Based on monoclonal antibody analysis and exposure history, three of the four cases of human rabies acquired within the United States from 1980 through 1990 resulted from exposure to bats. The most common clinical manifestation of viral encephalitis is acute onset of febrile illness with headache, fever, disorientation, behavioral and speech changes, and other neurologic signs. As this report indicates, diagnosis of central nervous system infections is difficult. Although definite exposure histories are sometimes absent, a history of an animal bite and a rapidly progressive encephalitis should prompt health-care providers to consider rabies in the differential diagnosis. Human rabies can be prevented by avoiding contact with rabid animals.
Most terrestrial mammals are susceptible to rabies virus infection.
Contact should be avoided with all wild and domestic animals exhibiting atypical behavior. Family dogs and cats should be vaccinated against rabies. If human exposures do occur, immediate cleansing of the bite wound with soap and water is recommended. When possible, the biting animal should be captured and submitted for testing for rabies. Medical care should also be sought to assess the need for tetanus vaccination, general wound care, and rabies prophylaxis.