World Rabies Day – 28 September

RABIES causes thousands of deaths every year in more than 100 countries in which communities have limited access to health and veterinary systems.

Successful rabies control programmes comprise of three pillars – community participation; education, public awareness and access to mass vaccination of dogs; and access to post bite treatment.

The incubation period for rabies is one to three months and initial symptoms include a fever with pain and unusual or unexplained tingling, pricking, or burning sensation at the wound site.

Rabies is almost always fatal once initial symptoms appear.

As the virus spreads to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops.

Kinds of rabies

Furious rabies: People with this kind of rabies exhibit signs of hyperactivity, excitable behaviour, a fear of water and sometimes of drafts of fresh air.

Death occurs after a few days owing to cardiorespiratory arrest.

Paralytic rabies: Muscles become paralysed, starting at the site of the bite or scratch.

A coma develops, and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

Transmission

Dogs are the main source of human rabies deaths, contributing up to 99% of all rabies transmissions to humans.

People are usually infected following a deep bite or scratch from an animal with rabies.

Transmission can also occur when infectious material – usually saliva – comes into direct contact with human mucosa or fresh skin wounds.

Rabies elimination is feasible through the vaccination of dogs and the prevention of dog bites.

After exposure

The immediate treatment of a bite victim after rabies exposure prevents virus entry into the central nervous system.

The treatment consists of:

• Extensive washing and local treatment of the wound as soon as possible after exposure

• A course of potent and effective rabies vaccine that meets World Health Organization standards

• The administration of rabies immunoglobulin, if indicated

• Effective treatment soon after exposure can prevent the onset of rabies.

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