Will rabies bite people?

Many people believe that once rabies attacks, the patient will bite people randomly. Even humans will also show such symptoms when they are suffering from rabies. In fact, rabies will not bite people. The patient will just be extremely afraid of some things, such as fear of water, light, wind, throat spasms, and difficulty breathing, which are similar to the symptoms of an acute disease outbreak.

The incubation period of clinical manifestations varies in length, but most are within 3 months. The length of the incubation period is related to factors such as age (shorter in children), wound site (bites on the head and face occur earlier), wound depth (deep wounds have a shorter incubation period), the number and virulence of the invading virus, etc. Other factors such as incomplete debridement, trauma, cold, excessive fatigue, etc. may cause the disease to occur prematurely. The typical clinical course can be divided into the following three stages:

1. Prodromal or invasive phase

Before the excited state appears, most patients have low fever, loss of appetite, nausea, headache, fatigue, general discomfort, etc., which are similar to a "cold"; then fear and anxiety appear, and they are more sensitive to sound, light, wind, pain, etc., and have a tightness in the throat. The most diagnostically significant early symptom is abnormal sensation in and around the wound, including numbness, itching, pain, and a crawling sensation. This is caused by the stimulation of neurons by the virus during reproduction and lasts for 2 to 4 days.

2. Excitement

The patient gradually enters a highly excited state, with prominent manifestations such as extreme terror, fear of water, fear of wind, paroxysmal pharyngeal muscle spasms, difficulty breathing, difficulty urinating and defecating, and excessive sweating and drooling. This phase lasts 1 to 3 days.

Hydrophobia is a specific symptom of rabies. Typically, seeing water, drinking water, hearing the sound of flowing water, or even just mentioning drinking water can cause severe spasm of the throat muscles. Fear of wind is also a common symptom. Breeze or other stimuli such as light, sound, touch, etc. can cause spasms of the pharyngeal muscles. In severe cases, it can cause painful convulsions throughout the body.

3. Paralysis

The spasm stops and the patient gradually becomes quiet, but develops flaccid paralysis, especially limb flaccidity. The eye muscles, facial muscles and chewing muscles may also be affected, manifesting as strabismus, eye movement disorders, drooping mandible, inability to close the mouth, lack of facial expression, etc. This stage lasts 6 to 18 hours.

The entire course of rabies generally does not exceed 6 days, and occasionally exceeds 10 days. In addition, there is a "paralytic type" or "static type" with paralysis as the main manifestation, also known as dumb rabies. Patients of this type have no excitement period and hydrophobia, but start with high fever, headache, vomiting, and pain at the bite site, followed by limb weakness, abdominal distension, ataxia, muscle paralysis, and incontinence. The disease lasted for 10 days and eventually resulted in death from respiratory muscle paralysis and bulbar paralysis. Rabies caused by vampire bat bites is often of this type.