Rabies is an acute and usually fatal virus-related disease of mammals and humans.

The rabies virus is spread worldwide. The disease is particularly common in Africa, Asia and large parts of South America.

Dogs, foxes, tanuki, coyotes, raccoons and mongooses. Theoretically, however, all mammals as well as humans can become infected with the rabies virus. Bats are considered a reservoir for certain strains of lyssavirus.

The pathogen is transmitted through the saliva of infected animals, in most cases through a bite. However, in rare cases, the virus can also use uninjured mucous membranes and abrasions as a port of entry when direct contact with saliva occurs.

2 to 12 weeks (in exceptional cases up to one year), depending on the bite site

Altered behaviour, shyness, nervousness, irritability, difficulty swallowing, salivation, hydrophobia (aversion to water), increasing aggressiveness, signs of paralysis. Rabies almost always leads to death within 14 days after the onset of the disease.

There is no therapy

Rabies is incurable, but preventable. Regular vaccination of dogs and oral vaccination of reservoir animals can largely prevent human infections. Prophylactic vaccination (pre-exposure prophylaxis) is recommended for travellers to countries with a high rabies risk. In the event of a bite by a suspect animal, postexpositive prophylaxis (PEP) with administration of immunoglobulins and active immunisation are carried out.

The last human death as a result of silvatic rabies transmitted by wild animals was recorded in Carinthia in 1979 after a fox bite. An imported rabies fatality in Austria was last documented in 2004: a man died after being bitten by a rabid dog in Morocco. Austria was declared free of terrestrial rabies (= rabies in animals living on land) in 2008.

The last time a fox was diagnosed with rabies was in 2004 and 2006. However, further investigations revealed that it was a vaccine virus that had been ingested by young animals in the form of vaccine baits. Prior to this, there was an animal rabies outbreak in Carinthia in 2002, which was due to the immigration of foxes from Slovenia. The circulation of the rabies virus in the Austrian dog population has been extinct since 1950.

Bat rabies is an independent infection and is not related to terrestrial rabies. Between 2006 and 2023, over 1,800 bats were tested for lyssaviruses at the national reference laboratory for rabies, all with negative results. In September 2023, bat rabies virus was confirmed for the first time in a broad-winged bat in Austria in the course of monitoring investigations: The animal had already died at the Bat Rescue Austria rescue centre in June. Transmission of bat rabies to other animal species or to humans is extremely rare and has not been detected in Austria to date.

The Austrian animal disease radar evaluates and compiles information on the international situation and spread of the most important animal diseases that are relevant to Austria. This enables potential risks for Austria to be recognised and communicated at an early stage. The animal disease radar is published monthly.

The rabies viruses belong to the Rhabdoviridae family, genus Lyssavirus. A total of 18 different rabies virus species are currently recognised. Four further isolates are currently being analysed to determine whether they are independent virus species.

According to the World Health Organisation (WHO), around 55,000 - 60,000 people are infected with the rabies virus every year, with dogs acting as carriers in most cases. Almost half of the people bitten by dogs suspected of rabies are children under the age of 15. In Austria, the last human death as a result of silvatic rabies transmitted by wild animals was recorded in Carinthia in 1979 following a fox bite. An imported rabies fatality in Austria was last documented in 2004: a man died after being bitten by a rabid dog in Morocco.

Depending on the host animal, rabies can occur in three different forms:

Urban rabies: Dogs are the main reservoir and transmit the rabies virus to other animals and humans. The circulation of the rabies virus in the Austrian dog population has been extinct since 1950.

Silvatic rabies: This is rabies transmitted by wild carnivores. The main reservoir in Europe is the red fox, in Eastern Europe also the raccoon dog. No rabies virus has been detected in wild animals in Austria since 2007.

Bat rabies: Bat rabies is an independent infection and is not related to silvatic rabies. In September 2023, bat rabies was detected for the first time in Austria in a broad-winged bat.

The pathogen is transmitted through the saliva of infected animals, in most cases through a bite. However, in rare cases, the virus can also use uninjured mucous membranes and abrasions as a portal of entry if there is direct contact with saliva. Contact with blood, urine or faeces of an infected animal or simply touching or stroking sick animals does not pose a risk of infection.

Exposure to bats in their habitats (caves with large bat populations) is controversial as a relevant risk for possible airborne transmission. The mere presence of a bat in the same room is not sufficient for transmission of the pathogen. Direct contact with bats, on the other hand, poses a risk of infection.

Some cases of human-to-human transmission have been published. The main cause in this context is transplantation. Individual cases of human-to-human transmission through bites have also been reported. Transmission in the context of caring for patients has not yet been observed.

Course of the disease

Rabies almost always leads to death within 14 days of the onset of the disease. The time between the bite and the appearance of the first symptoms depends on the bite site. The further away the bite site is from the central nervous system, the longer it takes for the first symptoms to appear. Depending on whether the clinical picture is characterised by a strong excitement stage or only signs of paralysis, a distinction is also made between raging and silent rage.

The classic course of the disease comprises three stages:

Prodromal stage (prodromal stage): Non-specific symptoms such as signs of a flu-like infection, pain, itching or paraesthesia (paresthesia) in the area of the bite wound

Stage irritationis (excitation stage): Approximately 80 % of patients develop the classic form of rabies ("furious rage"). This is characterised by episodes of confusion, agitation and aggressive behaviour alternating with periods of consciousness. Fever, increased salivation, sweating, dilated pupils and goose bumps have also been described. Seizures occur rarely, usually in the advanced course of the disease. The majority of patients develop hydrophobia, which is characteristic of rabies. Eventually, flaccid paresis, coma and multi-organ failure occur.

Paralytic stage (paralysed stage): In the paralytic form of Rabies ("silent rage", approx. 20% of cases), flaccid paralysis occurs early on and pain, sensory disturbances and autonomic dysregulation develop as the disease progresses. Hydrophobia is rather atypical in this form of the disease, but can occur. Death eventually occurs due to paralysis of the respiratory muscles.

Rabies advice centre

The Rabies Advice Centre at the AGES Institute of Medical Microbiology and Hygiene in Vienna provides specialist information and advice for doctors and patients on the rabies situation in Austria and abroad, as well as in the event of an emergency, including advice on indications for rabies vaccination after a bite from an animal suspected of being rabid and for long-distance travellers based on WHO recommendations. Counselling is provided 365 days a year with the personal presence of a veterinarian (Tel: +43 50 555-37111).

Detailed information can be found in the AGES report Rabies

Austria was declared free of terrestrial rabies in 2008. The last time a fox was diagnosed with rabies was in 2004 and 2006. However, further investigations revealed that it was a vaccine virus that had been ingested by young animals in the form of vaccine baits. Prior to this, there was an animal rabies outbreak in Carinthia in 2002, which was due to an immigration of foxes from Slovenia.

The circulation of the rabies virus in the Austrian dog population has been extinct since 1950. No rabies virus has been detected in wild animals since 2007. A case of rabies (dog) in the context of an illegal pet import last occurred in Austria in 1999.

Dogs and cats normally only excrete rabies viruses in their saliva in the final stages of the disease. It is extremely unlikely that they will exhibit normal behaviour at this stage. Contact with the blood, urine or faeces of an infected animal or simply touching or stroking a sick animal does not pose a risk of infection.

Bats suffering from rabies are often found lying on the ground. They show abnormal behavioural patterns, attack nearby objects, have orientation difficulties and symptoms of paralysis. Rabies-infected bats change their habits, become diurnal and are found in places where they do not normally spend time.

Course of the disease in animals

Prodromal stage (prodromal stage): Depression, fever, nausea, reluctance to eat, vomiting, hydrophobia

Stage irritationis (excitation stage): agitation, hyperactivity, aggressiveness, salivation

Paralytic stage (paralysis stage): Paralyses, impairment of the sensorium, coma

Rabies vaccination of pets

Since the introduction of the EU pet passport, rabies vaccination has become even more important. The EU pet passport is a standardised animal passport in English and in the respective national language for dogs, cats and ferrets. It replaces all previous border formalities with regard to EU countries and facilitates travelling with animals within the EU The EU pet passport, which is valid for entry and exit, must contain the rabies vaccination and the animal's unique identification (tattoo or microchip).

A blood test with determination of the rabies titre is required as proof of adequate rabies vaccination. This must be at least 0.5 IU/ml (IU = International Units)
and indicates the concentration of antibodies in the blood. The rabies titre determination may only be carried out in an EU-recognised laboratory. In Austria, this is the AGES Institute for Veterinary Examinations in Mödling.