What should you know about rabies headache?

Rabies may include headache and fever early in illness, usually in the context of a bite, scratch, or saliva exposure from a mammal. Headache by itself does not indicate rabies. Other possible explanations include a common cold, allergic rhinitis, chronic sinusitis, dehydration, heat exhaustion, COVID-19, dengue fever, or generalised anxiety disorder. The pattern, associated symptoms, recent travel or heat exposure, and animal contact help guide assessment.

Rest in a cool, quiet place, drink fluids if you can do so safely, and note when the headache began and what accompanies it. If a mammal bite or scratch occurred, wash the area with soap and running water and seek urgent advice; do not wait for headache or fever. Tell a clinician about travel, heat exposure, mosquito exposure, respiratory symptoms, nasal congestion, anxiety symptoms, and any contact with animal saliva.

Seek emergency help for a sudden severe headache, confusion, fainting, seizure, stiff neck, new weakness, trouble speaking, breathing difficulty, or difficulty swallowing. Get urgent medical assessment after a possible rabies exposure, even without symptoms. Medical review is also appropriate when headache persists, repeatedly returns, or comes with high fever, vomiting, rash, dehydration, or marked sensitivity to light.

Ask which features make your headache urgent, whether you need testing for an infection or dehydration, and how your examination changes the likely causes. If an animal was involved, ask specifically whether the contact qualifies for rabies prevention and what wound care is required.