- Rabies is acute viral encephalitis
- Rabies is 100% fatal but easily preventable.
- There is no specific treatment for rabies. Death is inevitable once clinical signs develop.
- Every year, more than 20,000 people die of rabies in India. About 70% are children younger than 15 years.
- Rabies is caused by bite, scratch or lick of dog, cat, monkey, or any wild animal. Rat bite cases do not require rabies vaccination.
- Hydrophobia is the best known clinical feature of rabies and is typically unique to human beings.
- Observation of an animal for 10 days from the day of biting for signs of rabies is applicable only to dogs and cats.
Two Types of Rabies:-
- Furious type of rabies which has Fluctuating consciousness, Aerophobia, Hydrophobia, and Photophobia, increased salivation, Excessive Sweating.
- Remaining patients present with paralysis- Dumb Rabies. Hydrophobia is usually absent in these cases.
PEP includes:-
- Local treatment of wound(s)
- Categorization of animal bite wound(s)
- Anti Rabies Vaccination. (ARV)
- Administration of Rabies Immunoglobulin (RIG)
- In addition, Tetanus prophylaxis, analgesics & systemic antibiotics may be given.
- There is NO contraindication for Post Exposure Immunization.
- By mere washing of wounds, the risk of rabies will reduce by about 50%.
- This can be done by washing with ordinary soap and water for at least 15 minutes.
- 15 to 20 percent of dog bite wounds become infected.
- An early and correct administration of modern vaccine is life saving.
- A person receiving antirabies immunization can donate blood.
- Rabies vaccine can be given to a child with chicken pox or measles or jaundice.
- PEP is required for a person bitten by a vaccinated dog.
- There is no single dose vaccine or a vaccine that gives lifelong immunity.
- Day 0 dose should be doubled in patients who seek treatment after a delay of 48 hours, on drugs, such as steroids, antimalarials, anticancer drugs, patients with underlying chronic disease like liver cirrhosis.
- Pre-exposure (Prebite) vaccination means immunization before the bite.
- The regimen is three IM injections on days 0, 7 & 28. A booster at one year. After bite, those who have received full Pre-exposure vaccination, only two doses of vaccine at days 0 & 3 are required.
- RIG is a life saving drug.
- Protective levels of antibodies are seen 7 to 14 days after the initial dose of vaccine. Thus the patients are vulnerable to develop rabies during this period. RIGs are readymade anti-rabies antibodies which offer immediate protection.
- RIGs should not be given after day 7.
- Unboiled milk of a rabid animal may contain rabies virus. There is a risk of humans contracting rabies after having consumed unboiled milk of a rabid animal.
- Kissing a rabies patient may transmit disease because there may be contact with rabies patient`s saliva.
- If a person has handled or eaten the raw meat of a rabid animal, he should receive full course of rabies vaccine.
- In case the mother develops rabies, the foetus is safe.
- If a vaccinated pet dog dies of sudden unexplained death, then all those who came in its contact, should be given full PEP vaccination.
- If unvaccinated or partially vaccinated pet dog is bitten by a suspected rabid stray dog, then the pet dog should ideally be put to sleep.
- It is important to get the pet dog properly vaccinated.
The signs of rabies in dogs/cats are:-
- Any change in normal behavior suggesting either undue aggression or depression.
- Running aimlessly and attacking others without provocation.
- Becomes too drowsy and withdraws to a corner.
- Change in voice/bark.
- Excessive salivation.
- Refusal to feed or eating objects like stone, paper, wood, metal pieces etc.
- Hydrophobia is not a sign of rabies in dogs. Rabid dogs can drink water and even swim.
- Rabies can be transmitted to a dog that has eaten the flesh of a dead rabid cow or buffalo.
- For the dogs and cats, the primary vaccination schedule consists of two doses of vaccine, that is, one dose given at 2 months of age and the second given 1 month later. This is followed by a booster dose of vaccine every year.
Myths about rabies in India:-
- Some herbal extracts will cure rabies.
- In rural areas, people also resort to magico-religious practices.
- Washing of wound can cause hydrophobia.
- Dietary changes can cure, that is, shift from vegetarianism to non-vegetarianism or vice versa; stopping consumption of white things. etc.
- A single dose vaccine will prevent rabies.
- Vaccines are more effective if taken on empty stomach.
- One should not take bath; eat meat and eggs during vaccination.
- Gems and stones have magical properties against rabies.