Rabies

What is it?          Cause          Symptoms          Diagnosis          Treatment          Prevention

There’s a short glossary of technical words at the bottom of the page.

What is it?

The World Health Organisation (WHO) says that:

Rabies is an infectious viral disease that is almost always fatal following the onset of clinical signs. In up to 99% of human cases, the rabies virus is transmitted by domestic dogs. Rabies affects domestic and wild animals, and is spread to people through bites or scratches, usually via saliva.

Rabies is present on all continents, with the exception of Antarctica, but more than 95% of human deaths occur in Asia and Africa.

Rabies is a neglected disease of poor and vulnerable populations whose deaths are rarely reported and where human vaccines and immunoglobulin are not readily available or accessible. It occurs mainly in remote rural communities where children between the age of 5–14 years are frequent victims.

 


Cause

People inexperienced in handling dogs can be more vulnerable to contracting rabies, because they don’t recognise the signs and symptoms of rabies. They may go to help a dog and the dog then bites.

People are usually infected following a deep bite or scratch by an infected animal. Dogs are the main host and transmitter of rabies. They are the cause of human rabies deaths in Asia and Africa in more than 95% of all cases.

Transmission can also occur when infectious material – usually saliva – comes into direct contact with human mucosa or fresh skin wounds. Human-to-human transmission by bite is theoretically possible, but has never been confirmed.


Symptoms

Infected dogs do not like light. They will move away from the light into darker places. They do not like water. They may start eating things they do not normally eat. They can be more shy – or more aggressive – than usual. They may walk in an unusual way, staggering or appearing drunk.

There are two forms of rabies: paralytic and furious. In the early symptom (prodomal) stage of rabies infection, the dog will show only mild signs of central nervous system abnormalities. This stage will last from one to three days. Most dogs will then progress to either the furious stage, the paralytic stage, or a combination of the two, while others succumb to the infection without displaying any major symptoms.

Furious rabies is characterised by extreme behavioural changes, including overt aggression and attack behaviour. Paralytic rabies, also referred to as dumb rabies, is characterised by weakness and loss of coordination, followed by paralysis.

This is a fast-moving virus. If it is not treated soon after the symptoms have begun, the prognosis is poor. Therefore, if your dog has been in a fight with another animal, or has been bitten or scratched by another animal, or if you have any reason to suspect that your pet has come into contact with a rabid animal (even if your pet has been vaccinated against the virus), you must take your dog to a veterinarian for preventive care immediately.

Some signs of rabies:

  • Pica
  • Fever
  • Seizures
  • Paralysis
  • Hydrophobia
  • Jaw is dropped
  • Inability to swallow
  • Change in tone of bark
  • Muscular lack of coordination
  • Unusual shyness or aggression
  • Excessive excitability
  • Constant irritability/changes in attitude and behavior
  • Paralysis in the mandible and larynx
  • Excessive salivation (hypersalivation), or frothy saliva

Source

 

In humans   The incubation period for rabies is typically 1–3 months, but may vary from <1 week to >1 year, dependent upon factors such as location of rabies entry and rabies viral load. The initial symptoms of rabies are fever and often pain or an unusual or unexplained tingling, pricking or burning sensation at the wound site. As the virus spreads through the central nervous system, progressive, fatal inflammation of the brain and spinal cord develops.

Two forms of the disease can follow. People with furious rabies exhibit signs of hyperactivity, excited behaviour, hydrophobia (fear of water) and sometimes aerophobia (fear of flying). After a few days, death occurs by cardiorespiratory arrest.

Paralytic rabies accounts for about 30% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. The muscles gradually become paralysed, starting at the site of the bite or scratch. A coma slowly develops, and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

Source


Diagnosis

No tests are available to diagnose rabies infection in humans before the onset of clinical disease, and unless the rabies-specific signs of hydrophobia or aerophobia are present, the clinical diagnosis may be difficult. Human rabies can be confirmed intra-vitam and post mortem by various diagnostic techniques aimed at detecting whole virus, viral antigens or nucleic acids in infected tissues (brain, skin, urine or saliva). (WHO)


Treatment

What should I do if I’ve been bitten by an animal that might be rabid? 

The FIRST thing you should do is to clean the wound under running water. Stop any bleeding with gauze, ice, etc. Then go to the doctor.

When should I go to a doctor?

If you have had ANY bite from an animal that might be rabid, you should go to the doctor immediately, and certainly within 12 hours. The doctor will give you an immunoglobulin injection at the site of the wound.

If there is no doctor, you can buy the vaccine from a hospital or pharmacy and have the injection done by a paramedic. The cost of the vaccine is about Rs1,500 (in late 2016).

Here is a list of Apollo pharmacy shops in Kolkata. Some are open 24 hours a day. Type Kolkata in the ‘Location’ box, enter and scroll down the page for maps and shop addresses and phone numbers.

Immediate wound cleansing with soap and water after contact with a suspect rabid animal can be life-saving.

Source


Prevention

DOGS   Dogs should be vaccinated every year, the first vaccine to be given after they are 3 months old.

The vaccine lasts for one year.

In India, vaccine names include: Raksharab, NobiVacR, Canvac.

In Kolkata, one vaccine typically costs around Rs200 (in late 2016).

HUMANS   People likely to be in contact with rabies, or with a chance of being in contact with a rabid dog, should get themselves vaccinated. See your doctor and ask her or him to give you the jab. If you’re a member of KSD or another group for street dogs, this probably includes you!

Rabies is a vaccine-preventable disease. Vaccinating dogs is the most cost-effective strategy for preventing rabies in people.

The same safe and effective vaccines can be used for pre-exposure immunisation. This is recommended for people spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, or hiking as well as for long-term travellers and expatriates living in areas with a significant risk of exposure to dog bites.

Pre-exposure immunisation is also recommended for people in certain high-risk occupations such as people involved in any activities that might bring them  into direct contact with dogs, plus bats, carnivores, and other mammals in rabies-affected areas. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites.


Read more


Glossary

  • Cardiorespiratory – heart and lungs
  • Coma – deep, lengthy unconsciousness
  • Faeces (feces in America) – poo (shit)
  • Hyperactivity – more activity than usual (hyper = more; hypo = less)
  • Immunity – the body’s resistance to disease
  • Immunoglobulin – antibody, helps to create immunity
  • Incubation – the time between being infected and showing symptoms
  • Intra-vitam – during life
  • Larynx – voice box (part of the respiratory system)
  • Mandible – lower jaw (bone)
  • Mucosa – the lining of parts of the body open to the outside, e.g. inside the mouth, nose, ears
  • Pica – eating things that are not normally eaten
  • Post mortem – after death
  • Saliva – spit (the liquid in your mouth)
  • Urine – pee (piss)
  • Vaccine – medicine to treat or prevent a disease