Rabies Infection Risks and Long-Term Effects After Animal Bites

Hello, I am the questioner 198067. I apologize for having some additional questions to ask you?

Hello, Doctor.
I would like to ask: 1.
My understanding is that after being bitten by a monkey over 20 years ago, even though the initial treatment was incomplete (for example, I only received one dose of rabies immune globulin or rabies antiserum, and did not receive the rabies vaccine), and this led to incomplete antibody production, I have been fine for over 20 years.
Does this mean that I have not been infected with rabies and that there is no rabies virus in my body? Is this understanding correct? 2.
You mentioned that the incubation period generally does not exceed one year.
Is it possible for the rabies virus to mutate and exhibit an extremely long incubation period (for example, 20 or 30 years)? Thank you for clarifying, Doctor.

A Qiang, 30~39 year old female. Ask Date: 2023/07/11

Dr. Lin Wufu reply Internal Medicine

1.
Correct.
2.
I haven't heard of it so far!

Reply Date: 2023/07/11

More Info

Rabies is a viral disease that primarily affects mammals, including humans, and is most commonly transmitted through the bite of an infected animal. The rabies virus is present in the saliva of infected animals, and once it enters the human body, it travels along peripheral nerves to the central nervous system, leading to severe neurological symptoms and, ultimately, death if left untreated. Given your questions, let’s address them in detail.

1. Understanding Past Exposure and Immunity: If you were bitten by a monkey over 20 years ago and received incomplete treatment (only one dose of rabies immune globulin or rabies vaccine), your concern about whether you might still be harboring the virus is valid. However, rabies has a well-documented incubation period, which typically ranges from a few weeks to several months, with most cases presenting symptoms within one year of exposure. The fact that you have remained healthy for over 20 years strongly suggests that you did not contract rabies from that incident. The absence of symptoms for such an extended period is a strong indicator that the virus did not establish an infection in your body.
2. Potential for Extended Incubation Periods: While the standard understanding is that rabies does not have an incubation period longer than one year, there are rare exceptions reported in the literature. However, these cases are extremely uncommon and often involve unusual circumstances, such as bites in specific anatomical locations or immunocompromised individuals. The rabies virus does not typically mutate to create a significantly longer incubation period like 20 or 30 years. The biological mechanisms of the virus and the immune response in humans do not support such extended latency. Therefore, it is highly unlikely that rabies could remain dormant for decades without causing symptoms.

In summary, your understanding that you are likely not infected with rabies after such a long time without symptoms is correct. Rabies is a serious disease, but the timeline of your exposure and the absence of any health issues over the years strongly indicate that you are safe. If you have any lingering concerns or experience any unusual symptoms, it would be prudent to consult a healthcare professional for further evaluation and peace of mind.

In terms of rabies prevention, it is crucial to seek immediate medical attention after any potential exposure to rabies, especially from wild animals or pets with unknown vaccination status. Post-exposure prophylaxis (PEP), which includes rabies vaccinations and immune globulin, is highly effective if administered promptly after exposure. Always ensure that pets are vaccinated against rabies and avoid contact with wild animals to minimize the risk of rabies transmission.
If you have further questions or need clarification on rabies or any other health-related topics, feel free to ask!

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