The saliva of the infected animal enters the wound or blood stream. The virus infects the peripheral nerves through which it travels to the spinal cord and central nervous system. After multiplication in the brain, the virus migrates to the salivary glands. Once rabies progresses, the ability to swallow may be lost and drooling may occur. If a human is bitten by a rabid animal, the average incubation period is four to six weeks, but can vary from several days to a year.
Rabies is difficult to diagnose.
If a patient has been bitten by an animal and there is a suspicion of rabies, authorities, such as the department of health or police, should be notified immediately. Rabies is a fragile virus easily killed by soap and water, which has prompted recommendations that victims wash wounds quickly and thoroughly, even before seeking treatment. When treating a patient for suspected rabies, hospital personnel should follow universal precautions when handling body fluids, especially blood and saliva. Follow your institution's policy when labeling specimens to alert lab personnel that the rabies virus may be present. Vaccinations are available to prevent rabies, but once the disease occurs, death will occur from encephalopathy.