What should you know about paralytic rabies?

Rabies is usually transmitted through saliva from an infected animal, most often through a bite or scratch. The paralytic form may resemble other neurological illnesses: weakness can start near the exposure site or in the legs and gradually spread. Fever, tingling, pain, confusion or difficulty swallowing may also occur. Once neurological illness begins, it is a medical emergency, so the exposure history matters even when the wound seems small or has healed.

Wash a bite, scratch or saliva-contaminated wound thoroughly with soap and running water, then seek urgent medical advice. Do not wait for symptoms. Clinicians assess the animal, the exposure and vaccination history before deciding on post-exposure treatment, which may include rabies vaccine and other protective medicine. Avoid handling the animal again and report its location safely to local authorities.

Go to an emergency department immediately for progressive weakness, trouble swallowing, breathing difficulty, confusion, unusual agitation or severe drowsiness after a possible animal exposure. Seek urgent advice for any bite, scratch or saliva contact with broken skin or the eyes, even if the animal is a pet. Do not delay because the injury is painless or there is no visible bleeding.

Ask whether the exposure requires post-exposure prophylaxis, which doses are needed, how the wound should be followed, and what symptoms should trigger immediate return to hospital.