RABIES is found in more than 150 countries and territories.
ER24 gives an overview of this widespread and dangerous viral disease, which can be prevented with a vaccine.
Symptons
The incubation period for rabies is one to three months.
Initial symptoms of include a fever with pain and unusual or unexplained tingling, pricking or burning sensation at the wound site.
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 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.
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Diagnosis
Current diagnostic tools are not suitable for detecting rabies infection before the onset of the clinical disease.
Unless specific signs of fear of water or air drafts are present, clinical diagnosis may be difficult.
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.
Prevention immunisation
Human rabies vaccines exist for pre-exposure immunisation and are recommended for travellers to rabies affected areas.
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 Organisation standards.
• The administration of rabies immunoglobulin, if indicated.
Effective treatment soon after exposure can prevent the onset of rabies.
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