Infection with the rabies virus progresses through three distinct stages.
Prodromal: Stage One. Marked by altered behavioral patterns. “Docility” and “likes to be pet” are very common in the prodromal stage. Usually lasts 1-3 days. An animal in this stage carries virus bodies in its saliva and is infectious.
Excitative: Stage Two. Also called “furious” rabies. This is what everyone thinks rabies is–hyperreacting to stimuli and biting everything. Excessive salivation occurs. Animals in this stage also exhibit hydrophobia or the fear of water; they cannot drink (swallowing causes painful spasms of the throat muscles), and will panic if shown water. Usually lasts 3-4 days before rapidly progressing into the next stage.
Paralytic: Stage Three. Also called “dumb” rabies. As the infection runs its course, the virus starts degrading the nervous system. Limbs begin to fail; animals in this stage will often limp or drag their haunches behind them. If the animal has survived all this way, death will usually come through respiratory arrest: Their diaphragm becomes paralyzed and they stop breathing.
And to add onto the above, saliva isn’t the only infectious fluid. Brain matter is, too. If, somehow, you find yourself in possession of a firearm and faced with a rabid animal, do not go for a head shot. If you do, you will aerosolize the brain matter and effectively create a cloud of infectious material. Breathe it in, and you’ll give yourself an infection.
When I worked in wildlife rehabilitation, I actually did see a rabid animal in person, and it remains one of the most terrifying experiences of my life, because I was literally looking death in the eyes.
A pair of well-intentioned women brought us a raccoon that they thought had been hit by a car. They had found it on the side of the road, dragging its hind legs. They managed–somehow–to get it into a cat carrier and brought it to us.
As they brought it in, I remember how eerily silent it was. Normal raccoons chatter almost constantly. They fidget. They bump around. They purr and mumble and make little grabby-hands at everything. Even when they’re in pain, and especially when they’re stressed. But this one wasn’t moving around inside the carrier, and it wasn’t making a sound.
The clinic director also noticed this, and he asked in a calm but urgent voice for the women to hand the carrier to him. He took it to the exam room and set it on the table while they filled out some forms in the next room. I took a step towards the carrier, to look at our new patient, and without turning around, he told me, “Go to the other side of the room, and stay there.”
He took a small penlight out of the drawer and shone it briefly into the carrier, then sighed. “Bear, if you want to come look at this, you can put on a mask,” he said. “It’s really pretty neat, but I know you’re not vaccinated and I don’t want to take any chances.”
And at that point, I knew exactly what we were dealing with, and I knew that this would be the closest I had ever been to certain death. So I grabbed a respirator from the table and put it on, and held my breath for good measure as I approached the table. The clinic director pointed where I should stand, well back from the carrier door. He shone the light inside again, and I saw two brilliant flashes of emerald green–the most vivid, unnatural eyeshine I had ever seen.
“I don’t know why it does it,” the director murmured, “but it turns their eyes green.”
“What does?” one of the women asked, with uncanny, unintentionally dramatic timing, as she poked her head around the corner.
“Rabies,” the director said. “The raccoon is rabid. Did it bite either of you, or even lick you?” They told us no, said they had even used leather garden gloves when they herded it into the carrier. He told them to throw away the gloves as soon as possible, and steam-clean the upholstery in their car. They asked how they should clean the cat carrier; they wanted it back and couldn’t be convinced otherwise, so he told them to soak it in just barely diluted bleach.
But before we could give them the carrier back, we had to remove the raccoon. The rabid raccoon.
The clinic director readied a syringe with tranquilizers and attached it to the end of a short pole. I don’t remember how it was rigged exactly–whether he had a way to push down the plunger or if the needle would inject with pressure–but all he would have to do was stick the animal to inject it. And so, after sending me and the women back to the other side of the room, he made his fist jab.
The sound that that animal made on being brushed by the pole can only be described as a roar. It was throaty and ragged and ungodly loud. It was not a sound that a raccoon should ever make. I’m convinced it was a sound that a raccoon physically could not make.
It thrashed inside the carrier, sending it tipping from side to side. Its claws clattered against the walls. It bellowed that throaty, rasping sound again. It was absolutely frenzied, and I was genuinely scared that it would break loose from inside those plastic walls.
Somehow, the clinic director kept his calm, and as the raccoon jolted around inside the cat carrier, he moved in with the syringe again, and this time, he hit it. He emptied the syringe into its body and withdrew the pole.
We waited for those awful screams, that horrible thrashing, to die down. As we did, the director loaded up another syringe with even more tranquilizer, and as the raccoon dropped off into unconsciousness, he stuck it a second time with the heavier dose. Even then, it growled at him and flailed a paw against the wall.
More waiting, this time to make sure the animal was truly down for the count.
Then, while wearing welder’s gloves, the director opened the door of the carrier and removed the raccoon. She was limp, bedraggled, and utterly emaciated, but she was still alive. We bagged up the cat carrier and gave it to the women again, advising them that now was a good time to leave. They heeded our warning.
I asked if I could come closer to see, and the clinic director pointed where I could stand. I pushed the mask up against my face and tried to breathe as little as possible.
He and his co-director–who I think he was grooming to be his successor, but the clinic actually went under later that year–examined the raccoon together. Donning a pair of nitrile gloves, he reached down and pulled up a handful, a literal fistful, of the raccoon’s skin and released it. It stayed pulled up.
Severe dehydration causes a phenomenon called “skin tenting”. The skin loses its elasticity somewhat, and will be slow to return to its “normal” shape when manipulated. The clinic director estimated that it had been at least four or five days since the raccoon had had anything to eat or drink.
She was already on death’s doorstep, but her rabies infection had driven her exhausted body to scream and lunge and bite.
Because, the scariest thing about rabies (if you ask me) is the way that it alters the behavior of those it infects to increase chances of spreading.
The prodromal stage? Nocturnal animals become diurnal–allowing them to potentially infect most hosts than if they remained nocturnal.
The excitative stage? The infected animal bites at the slightest provocation. Swallowing causes painful spasms, so they drool, coating their bodies in infectious matter. A drink could wash away the virus-charged saliva from their mouth and bodies, so the virus drives them to panic at the sight of water.
(The paralytic stage? By that point, the animal has probably spread its infection to new hosts, so the virus has no need for it any longer.)
Rabies is deadly. Rabies is dangerous. In all of recorded history, one person survived an infection after she became symptomatic, and so far we haven’t been able to replicate that success. The Milwaukee Protocol hasn’t saved anyone else. Just one person. And even then, she still had to struggle to gain back control of her body after all that nerve damage.
Please, please, take rabies seriously.
This has been a warning from your old pal Bear.
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