred to as hydrophobia („fear of water”) throughout its history. It refers to a set of symptoms in the later stages of an infection in which the person has difficulty swallowing, shows panic when presented with liquids to drink, and cannot quench their thirst. Saliva production is greatly increased, and attempts to drink, or even the intention or suggestion of drinking, may cause excruciatingly painful spasms of the muscles in the throat and larynx. […] Hydrophobia is commonly associated with furious rabies, which affects 80% of rabies-infected people. This form of rabies causes irrational aggression in the host, which aids in the spreading of the virus through animal bites; a „foaming at the mouth” effect, caused by the accumulation of saliva, is also commonly associated with rabies in the public perception and in popular culture. The remaining 20% may experience a paralytic form of rabies that is marked by muscle weakness, loss of sensation, and paralysis; this form of rabies does not usually cause fear of water.

• #59 Rabies – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448076/

  Rabies virus infection often begins with symptoms similar to a febrile viral illness and vague neurological signs. Once symptoms manifest, the infection has an almost 100% fatality rate. In all but the rarest of cases, clinicians can only provide palliative care to minimize the patient’s pain and suffering before death. […] Following an incubation period ranging from a few days to a few years, rabies presents with a vague, febrile illness, frequently with pain and paresthesias at the wound site. Within 2 weeks, the neurological phase typically progresses into encephalitic or paralytic rabies, followed by coma. Death typically occurs within 2 to 3 days of coma onset. Once symptoms begin, treatment typically focuses on minimizing the patient’s pain and suffering. […] Nonspecific viral symptoms such as fever, malaise, myalgias, gastrointestinal symptoms, and headache, which are difficult to distinguish from other common viral illnesses, characterize the initial prodromal phase of rabies. Within 2 weeks, the neurological phase begins with anxiety, agitation, and delirium. Approximately 80% of patients develop encephalitis or furious rabies, with severe pharyngeal muscle spasms stimulated by the sight, sounds, or thought of water resulting in hydrophobia or aerophobia, hyperactivity, and spasms progressing to paralysis. The remaining 20% develop paralytic rabies, with ascending, progressive paralysis initially affecting the exposed limb. The coma stage of rabies typically begins within 10 days of the onset of neurological symptoms. Patients may have ongoing hydrophobia, prolonged apneic periods, and flaccid paralysis. Most patients die within 2 to 3 days of coma onset.

• #60 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #61 Rabies: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13848-rabies

  In this phase, the rabies virus starts damaging your brain and spinal cord. About two-thirds of people have furious rabies, with symptoms like aggression, seizures and delirium. Others have paralytic rabies, with weakness and paralysis progressing from the bite wound to the rest of their body. […] Many people enter a coma in the final stages of a rabies infection. Rabies eventually leads to death. […] You usually have no symptoms of rabies for several weeks after it enters your body. When rabies makes it to your central nervous system (prodromal phase), you experience flu-like symptoms. In the final stages, you have neurological (brain) symptoms. […] Neurological symptoms of rabies are either furious or paralytic. […] Furious rabies symptoms may come and go with periods of calm in between (furious episodes).

• #62

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Furious rabies results in hyperactivity, excitable behaviour, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest. […] Paralytic rabies accounts for about 20% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. Muscles gradually become paralysed, starting from the wound site. A coma slowly develops and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

• #63 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  In patients with paralytic rabies, fever and nuchal rigidity may occur. Paralysis is symmetrical and may be either generalized or ascending and may be mistaken for Guillain-Barr syndrome. The sensory system usually is spared. Calm clarity gradually progresses to delirium, stupor, and then coma. […] Respiratory failure occurs within 1 week of neurologic symptoms. Hypoventilation and metabolic acidosis predominate. Acute respiratory distress syndrome is common. Wide variations in blood pressure, cardiac arrhythmias, and hypothermia ensue. Bradycardia and cardiac arrest occur. With intensive support, life may be extended for 3 or 4 months; however, death usually is the outcome.

• #64 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The remaining one third of patients with rabies develop paralytic rabies, also known as dumb rabies or apathetic rabies, because the patient is relatively quiet compared with a person with the furious form. Paralysis occurs from the outset, and fever and headache are prominent. Paralytic rabies may initially mimic Guillain-Barr syndrome (GBS) with ascending lowermotor-neuron weakness unpreceded by classic „mad” signs, and rabies should be considered in the differential diagnosis of GBS. […] This begins within 10 days of onset, and the duration varies. Without intensive supportive care, respiratory depression, arrest, and death occur shortly after coma. […] With furious rabies, patients present with episodic delirium, psychosis, restlessness, thrashing, muscular fasciculations, seizures, and aphasia. Hydrophobia and aerophobia are pathognomonic for rabies and occur in 50% of patients. Attempting to drink or having air blown in the face produces severe laryngeal or diaphragmatic spasms and a sensation of asphyxia. This may be related to a violent response of the airway irritant mechanisms. Even the suggestion of drinking may induce hydrophobic spasm.

• #65

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Furious rabies results in hyperactivity, excitable behaviour, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest. […] Paralytic rabies accounts for about 20% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. Muscles gradually become paralysed, starting from the wound site. A coma slowly develops and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

• #66 Rabies – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448076/

  Rabies virus infection often begins with symptoms similar to a febrile viral illness and vague neurological signs. Once symptoms manifest, the infection has an almost 100% fatality rate. In all but the rarest of cases, clinicians can only provide palliative care to minimize the patient’s pain and suffering before death. […] Following an incubation period ranging from a few days to a few years, rabies presents with a vague, febrile illness, frequently with pain and paresthesias at the wound site. Within 2 weeks, the neurological phase typically progresses into encephalitic or paralytic rabies, followed by coma. Death typically occurs within 2 to 3 days of coma onset. Once symptoms begin, treatment typically focuses on minimizing the patient’s pain and suffering. […] Nonspecific viral symptoms such as fever, malaise, myalgias, gastrointestinal symptoms, and headache, which are difficult to distinguish from other common viral illnesses, characterize the initial prodromal phase of rabies. Within 2 weeks, the neurological phase begins with anxiety, agitation, and delirium. Approximately 80% of patients develop encephalitis or furious rabies, with severe pharyngeal muscle spasms stimulated by the sight, sounds, or thought of water resulting in hydrophobia or aerophobia, hyperactivity, and spasms progressing to paralysis. The remaining 20% develop paralytic rabies, with ascending, progressive paralysis initially affecting the exposed limb. The coma stage of rabies typically begins within 10 days of the onset of neurological symptoms. Patients may have ongoing hydrophobia, prolonged apneic periods, and flaccid paralysis. Most patients die within 2 to 3 days of coma onset.

• #67 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  The acute neurologic period begins with objective signs of central nervous system dysfunction. The disease may be classified as furious rabies if hyperactivity (i.e., hydrophobia) predominates and as dumb rabies if paralysis dominates the clinical picture. Fever, paresthesia, nuchal rigidity, muscle fasciculations, focal and generalized convulsions, hyperventilation, and hypersalivation may occur in both forms of the disease. […] At the end of the acute neurologic phase, periods of rapid, irregular breathing may begin; paralysis and coma soon follow. Respiratory arrest may occur thereafter, unless the patient is receiving ventilatory assistance, which may prolong survival for days, weeks, or longer, with death due to other complications. […] Although life support measures can prolong the clinical course of rabies, rarely will they affect the outcome of disease. The possibility of recovery, however, must be recognized, and when resources permit, every effort should be made to support the patient. At least seven cases of human recovery have been documented.

• #68 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  In patients with paralytic rabies, fever and nuchal rigidity may occur. Paralysis is symmetrical and may be either generalized or ascending and may be mistaken for Guillain-Barr syndrome. The sensory system usually is spared. Calm clarity gradually progresses to delirium, stupor, and then coma. […] Respiratory failure occurs within 1 week of neurologic symptoms. Hypoventilation and metabolic acidosis predominate. Acute respiratory distress syndrome is common. Wide variations in blood pressure, cardiac arrhythmias, and hypothermia ensue. Bradycardia and cardiac arrest occur. With intensive support, life may be extended for 3 or 4 months; however, death usually is the outcome.

• #69 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  The acute neurologic period begins with objective signs of central nervous system dysfunction. The disease may be classified as furious rabies if hyperactivity (i.e., hydrophobia) predominates and as dumb rabies if paralysis dominates the clinical picture. Fever, paresthesia, nuchal rigidity, muscle fasciculations, focal and generalized convulsions, hyperventilation, and hypersalivation may occur in both forms of the disease. […] At the end of the acute neurologic phase, periods of rapid, irregular breathing may begin; paralysis and coma soon follow. Respiratory arrest may occur thereafter, unless the patient is receiving ventilatory assistance, which may prolong survival for days, weeks, or longer, with death due to other complications. […] Although life support measures can prolong the clinical course of rabies, rarely will they affect the outcome of disease. The possibility of recovery, however, must be recognized, and when resources permit, every effort should be made to support the patient. At least seven cases of human recovery have been documented.

• #70 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  The acute neurologic period begins with objective signs of central nervous system dysfunction. The disease may be classified as furious rabies if hyperactivity (i.e., hydrophobia) predominates and as dumb rabies if paralysis dominates the clinical picture. Fever, paresthesia, nuchal rigidity, muscle fasciculations, focal and generalized convulsions, hyperventilation, and hypersalivation may occur in both forms of the disease. […] At the end of the acute neurologic phase, periods of rapid, irregular breathing may begin; paralysis and coma soon follow. Respiratory arrest may occur thereafter, unless the patient is receiving ventilatory assistance, which may prolong survival for days, weeks, or longer, with death due to other complications. […] Although life support measures can prolong the clinical course of rabies, rarely will they affect the outcome of disease. The possibility of recovery, however, must be recognized, and when resources permit, every effort should be made to support the patient. At least seven cases of human recovery have been documented.

• #71 Rabies: Symptoms and treatment – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/rabies.html

  Rabies is fatal unless you get treatment before symptoms develop. […] Symptoms of rabies usually take about 3 to 8 weeks to develop. However, this can also range from several days to many months. Once symptoms appear, death usually occurs within 7 to 14 days. […] Early rabies symptoms can include: fever, tiredness, headaches, anxiety or irritability. […] Symptoms worsen quickly as the virus attacks the central nervous system. The neurologic symptoms can take the following 2 forms: encephalitic rabies and paralytic rabies. […] Symptoms can include: anxiety, seizures, confusion, hyperactivity, hallucinations, strange behaviour and general agitation, fear of water (hydrophobia), fear of fresh air or drafts of air (aerophobia). […] Symptoms of paralytic rabies include weakness and gradual paralysis, often starting near the wound site and progressing slowly. […] It’s important to remember that rabies is almost always fatal once symptoms develop.

• #72 Rabies: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001334.htm

  Once the symptoms appear, the person rarely survives the disease, even with treatment. Death from respiratory failure usually occurs within 7 days after symptoms start. […] There is no known curative treatment for people with symptoms of a rabies infection. It is nearly always a fatal illness, but there have been a few reports of people surviving with experimental treatments.

• #73 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  The acute neurologic period begins with objective signs of central nervous system dysfunction. The disease may be classified as furious rabies if hyperactivity (i.e., hydrophobia) predominates and as dumb rabies if paralysis dominates the clinical picture. Fever, paresthesia, nuchal rigidity, muscle fasciculations, focal and generalized convulsions, hyperventilation, and hypersalivation may occur in both forms of the disease. […] At the end of the acute neurologic phase, periods of rapid, irregular breathing may begin; paralysis and coma soon follow. Respiratory arrest may occur thereafter, unless the patient is receiving ventilatory assistance, which may prolong survival for days, weeks, or longer, with death due to other complications. […] Although life support measures can prolong the clinical course of rabies, rarely will they affect the outcome of disease. The possibility of recovery, however, must be recognized, and when resources permit, every effort should be made to support the patient. At least seven cases of human recovery have been documented.

• #74 Rabies: Symptoms, causes, vaccine, treatment, and prevention

  https://www.medicalnewstoday.com/articles/181980

  A person may enter a coma, and most people then die within 2 to 3 days. During the coma stage, even with supportive therapy, virtually no person survives rabies. […] People used to call rabies hydrophobia because it appears to cause a fear of water. The reason is that the infection causes intense spasms in the throat when a person tries to swallow. Even the thought of swallowing water can cause spasms, making it appear that the individual is afraid of water. […] Rabies is a deadly virus that infected animals spread through their saliva. It causes flu-like symptoms initially, which progress into a fever, muscle spasms, coma, and, eventually, death. […] Although there is no effective treatment once symptoms appear, rabies vaccines are usually successful in preventing infections. However, people must seek treatment immediately and not wait for any symptoms.

• #75 Rabies symptoms, treatment, prevention

  https://www.encephalitis.info/types-of-encephalitis/infectious-encephalitis/rabies/

  Rabies is a severe viral infection of the brain transmitted to people from infected animals. Rabies encephalitis is almost always fatal, with death occurring seven to ten days from the start of the symptoms. […] Symptoms can appear from 20 to 90 days or even longer (up to several years) after the bite/scratch from a rabid animal. Early symptoms are often non-specific, mimicking viral infections (e.g., fever, general feeling of unwell, headache). There may be initial pain or intense itching at the site of the bite, or weakness of the affected limb. Other symptoms include intolerance to noise or light, anger and depression. […] Two thirds of people infected with the virus then progress to encephalitic rabies (furious rabies), which is characterised by episodes of hyperactivity, hallucinations, agitation, confusion, muscle spasms, altered functioning of the heart, bladder, intestines, sweat glands, pupils, and blood vessels, and hydrophobia (fear of water) with hypersalivation (excessive production of saliva). The remainder develop paralytic rabies with paralysis of the limbs and respiratory muscles. It is not known why some patients develop the encephalitic form and others paralytic rabies. […] Tests are unable to diagnose rabies before the appearance of symptoms.

• #76 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #77 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #78 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #79

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  This is primarily a viral infection of non-human carnivores. Transmission to man is rare and is usually effected through a bite. Clinical evidence of involvement of the CNS appears after an extremely variable period of incubation. […] The manifestations of rabies begins in man anywhere from 10-240 days after exposure. However, the incubation period is usually 30-90 days. […] There are three clinical phases of the disease: […] 1. Prodromal phase – the onset of clinical rabies in man includes 2-4 days of prodromal manifestations, most of which are non-specific. A low fever, malaise, headache, anorexia, nausea and sore throat are common. There may also be increasing nervousness, anxiety, irritability and depression and melancholia, with or without a sense of impending death. Hyperesthesia, an increased sensitivity to bright light and loud noise, excessive salivation, lacrimation and perspiration have been noted. The general muscle tone may be increased, and facial expression can be overactive. Dilated pupils, an increased pulse rate and shallow respirations are seen. However, by far, the most significant symptoms are abnormal sensations referred to the site of inoculation; noted by 80% of patients, these include pain (local or radiating), a sensation of cold, pruritus (itching) and tingling.

• #80 Rabies: Symptoms, causes, vaccine, treatment, and prevention

  https://www.medicalnewstoday.com/articles/181980

  Rabies progresses in five distinct stages: incubation, prodrome, acute neurologic period, coma, and death. […] Incubation is the time before symptoms appear. It usually lasts for 2 to 3 months and varies from 1 week to 1 year, depending on where the virus entered the body and the number of viral particles involved. The closer the bite is to the brain, the sooner the effects are likely to appear. […] By the time symptoms appear, rabies is usually fatal. Anyone who has exposure to the virus should seek medical help immediately, without waiting for symptoms. […] During prodrome, early, flu-like symptoms occur, including: a fever of 100.4F (38C) or above, headache, anxiety, feeling generally unwell, sore throat and a cough, nausea and vomiting, discomfort at the site of the bite. […] During this stage, neurologic symptoms develop, including: confusion and aggression, partial paralysis, involuntary muscle twitching, rigid neck muscles, convulsions, hyperventilation and difficulty breathing, hypersalivation, or producing a lot of saliva, frothing at the mouth, fear of water, or hydrophobia, hallucinations, nightmares, and insomnia, priapism, or permanent erection, photophobia, or a fear of light.

• #81 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #82 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  The acute neurologic period begins with objective signs of central nervous system dysfunction. The disease may be classified as furious rabies if hyperactivity (i.e., hydrophobia) predominates and as dumb rabies if paralysis dominates the clinical picture. Fever, paresthesia, nuchal rigidity, muscle fasciculations, focal and generalized convulsions, hyperventilation, and hypersalivation may occur in both forms of the disease. […] At the end of the acute neurologic phase, periods of rapid, irregular breathing may begin; paralysis and coma soon follow. Respiratory arrest may occur thereafter, unless the patient is receiving ventilatory assistance, which may prolong survival for days, weeks, or longer, with death due to other complications. […] Although life support measures can prolong the clinical course of rabies, rarely will they affect the outcome of disease. The possibility of recovery, however, must be recognized, and when resources permit, every effort should be made to support the patient. At least seven cases of human recovery have been documented.

• #83 rabies: symptoms, treatment, prevention – Institut Pasteur

  https://www.pasteur.fr/en/medical-center/disease-sheets/rabies

  The symptomatic phase involves various neurological disorders, especially anxiety, agitation and fluctuations of consciousness, as well as dysfunction of the autonomic nervous system (excessive salivation, fluctuations in heart rate and blood pressure, etc.). Hydrophobia (involuntary spasms of the muscles in the neck and diaphragm at the sight of water) is sometimes observed. Once the symptoms appear, the disease leads to coma and death within a few hours or a few days. […] Apart from a few cases reported in children, the outcome is always fatal after the onset of clinical signs.

• #84 Rabies – Brain, Spinal Cord, and Nerve Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/brain-spinal-cord-and-nerve-disorders/brain-infections/rabies

  Rabies symptoms appear when the rabies virus reaches the brain or spinal cord, usually 30 to 50 days after a person is bitten. However, this interval can vary from 10 days to more than a year. The closer the bite to the brain (for example, on the face), the more quickly symptoms appear. […] Rabies may begin with a fever, headache, and a general feeling of illness (malaise). Most people become restless, confused, and uncontrollably excited. Their behavior may be bizarre. They may hallucinate and have insomnia. Saliva production greatly increases. Spasms of the muscles in the throat and larynx occur because rabies affects the area in the brain that controls swallowing, speaking, and breathing. The spasms can be excruciatingly painful. A slight breeze or an attempt to drink water can trigger the spasms. Thus, people with rabies cannot drink. For this reason, the disease is sometimes called hydrophobia (fear of water).

• #85 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The remaining one third of patients with rabies develop paralytic rabies, also known as dumb rabies or apathetic rabies, because the patient is relatively quiet compared with a person with the furious form. Paralysis occurs from the outset, and fever and headache are prominent. Paralytic rabies may initially mimic Guillain-Barr syndrome (GBS) with ascending lowermotor-neuron weakness unpreceded by classic „mad” signs, and rabies should be considered in the differential diagnosis of GBS. […] This begins within 10 days of onset, and the duration varies. Without intensive supportive care, respiratory depression, arrest, and death occur shortly after coma. […] With furious rabies, patients present with episodic delirium, psychosis, restlessness, thrashing, muscular fasciculations, seizures, and aphasia. Hydrophobia and aerophobia are pathognomonic for rabies and occur in 50% of patients. Attempting to drink or having air blown in the face produces severe laryngeal or diaphragmatic spasms and a sensation of asphyxia. This may be related to a violent response of the airway irritant mechanisms. Even the suggestion of drinking may induce hydrophobic spasm.

• #86 Rabies – Brain, Spinal Cord, and Nerve Disorders – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/brain-spinal-cord-and-nerve-disorders/brain-infections/rabies

  Rabies symptoms appear when the rabies virus reaches the brain or spinal cord, usually 30 to 50 days after a person is bitten. However, this interval can vary from 10 days to more than a year. The closer the bite to the brain (for example, on the face), the more quickly symptoms appear. […] Rabies may begin with a fever, headache, and a general feeling of illness (malaise). Most people become restless, confused, and uncontrollably excited. Their behavior may be bizarre. They may hallucinate and have insomnia. Saliva production greatly increases. Spasms of the muscles in the throat and larynx occur because rabies affects the area in the brain that controls swallowing, speaking, and breathing. The spasms can be excruciatingly painful. A slight breeze or an attempt to drink water can trigger the spasms. Thus, people with rabies cannot drink. For this reason, the disease is sometimes called hydrophobia (fear of water).

• #87

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  2. Excitation phase – the excitation phase begins gradually and may persist to death. It may be punctuated at any time by depression and paralysis. There usually are increasing anxiety, apprehension and a sense of impending doom. […] Hydrophobia, the classical diagnostic manifestation of rabies, is an affliction of the excitatory phase of the disease. When the patient attempts to swallow liquids, forceful, painful expulsion occurs as a consequence of spasmodic contraction of the muscles of swallowing and respiration. Once experienced, the sight, sound or smell of liquids may provoke the syndrome. The ensuing choking may cause severe apnea (temporary cessation of breathing) and cyanosis. Death frequently occurs during the course of such a convulsive attack. Dehydration is a common consequence.

• #88

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  2. Excitation phase – the excitation phase begins gradually and may persist to death. It may be punctuated at any time by depression and paralysis. There usually are increasing anxiety, apprehension and a sense of impending doom. […] Hydrophobia, the classical diagnostic manifestation of rabies, is an affliction of the excitatory phase of the disease. When the patient attempts to swallow liquids, forceful, painful expulsion occurs as a consequence of spasmodic contraction of the muscles of swallowing and respiration. Once experienced, the sight, sound or smell of liquids may provoke the syndrome. The ensuing choking may cause severe apnea (temporary cessation of breathing) and cyanosis. Death frequently occurs during the course of such a convulsive attack. Dehydration is a common consequence.

• #89

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  2. Excitation phase – the excitation phase begins gradually and may persist to death. It may be punctuated at any time by depression and paralysis. There usually are increasing anxiety, apprehension and a sense of impending doom. […] Hydrophobia, the classical diagnostic manifestation of rabies, is an affliction of the excitatory phase of the disease. When the patient attempts to swallow liquids, forceful, painful expulsion occurs as a consequence of spasmodic contraction of the muscles of swallowing and respiration. Once experienced, the sight, sound or smell of liquids may provoke the syndrome. The ensuing choking may cause severe apnea (temporary cessation of breathing) and cyanosis. Death frequently occurs during the course of such a convulsive attack. Dehydration is a common consequence.

• #90

  https://www.atsu.edu/faculty/chamberlain/website/tritzid/rabies.htm

  2. Excitation phase – the excitation phase begins gradually and may persist to death. It may be punctuated at any time by depression and paralysis. There usually are increasing anxiety, apprehension and a sense of impending doom. […] Hydrophobia, the classical diagnostic manifestation of rabies, is an affliction of the excitatory phase of the disease. When the patient attempts to swallow liquids, forceful, painful expulsion occurs as a consequence of spasmodic contraction of the muscles of swallowing and respiration. Once experienced, the sight, sound or smell of liquids may provoke the syndrome. The ensuing choking may cause severe apnea (temporary cessation of breathing) and cyanosis. Death frequently occurs during the course of such a convulsive attack. Dehydration is a common consequence.

• #91 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #92 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The remaining one third of patients with rabies develop paralytic rabies, also known as dumb rabies or apathetic rabies, because the patient is relatively quiet compared with a person with the furious form. Paralysis occurs from the outset, and fever and headache are prominent. Paralytic rabies may initially mimic Guillain-Barr syndrome (GBS) with ascending lowermotor-neuron weakness unpreceded by classic „mad” signs, and rabies should be considered in the differential diagnosis of GBS. […] This begins within 10 days of onset, and the duration varies. Without intensive supportive care, respiratory depression, arrest, and death occur shortly after coma. […] With furious rabies, patients present with episodic delirium, psychosis, restlessness, thrashing, muscular fasciculations, seizures, and aphasia. Hydrophobia and aerophobia are pathognomonic for rabies and occur in 50% of patients. Attempting to drink or having air blown in the face produces severe laryngeal or diaphragmatic spasms and a sensation of asphyxia. This may be related to a violent response of the airway irritant mechanisms. Even the suggestion of drinking may induce hydrophobic spasm.

• #93

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Furious rabies results in hyperactivity, excitable behaviour, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest. […] Paralytic rabies accounts for about 20% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. Muscles gradually become paralysed, starting from the wound site. A coma slowly develops and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

• #94 Rabies: Symptoms and treatment – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/rabies.html

  Rabies is fatal unless you get treatment before symptoms develop. […] Symptoms of rabies usually take about 3 to 8 weeks to develop. However, this can also range from several days to many months. Once symptoms appear, death usually occurs within 7 to 14 days. […] Early rabies symptoms can include: fever, tiredness, headaches, anxiety or irritability. […] Symptoms worsen quickly as the virus attacks the central nervous system. The neurologic symptoms can take the following 2 forms: encephalitic rabies and paralytic rabies. […] Symptoms can include: anxiety, seizures, confusion, hyperactivity, hallucinations, strange behaviour and general agitation, fear of water (hydrophobia), fear of fresh air or drafts of air (aerophobia). […] Symptoms of paralytic rabies include weakness and gradual paralysis, often starting near the wound site and progressing slowly. […] It’s important to remember that rabies is almost always fatal once symptoms develop.

• #95 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #96 Rabies (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/rabies.html

  Someone with rabies can produce a lot of saliva (spit), and muscle spasms in their throat might make it hard to swallow. This causes the „foaming at the mouth” effect that has long been associated with rabies infection. It also leads to a fear of choking or what seems like a „fear of water,” another well-known rabies sign. […] If rabies symptoms start, there is no effective treatment. This is why doctors focus on prevention and try to stop the disease right after a person is exposed. Anyone who thinks they may have been exposed to the rabies virus must get medical care right away.

• #97 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  The symptoms eventually progress to delirium and coma. Death usually occurs two to ten days after first symptoms. Survival is almost unknown once symptoms have presented, even with intensive care. […] Rabies has also occasionally been referred to as hydrophobia („fear of water”) throughout its history. It refers to a set of symptoms in the later stages of an infection in which the person has difficulty swallowing, shows panic when presented with liquids to drink, and cannot quench their thirst. Saliva production is greatly increased, and attempts to drink, or even the intention or suggestion of drinking, may cause excruciatingly painful spasms of the muscles in the throat and larynx. […] Hydrophobia is commonly associated with furious rabies, which affects 80% of rabies-infected people. This form of rabies causes irrational aggression in the host, which aids in the spreading of the virus through animal bites; a „foaming at the mouth” effect, caused by the accumulation of saliva, is also commonly associated with rabies in the public perception and in popular culture. The remaining 20% may experience a paralytic form of rabies that is marked by muscle weakness, loss of sensation, and paralysis; this form of rabies does not usually cause fear of water.

• #98 Rabies (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/rabies.html

  Someone with rabies can produce a lot of saliva (spit), and muscle spasms in their throat might make it hard to swallow. This causes the „foaming at the mouth” effect that has long been associated with rabies infection. It also leads to a fear of choking or what seems like a „fear of water,” another well-known rabies sign. […] If rabies symptoms start, there is no effective treatment. This is why doctors focus on prevention and try to stop the disease right after a person is exposed. Anyone who thinks they may have been exposed to the rabies virus must get medical care right away.

• #99 Rabies (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/rabies.html

  Someone with rabies can produce a lot of saliva (spit), and muscle spasms in their throat might make it hard to swallow. This causes the „foaming at the mouth” effect that has long been associated with rabies infection. It also leads to a fear of choking or what seems like a „fear of water,” another well-known rabies sign. […] If rabies symptoms start, there is no effective treatment. This is why doctors focus on prevention and try to stop the disease right after a person is exposed. Anyone who thinks they may have been exposed to the rabies virus must get medical care right away.

• #100 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  The symptoms eventually progress to delirium and coma. Death usually occurs two to ten days after first symptoms. Survival is almost unknown once symptoms have presented, even with intensive care. […] Rabies has also occasionally been referred to as hydrophobia („fear of water”) throughout its history. It refers to a set of symptoms in the later stages of an infection in which the person has difficulty swallowing, shows panic when presented with liquids to drink, and cannot quench their thirst. Saliva production is greatly increased, and attempts to drink, or even the intention or suggestion of drinking, may cause excruciatingly painful spasms of the muscles in the throat and larynx. […] Hydrophobia is commonly associated with furious rabies, which affects 80% of rabies-infected people. This form of rabies causes irrational aggression in the host, which aids in the spreading of the virus through animal bites; a „foaming at the mouth” effect, caused by the accumulation of saliva, is also commonly associated with rabies in the public perception and in popular culture. The remaining 20% may experience a paralytic form of rabies that is marked by muscle weakness, loss of sensation, and paralysis; this form of rabies does not usually cause fear of water.

• #101

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Furious rabies results in hyperactivity, excitable behaviour, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest. […] Paralytic rabies accounts for about 20% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. Muscles gradually become paralysed, starting from the wound site. A coma slowly develops and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

• #102

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Furious rabies results in hyperactivity, excitable behaviour, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest. […] Paralytic rabies accounts for about 20% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. Muscles gradually become paralysed, starting from the wound site. A coma slowly develops and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

• #103 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  In patients with paralytic rabies, fever and nuchal rigidity may occur. Paralysis is symmetrical and may be either generalized or ascending and may be mistaken for Guillain-Barr syndrome. The sensory system usually is spared. Calm clarity gradually progresses to delirium, stupor, and then coma. […] Respiratory failure occurs within 1 week of neurologic symptoms. Hypoventilation and metabolic acidosis predominate. Acute respiratory distress syndrome is common. Wide variations in blood pressure, cardiac arrhythmias, and hypothermia ensue. Bradycardia and cardiac arrest occur. With intensive support, life may be extended for 3 or 4 months; however, death usually is the outcome.

• #104 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  In patients with paralytic rabies, fever and nuchal rigidity may occur. Paralysis is symmetrical and may be either generalized or ascending and may be mistaken for Guillain-Barr syndrome. The sensory system usually is spared. Calm clarity gradually progresses to delirium, stupor, and then coma. […] Respiratory failure occurs within 1 week of neurologic symptoms. Hypoventilation and metabolic acidosis predominate. Acute respiratory distress syndrome is common. Wide variations in blood pressure, cardiac arrhythmias, and hypothermia ensue. Bradycardia and cardiac arrest occur. With intensive support, life may be extended for 3 or 4 months; however, death usually is the outcome.

• #105 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The remaining one third of patients with rabies develop paralytic rabies, also known as dumb rabies or apathetic rabies, because the patient is relatively quiet compared with a person with the furious form. Paralysis occurs from the outset, and fever and headache are prominent. Paralytic rabies may initially mimic Guillain-Barr syndrome (GBS) with ascending lowermotor-neuron weakness unpreceded by classic „mad” signs, and rabies should be considered in the differential diagnosis of GBS. […] This begins within 10 days of onset, and the duration varies. Without intensive supportive care, respiratory depression, arrest, and death occur shortly after coma. […] With furious rabies, patients present with episodic delirium, psychosis, restlessness, thrashing, muscular fasciculations, seizures, and aphasia. Hydrophobia and aerophobia are pathognomonic for rabies and occur in 50% of patients. Attempting to drink or having air blown in the face produces severe laryngeal or diaphragmatic spasms and a sensation of asphyxia. This may be related to a violent response of the airway irritant mechanisms. Even the suggestion of drinking may induce hydrophobic spasm.

• #106 Rabies – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448076/

  Rabies virus infection often begins with symptoms similar to a febrile viral illness and vague neurological signs. Once symptoms manifest, the infection has an almost 100% fatality rate. In all but the rarest of cases, clinicians can only provide palliative care to minimize the patient’s pain and suffering before death. […] Following an incubation period ranging from a few days to a few years, rabies presents with a vague, febrile illness, frequently with pain and paresthesias at the wound site. Within 2 weeks, the neurological phase typically progresses into encephalitic or paralytic rabies, followed by coma. Death typically occurs within 2 to 3 days of coma onset. Once symptoms begin, treatment typically focuses on minimizing the patient’s pain and suffering. […] Nonspecific viral symptoms such as fever, malaise, myalgias, gastrointestinal symptoms, and headache, which are difficult to distinguish from other common viral illnesses, characterize the initial prodromal phase of rabies. Within 2 weeks, the neurological phase begins with anxiety, agitation, and delirium. Approximately 80% of patients develop encephalitis or furious rabies, with severe pharyngeal muscle spasms stimulated by the sight, sounds, or thought of water resulting in hydrophobia or aerophobia, hyperactivity, and spasms progressing to paralysis. The remaining 20% develop paralytic rabies, with ascending, progressive paralysis initially affecting the exposed limb. The coma stage of rabies typically begins within 10 days of the onset of neurological symptoms. Patients may have ongoing hydrophobia, prolonged apneic periods, and flaccid paralysis. Most patients die within 2 to 3 days of coma onset.

• #107

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Once the virus infects the central nervous system and clinical symptoms appear, rabies is fatal in 100% of cases. […] Rabies spreads to people and animals via saliva, usually through bites, scratches, or direct contact with mucosa (e.g. eyes, mouth, or open wounds). Once clinical symptoms appear, rabies is virtually 100% fatal. […] The incubation period for rabies is typically 2 to 3 months but may vary from one week to one year, depending on factors such as the location of virus entry and the viral load. Initial symptoms of rabies include generic signs like fever, pain and unusual or unexplained tingling, pricking, or burning sensations at the wound site. As the virus moves to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops. Clinical rabies in people can be managed but very rarely cured, and not without severe neurological deficits.

• #108 Rabies: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13848-rabies

  Rabies is an illness you get from an infection with the RABV virus. It causes symptoms like seizures, hallucinations and paralysis. […] Once symptoms start, rabies is fatal. […] Rabies virus gets into your body when the saliva (spit) of an infected animal gets into an open wound (usually from a bite). It moves very slowly along nerves into your central nervous system (your brain and spinal cord). When it reaches your brain, the damage causes neurological symptoms. From there, rabies leads to coma and death. […] Rabies moves from an infected wound to your brain over time. There are several phases that most people go through: incubation, prodromal phase, acute neurologic phase and coma. […] The prodromal phase starts when the rabies virus has entered your nervous system. Your immune system tries to fight back, causing flu-like symptoms. Nerve damage might cause tingling, pain or numbness where you were bitten. This lasts two to 10 days. There aren’t any effective treatments when rabies reaches this phase.

• #109 Rabies: Symptoms and treatment – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/rabies.html

  Rabies is fatal unless you get treatment before symptoms develop. […] Symptoms of rabies usually take about 3 to 8 weeks to develop. However, this can also range from several days to many months. Once symptoms appear, death usually occurs within 7 to 14 days. […] Early rabies symptoms can include: fever, tiredness, headaches, anxiety or irritability. […] Symptoms worsen quickly as the virus attacks the central nervous system. The neurologic symptoms can take the following 2 forms: encephalitic rabies and paralytic rabies. […] Symptoms can include: anxiety, seizures, confusion, hyperactivity, hallucinations, strange behaviour and general agitation, fear of water (hydrophobia), fear of fresh air or drafts of air (aerophobia). […] Symptoms of paralytic rabies include weakness and gradual paralysis, often starting near the wound site and progressing slowly. […] It’s important to remember that rabies is almost always fatal once symptoms develop.

• #110 Rabies: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13848-rabies

  If you’ve been exposed to rabies (were bitten by or been in contact with an infected animal), contact a healthcare provider as soon as possible. […] There’s no cure for rabies once it’s moved to your brain because it’s protected by your blood-brain barrier. […] You can survive rabies exposure if you’re treated within a few days of exposure, before you have symptoms. Once you have rabies that is, you’re showing symptoms of the virus affecting your brain there aren’t any effective treatments available. Without early vaccination and antibody treatment, rabies is nearly always fatal. […] You can live several weeks or months after being exposed to rabies without symptoms. Once symptoms start, rabies causes death within a few days.

• #111 11 Things You Need to Know About Rabies

  https://www.makatimed.net.ph/blogs/the-truth-about-rabies-11-facts-you-need-to-know/

  For paralytic rabies, it may take a longer, less dramatic course, wherein muscles gradually get paralyzed beginning at the location of exposure. After this, a coma will slowly develop. […] For both cases, once these symptoms appear, the disease is usually fatal. The Center for Disease Control and Prevention in America reports less than 20 cases of human survival from clinical rabies to date.

• #112 Rabies | Environmental Health and Safety | Illinois State

  https://ehs.illinoisstate.edu/research/animals/rabies/index.php

  Rabies virus infects the central nervous system, causing encephalopathy and ultimately death. Early symptoms of rabies in humans are nonspecific, consisting of fever, headache, and general malaise. As the disease progresses, neurological symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation, difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of symptoms. […] The first symptoms of rabies in people may be nonspecific flu-like signs – malaise, fever, or headache, which may last for days. There may be discomfort or paresthesia at the site of exposure (bite), progressing within days to symptoms of cerebral dysfunction, anxiety, confusion, agitation, progressing to delirium, abnormal behavior, hallucinations, and insomnia. The acute period of disease typically ends after two to 10 days. Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive.

• #113 Rabies – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/rabies/

  CNS symptoms include anxiety, agitation, and combativeness alternating with calm periods, confusion and hallucinations, photophobia, fasciculations, seizures, and muscle tone and reflexes with nuchal rigidity. […] Coma and death within days to weeks of the development of neurological symptoms. […] Flaccid paralysis, gradually ascending and spreading from bite wound. […] Symptomatic rabies is almost universally fatal. […] Patients are managed with palliative care (e.g., pain management, sedation).

• #114 Rabies – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/rabies/

  CNS symptoms include anxiety, agitation, and combativeness alternating with calm periods, confusion and hallucinations, photophobia, fasciculations, seizures, and muscle tone and reflexes with nuchal rigidity. […] Coma and death within days to weeks of the development of neurological symptoms. […] Flaccid paralysis, gradually ascending and spreading from bite wound. […] Symptomatic rabies is almost universally fatal. […] Patients are managed with palliative care (e.g., pain management, sedation).

• #115 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  In patients with paralytic rabies, fever and nuchal rigidity may occur. Paralysis is symmetrical and may be either generalized or ascending and may be mistaken for Guillain-Barr syndrome. The sensory system usually is spared. Calm clarity gradually progresses to delirium, stupor, and then coma. […] Respiratory failure occurs within 1 week of neurologic symptoms. Hypoventilation and metabolic acidosis predominate. Acute respiratory distress syndrome is common. Wide variations in blood pressure, cardiac arrhythmias, and hypothermia ensue. Bradycardia and cardiac arrest occur. With intensive support, life may be extended for 3 or 4 months; however, death usually is the outcome.

• #116 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  In patients with paralytic rabies, fever and nuchal rigidity may occur. Paralysis is symmetrical and may be either generalized or ascending and may be mistaken for Guillain-Barr syndrome. The sensory system usually is spared. Calm clarity gradually progresses to delirium, stupor, and then coma. […] Respiratory failure occurs within 1 week of neurologic symptoms. Hypoventilation and metabolic acidosis predominate. Acute respiratory distress syndrome is common. Wide variations in blood pressure, cardiac arrhythmias, and hypothermia ensue. Bradycardia and cardiac arrest occur. With intensive support, life may be extended for 3 or 4 months; however, death usually is the outcome.

• #117 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  In patients with paralytic rabies, fever and nuchal rigidity may occur. Paralysis is symmetrical and may be either generalized or ascending and may be mistaken for Guillain-Barr syndrome. The sensory system usually is spared. Calm clarity gradually progresses to delirium, stupor, and then coma. […] Respiratory failure occurs within 1 week of neurologic symptoms. Hypoventilation and metabolic acidosis predominate. Acute respiratory distress syndrome is common. Wide variations in blood pressure, cardiac arrhythmias, and hypothermia ensue. Bradycardia and cardiac arrest occur. With intensive support, life may be extended for 3 or 4 months; however, death usually is the outcome.

• #118 Is Rabies Really 100% Fatal? | Viruses101 | Learn Science at Scitable

  https://www.nature.com/scitable/blog/viruses101/is_rabies_really_100_fatal/

  Lasting side effects from her battle with rabies includes trouble with running and balance, and speaking more slowly than before becoming infected. […] The idea of inducing a coma left doctors wrestling with the possible side effects. Even if they did save her life would Jeanna be left severely disabled once she woke up? […] But despite the amazing recovery Jeanna experienced, the method has stirred up some controversy in regards to its effectiveness. Out of 41 patients who have so far received the Protocol only 6 have survived. […] New research has shown that humans may be able to survive Rabies without vaccination or treatment after all. […] Therefore, could Rabies really be the sole outlier we believe it to be? Even in animals who carry Rabies the virus isn’t completely fatal; 14% of dogs survive. […] Until more research is done on the Milwaukee Protocol and Rabies in general, it remains unclear why some people triumph over the world’s deadliest virus while others don’t.

• #119 Rabies: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13848-rabies

  If you’ve been exposed to rabies (were bitten by or been in contact with an infected animal), contact a healthcare provider as soon as possible. […] There’s no cure for rabies once it’s moved to your brain because it’s protected by your blood-brain barrier. […] You can survive rabies exposure if you’re treated within a few days of exposure, before you have symptoms. Once you have rabies that is, you’re showing symptoms of the virus affecting your brain there aren’t any effective treatments available. Without early vaccination and antibody treatment, rabies is nearly always fatal. […] You can live several weeks or months after being exposed to rabies without symptoms. Once symptoms start, rabies causes death within a few days.

• #120 Rabies: Symptoms, causes, vaccine, treatment, and prevention

  https://www.medicalnewstoday.com/articles/181980

  A person may enter a coma, and most people then die within 2 to 3 days. During the coma stage, even with supportive therapy, virtually no person survives rabies. […] People used to call rabies hydrophobia because it appears to cause a fear of water. The reason is that the infection causes intense spasms in the throat when a person tries to swallow. Even the thought of swallowing water can cause spasms, making it appear that the individual is afraid of water. […] Rabies is a deadly virus that infected animals spread through their saliva. It causes flu-like symptoms initially, which progress into a fever, muscle spasms, coma, and, eventually, death. […] Although there is no effective treatment once symptoms appear, rabies vaccines are usually successful in preventing infections. However, people must seek treatment immediately and not wait for any symptoms.

• #121 Rabies Symptoms – Superdrug Health Clinic

  https://healthclinics.superdrug.com/rabies-symptoms/

  If you have not completed a full course of the rabies vaccine, and are either not immune or only partially immune, then you may require an additional four doses of the rabies vaccine, over the course of a month, to boost your immune system. If you are not immune and are at a high-risk of developing rabies, you may also receive a human rabies immunoglobulin (HRIG) shot. […] The first sign of rabies in animals is a change in their behaviour, which you may only be able to tell if you are already familiar with the animal. […] As the infection progresses, the animal may become more aggressive, begin to excessively produce saliva, and froth at the mouth. […] There is another form of rabies called paralytic rabies, which is more common in dogs. In these cases the animal will develop paralysis, which will make it seem tired and weak. The paralysis will also make it more difficult for the animal to swallow, causing it to drool.

• #122 Rabies: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/220967-overview

  Rabies is a viral disease that affects the central nervous system (CNS). The genus Lyssavirus contains more than 80 viruses. Classic rabies, the focus of this article, is the prototypical human Lyssavirus pathogen. […] Rabies virus infection is remarkable for the lack of evident pathology despite dramatic neurologic symptoms. Minimal inflammation and neuronal cytopathy may be observed even postmortem. Similarly, viremia does not occur or play a role in spread to the CNS. […] Rabies PEP should begin as soon as possible after an exposure. PEP is safe and nearly 100% effective if administered before symptom onset. Depending on site and exposure, rabies may incubate for many years, and a subtle exposure may be forgotten. Although the incubation period of rabies is typically 1-3 months, this may be shortened to a few days if inoculation occurs on the head and neck. Given that rabies invariably is fatal once symptoms begin, elapsed time should not discourage prophylaxis, and it is never too late to prophylax a possible rabies exposure. […] Despite aggressive and intensive care management, the prognosis of rabies remains exceedingly poor. The very few cases of survival have involved bat variants.

• #123 Rabies – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448076/

  Rabies virus infection often begins with symptoms similar to a febrile viral illness and vague neurological signs. Once symptoms manifest, the infection has an almost 100% fatality rate. In all but the rarest of cases, clinicians can only provide palliative care to minimize the patient’s pain and suffering before death. […] Following an incubation period ranging from a few days to a few years, rabies presents with a vague, febrile illness, frequently with pain and paresthesias at the wound site. Within 2 weeks, the neurological phase typically progresses into encephalitic or paralytic rabies, followed by coma. Death typically occurs within 2 to 3 days of coma onset. Once symptoms begin, treatment typically focuses on minimizing the patient’s pain and suffering. […] Nonspecific viral symptoms such as fever, malaise, myalgias, gastrointestinal symptoms, and headache, which are difficult to distinguish from other common viral illnesses, characterize the initial prodromal phase of rabies. Within 2 weeks, the neurological phase begins with anxiety, agitation, and delirium. Approximately 80% of patients develop encephalitis or furious rabies, with severe pharyngeal muscle spasms stimulated by the sight, sounds, or thought of water resulting in hydrophobia or aerophobia, hyperactivity, and spasms progressing to paralysis. The remaining 20% develop paralytic rabies, with ascending, progressive paralysis initially affecting the exposed limb. The coma stage of rabies typically begins within 10 days of the onset of neurological symptoms. Patients may have ongoing hydrophobia, prolonged apneic periods, and flaccid paralysis. Most patients die within 2 to 3 days of coma onset.

• #124 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Once a person begins showing signs and symptoms of rabies, the disease nearly always causes death. […] The first symptoms of rabies may be very similar to those of the flu and may last for days. […] Later signs and symptoms may include: Fever, Headache, Nausea, Vomiting, Agitation, Anxiety, Confusion, Hyperactivity, Difficulty swallowing, Excessive salivation, Fear brought on by attempts to drink fluids because of difficulty swallowing water, Fear brought on by air blown on the face, Hallucinations, Insomnia, Partial paralysis.

• #125 LA County Department of Public Health

  http://publichealth.lacounty.gov/vet/rabiesmanual/clinical.htm

  Rabies infection characteristically produces a rapidly progressive encephalomyelitis (inflammation of the brain and spinal cord), and should be considered as a possible cause of any such illness in humans or other animals. […] The incubation period in humans is typically between 20 and 90 days, although incubation periods as short as 4 days and longer than 6 years have been documented. […] Early symptoms of rabies are non-specific, but often include pain or paresthesia at the inoculation site. The disease progresses to an acute neurologic phase characterized by delirium, convulsions, muscle weakness, and paralysis. Spasms of the swallowing muscles can lead to a fear of water (hydrophobia), and may be precipitated by blowing on the patient’s face (aerophobia). Not all persons exposed to rabies virus develop disease, but if symptoms do occur, rabies is almost invariably fatal — usually within 10 days.

• #126 Rabies Clinical Presentation: History, Physical Examination

  https://emedicine.medscape.com/article/220967-clinical

  The remaining one third of patients with rabies develop paralytic rabies, also known as dumb rabies or apathetic rabies, because the patient is relatively quiet compared with a person with the furious form. Paralysis occurs from the outset, and fever and headache are prominent. Paralytic rabies may initially mimic Guillain-Barr syndrome (GBS) with ascending lowermotor-neuron weakness unpreceded by classic „mad” signs, and rabies should be considered in the differential diagnosis of GBS. […] This begins within 10 days of onset, and the duration varies. Without intensive supportive care, respiratory depression, arrest, and death occur shortly after coma. […] With furious rabies, patients present with episodic delirium, psychosis, restlessness, thrashing, muscular fasciculations, seizures, and aphasia. Hydrophobia and aerophobia are pathognomonic for rabies and occur in 50% of patients. Attempting to drink or having air blown in the face produces severe laryngeal or diaphragmatic spasms and a sensation of asphyxia. This may be related to a violent response of the airway irritant mechanisms. Even the suggestion of drinking may induce hydrophobic spasm.

• #127 How to know if an animal has rabies and how to prevent it | Humane World for Animals

  https://www.humaneworld.org/en/resources/understanding-rabies

  Rabies (Lyssavirus) is an infectious disease that affects the central nervous system in mammals. It’s transmitted through the saliva a few days before death when the animal „sheds” the virus. Because it affects the nervous system, most rabid animals behave abnormally. […] In the „furious” form, wild animals may appear to be agitated, bite or snap at imaginary and real objects and drool excessively. In the „dumb” form, wild animals may appear tame and seem to have no fear of humans. […] There are other signs, such as the animal appearing drunk or excessively wobbly, circling, seeming partially paralyzed, acting disorientated or mutilating themself. However, most of these signs can also be indicative of other diseases like distemper or lead poisoning. There are few behavioral signs that are telltale of rabies alone.

• #128 Rhabdoviruses: Rabies Virus – Medical Microbiology – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK8618/

  Rabies virus causes acute infection of the central nervous system. Five general stages are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death. The incubation period is exceptionally variable, ranging from fewer than 10 days to longer than 2 years, but is usually 13 months. […] Five general stages of rabies are recognized in humans: incubation, prodrome, acute neurologic period, coma, and death (or, very rarely, recovery). The incubation period in rabies, usually 30 to 90 days but ranging from as few as 5 days to longer than 2 years after initial exposure, is more variable than in any other acute infection. Clinical symptoms are first noted during the prodromal period, which usually lasts from 2 to 10 days. These symptoms are often nonspecific (general malaise, fever, and fatigue) or suggest involvement of the respiratory system (sore throat, cough, and dyspnea), gastrointestinal system (anorexia, dysphagia, nausea, vomiting, abdominal pain, and diarrhea), or central nervous systems (headache, vertigo, anxiety, apprehension, irritability, and nervousness). More remarkable abnormalities (agitation, photophobia, priapism, increased libido, insomnia, nightmares, and depression) may also occur, suggesting encephalitis, psychiatric disturbances, or brain conditions. Pain or paresthesia at the site of virus inoculation, combined with a history of recent animal bite, should suggest a consideration of rabies.

• #129 Rabies – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448076/

  Rabies virus infection often begins with symptoms similar to a febrile viral illness and vague neurological signs. Once symptoms manifest, the infection has an almost 100% fatality rate. In all but the rarest of cases, clinicians can only provide palliative care to minimize the patient’s pain and suffering before death. […] Following an incubation period ranging from a few days to a few years, rabies presents with a vague, febrile illness, frequently with pain and paresthesias at the wound site. Within 2 weeks, the neurological phase typically progresses into encephalitic or paralytic rabies, followed by coma. Death typically occurs within 2 to 3 days of coma onset. Once symptoms begin, treatment typically focuses on minimizing the patient’s pain and suffering. […] Nonspecific viral symptoms such as fever, malaise, myalgias, gastrointestinal symptoms, and headache, which are difficult to distinguish from other common viral illnesses, characterize the initial prodromal phase of rabies. Within 2 weeks, the neurological phase begins with anxiety, agitation, and delirium. Approximately 80% of patients develop encephalitis or furious rabies, with severe pharyngeal muscle spasms stimulated by the sight, sounds, or thought of water resulting in hydrophobia or aerophobia, hyperactivity, and spasms progressing to paralysis. The remaining 20% develop paralytic rabies, with ascending, progressive paralysis initially affecting the exposed limb. The coma stage of rabies typically begins within 10 days of the onset of neurological symptoms. Patients may have ongoing hydrophobia, prolonged apneic periods, and flaccid paralysis. Most patients die within 2 to 3 days of coma onset.

• #130 Rabies symptoms, treatment, prevention

  https://www.encephalitis.info/types-of-encephalitis/infectious-encephalitis/rabies/

  Rabies is a severe viral infection of the brain transmitted to people from infected animals. Rabies encephalitis is almost always fatal, with death occurring seven to ten days from the start of the symptoms. […] Symptoms can appear from 20 to 90 days or even longer (up to several years) after the bite/scratch from a rabid animal. Early symptoms are often non-specific, mimicking viral infections (e.g., fever, general feeling of unwell, headache). There may be initial pain or intense itching at the site of the bite, or weakness of the affected limb. Other symptoms include intolerance to noise or light, anger and depression. […] Two thirds of people infected with the virus then progress to encephalitic rabies (furious rabies), which is characterised by episodes of hyperactivity, hallucinations, agitation, confusion, muscle spasms, altered functioning of the heart, bladder, intestines, sweat glands, pupils, and blood vessels, and hydrophobia (fear of water) with hypersalivation (excessive production of saliva). The remainder develop paralytic rabies with paralysis of the limbs and respiratory muscles. It is not known why some patients develop the encephalitic form and others paralytic rabies. […] Tests are unable to diagnose rabies before the appearance of symptoms.

• #131 Rabies | American Veterinary Medical Associationmultiple-users-1addaddaddadd

  https://www.avma.org/resources-tools/one-health/rabies

  Rabies is a deadly disease caused by a virus that attacks the nervous system. Once the outward signs of the disease appear, rabies is nearly always fatal. […] Once the rabies virus enters the body, it travels along the nerves to the brain. Animals with rabies may show a variety of signs: Fearfulness, Aggression, Excessive drooling, Difficulty swallowing, Staggering, Paralysis, Seizures. […] Although the most common signs of rabies are behavioral changes and unexplained paralysis, rabies should be considered in all cases of unexplained neurological disease. There is no treatment once the clinical signs of rabies appear. […] Rabies infection of an animal can only be confirmed after death, through microscopic examination of the animal’s brain.

• #132 Rabies | Environmental Health and Safety | Illinois State

  https://ehs.illinoisstate.edu/research/animals/rabies/index.php

  Rabies virus infects the central nervous system, causing encephalopathy and ultimately death. Early symptoms of rabies in humans are nonspecific, consisting of fever, headache, and general malaise. As the disease progresses, neurological symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation, difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of symptoms. […] The first symptoms of rabies in people may be nonspecific flu-like signs – malaise, fever, or headache, which may last for days. There may be discomfort or paresthesia at the site of exposure (bite), progressing within days to symptoms of cerebral dysfunction, anxiety, confusion, agitation, progressing to delirium, abnormal behavior, hallucinations, and insomnia. The acute period of disease typically ends after two to 10 days. Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive.

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