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RABIES

Rabies is one of the oldest diseases known to mankind. There is still no treatment available once a patient develops the symptoms of rabies. The following FAQs are intended to provide answers to common questions about the disease following the news about rabies cases detected in Sarawak. These are adapted from the World Health Organisation�s FAQ, which can be read in full at http://www.who.int/rabies/resources/SEA_CD_278_FAQs_Rabies.pdf

Q 1: What is Rabies?

Rabies is a disease transmitted from animals to humans, which is caused by a virus. There are two clinical manifestations of rabies � frantic and paralytic. Frantic rabies is most common form of human rabies.

Q 2: How is rabies transmitted?

The rabies virus is primarily transmitted from the rabid animal�s saliva when it bites or scratches someone. Licks to wounds or grazed and broken skin, or to the lining of the mouth and nose, can also transmit the disease. Dogs are responsible for 96% of human rabies cases in South-East Asia, but there are also reports of human rabies due to bites of cats, mongooses, jackals, foxes, wolves and other carnivorous animals. Rabies due to monkey and rat bites are rare.

Q 3: How do I treat an animal bite?

? Wounds should be washed and flushed immediately with soap and water for 10�15 minutes. This is the most effective first-aid treatment against rabies.

? Wounds should be cleaned thoroughly with 70% alcohol/ethanol or povidone-iodine, if available.

? As soon as possible, go to a hospital for further treatment.

Q 4: What you should not do with an animal bite wound?

? You should not apply irritants to the wound such as chilli powder, plant juices, acids or alkalis.

? You should not cover the wound with dressings or bandages.

Q 5: How does rabies develop in humans?

After entering the human body, the rabies virus progresses into the nerves in the body which are outside the brain or spinal cord. The infected person exhibits behavioural changes and clinical signs when the virus reaches the brain. The incubation period ranges from a few days to several months, and can be as long as one year.

Q 6: How long does it take for dogs and cats to develop rabies, and how long does a rabid animal survive?

The incubation period ranges from a few days to several months, whereas the duration of illness � until death � varies from 1 to 7 days.

Q 7: What are the clinical features of rabies in dogs?

Dog rabies is characterized by changes to its normal behaviour, such as:

? biting without any provocation

? eating abnormal items such as sticks, nails, faeces, etc.

? running for no apparent reason

? a change in sound e.g. hoarse barking and growling or inability to make a sound

? excessive salivation or foaming at the angles of the mouth � but not hydrophobia (fear of water).

Q 8: What are the signs and symptoms of rabies in humans?

Human rabies has the following signs and symptoms:

? pain or itching at the site of the bite wound (in 80% of cases)

? fever, malaise, headache lasting for 2�4 days.

? hydrophobia (fear of water)

? intolerance to noise, bright light or air

? fear of impending death

? anger, irritability and depression

? hyperactivity

? at a later stage the mere sight of water may provoke spasms in the neck and throat

? the duration of illness is usually 2�3 days, but might stretch to 5�6 days or more when receiving intensive care support.

Q 9: Is there any specific treatment for a rabies patient?

There is no specific treatment once rabies develops. There is almost nothing that can be done apart from keeping the patient comfortable, and free from physical pain and emotional upset.

? Precautions should be taken by the caregiver to avoid bites and saliva contamination of mucous membranes and wounds by using personal protection equipment.

? Keep the patient in a quiet room with subdued light and protect them from stimuli (e.g. loud noises, cold air) that are likely to increase spasms and convulsions.

? Feeding orally is usually impossible. Fluids should be given intravenously.

Q 10: Is rabies always fatal?

Human rabies caused by the classical rabies virus continues to be almost 100% fatal, with no specific treatment available anywhere in the world. There are only seven recorded cases of human rabies survivors in the world, who received intensive nursing care. Almost all of them received preventive/ pre-exposure rabies vaccination that might have modified the course of illness.

Q 11: Should I just observe the biting dog or cat for a few days before taking it to the vet?

No. It is better to take the dog/cat to the vet clinic to start treatment and keep the biting dog/cat under 10 days of observation. If the animal remains healthy during the observation period then post-exposure prophylaxis (PEP) can be converted into pre-exposure regimen, i.e. the vaccine taken will be to prevent rabies if bitten in the future.

Q 12: Under what conditions do I have to take anti-rabies vaccination after being bitten?

Post-exposure rabies prophylaxis (PEP) is compulsory if you are bitten by a dog, cat or other animal that is rabid or is suspected to be infected with rabies. PEP is required under following conditions:

? If the bite has broken the skin and the wound is bleeding.

? If a mucous membrane has been exposed to saliva from a suspect animal.

? If the animal that has bitten someone

1. is killed

2. disappears during the observation period

3. displays unusual, erratic behaviour

4. if laboratory tests of brain material from the suspected or rabid animal is positive.

Q 13: If I am bitten by a rat do I require post-exposure prophylaxis (PEP)?

Rat rabies has been reported from some Asian countries but is extremely rare. It is not necessary to take PEP in bite cases by house rats. However, if you are bitten by a wild rat, you could consult with a physician.

Q 14: Can consumption of meat from an infected animal transmit rabies?

The consumption of raw meat from an infected animal requires PEP. Cooked meat does not transmit rabies; however, it is not advisable to consume meat from an infected animal. Consumption of wildmeat should be avoided.

Q 15: Is there a single-dose human rabies vaccine which will provide life-long immunity?

No. There is no single-dose rabies vaccine available anywhere in the world which can provide lifelong immunity. Single-dose vaccines are available, but they only provide immunity for a limited period of time.

Q 16: Can I develop rabies from the vaccination?

No. All rabies vaccines for human use are inactivated. Human rabies vaccines undergo a series of quality control tests such as potency, toxicity, safety and sterility. It is not possible for the rabies vaccination to cause the disease.

Q 17: What can I do for rabies prevention and control?

Be responsible by vaccinating pet dogs or cats against rabies, as recommended by veterinarians or animal health workers.

? Keep the dog vaccination certificate safe and present it during annual vaccination.

? Do not sell or consume milk or meat from rabid or suspected rabid cows or buffalos.

Q 18: What is the rabies vaccination schedule for pet dogs?

Puppies get maternal antibodies against rabies for 3 months and therefore it is recommended to vaccinate at 3 months of age, then at 9 months of age and revaccinate annually. Puppies and dogs must be given anthelmintic drugs regularly before vaccination. If the puppies adopted are street dogs, the first vaccination should be given as the same protocol (at 3 months of age, 9 months, and yearly boosters). Alternately, first vaccination can be given as early as 2 months of age. Precautions should be taken in first 3 months of age. If adult street dogs are adopted, then the first vaccination should be given as soon as possible, and a local veterinarian should be consulted.

Source: https://www.facebook.com/SarawakSPCA/photos/a.176524749431.1..

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