The word "Rabies" usually brings the image of a rabid animal frothing at the lips. An encounter with an infected animal can develop this painful, potentially fatal and preventable illness.
The Rabies virus affects the central nervous system.
The virus can be spread to people by bites and scratches from domestic dogs, cats and rabbits, as well as from skunks, raccoons and bats. A prompt response is needed to fight this infection.
There has been a significant drop in Rabies cases due to the availability of vaccines for humans and animals. However, the actual toll of Rabies in India is unknown.
According to data provided by the WHO, it results in 18,000–20,000 deaths annually. Minors under the age of 15 make up 30 and 60% of Rabies cases and fatalities in India, as bites in children frequently go unnoticed and unreported.
The disease almost always ends in death once Rabies symptoms start to appear. For protection, Rabies vaccinations should be given to anyone who could be at risk of catching the disease.
There are two types of Rabies.
- Furious Rabies: 80% of human Rabies cases are of the first type, furious or encephalitic Rabies. And those who have it are more prone to exhibit hyperactivity and hydrophobia.
- Paralytic Rabies: Paralysis is a primary symptom of the second type of Rabies, sometimes known as paralytic or "dumb" Rabies.
Symptoms of Rabies
The incubation period refers to the time frame between the bite and the start of symptoms. According to the CDC, after a person has received the infection, Rabies symptoms typically take three weeks to 3 months to manifest.
However, according to the World Health Organization (WHO), incubation times can range from one week to one year.
Before the Rabies virus crosses the neuromuscular junction and enters the peripheral nerve, it first replicates at low levels in the skeletal muscle or connective tissue close to the bite site.
The bite’s closeness may explain this variation in the incubation period to the brain and the viral load in the saliva.
Fever and neurological sensations like pain, tingling, prickling or burning (grouped as paresthesias) at the site of the wound that has no apparent reason are some early symptoms that may appear. Additionally, the area has been described as being quite itchy.
1. Furious Rabies
Symptoms of furious Rabies include hyperactivity, excitement and the possibility of erratic behaviour.
Additional symptoms include:
- Insomnia
- Agitation
- Anxiety
- Confusion
- Too much salvation
- Frothing at the mouth
- Trouble swallowing
- Fear of water
2. Paralytic Rabies
According to the WHO, about 20% of all human cases of Rabies are paralytic, which has a less dramatic and typically lengthier course than the furious type. Muscles begin to paralyse at the bite or scratch location progressively. Slowly, a coma sets in, and then there is death.
The Rabies paralytic variant is frequently misdiagnosed, contributing to the disease underreporting.
Transmission of Rabies
With 95% of cases occurring in Asia and Africa, stray dogs are most prevalent in nations where Rabies is most prevalent.
Since the virus is spread through saliva, Rabies can occur if an infected animal attacks a human. It can also happen if an infected animal's saliva enters an open wound or passes through a mucous membrane, such as the mouth or eyes. The virus, however, cannot penetrate intact skin.
According to the Centre for Disease Control and Prevention (CDC), mammals can carry and spread the virus, but smaller mammals like rodents rarely contract or spread the disease.
Who is susceptible to Rabies?
The likelihood of developing Rabies is generally low. However, some circumstances can make you more vulnerable. These include:
- Living in a place where bats are prevalent
- Living in a rural environment where wild animals are more general, and there is little to no access to immunisations and preventive medicine
- Visiting developing nations
- Regular camping and encounters with wildlife
- Being under the age of 15
Diagnosis
Unfortunately, there is no test to identify Rabies infection in its early stages.
A doctor can use tests such as blood, tissue or saliva to identify whether you have the condition only after the symptoms start. A neck biopsy and the direct fluorescent antibody (DFA) test are tissue tests.
A doctor will often give you a prophylactic shot of the Rabies vaccination if a wild animal has bitten you to treat the disease before symptoms appear.
Doctors also usually rule out other illnesses if unaware that a patient contracted Rabies from an animal bite.
Antibodies may be detected in laboratory tests, although they may not be detected until much later during the disease.
Doctors might use a skin biopsy or a person's saliva to isolate the virus. However, it's frequently too late to take action when they confirm a diagnosis.
Because of this, the doctor usually begins a course of preventive medicine without waiting for a confirmed diagnosis.
Treatment
It is unlikely that you can treat Rabies once it has been diagnosed. However, you can receive a series of shots after exposure to the Rabies virus to stop the illness from developing.
After getting bitten by an animal
If an animal bites or scratches you and if you think it could be Rabies, then
- Clean the wound for several minutes while using running water and soap.
- Apply a primary dressing to the wound after cleaning it with an alcohol- or iodine-based disinfectant.
- If possible, go as quickly as possible to the nearest hospital, medical facility, or GP office and let them know you've been bitten or scratched.
- You'll get a series of shots at the hospital or clinic if you've been bitten by an animal known to have Rabies to stop the Rabies virus from infecting you.
Rabies vaccinations include:
- Rabies immune globulin, a vaccine that fights the virus quickly. You will get this if you haven't already had the Rabies vaccination. As soon as possible after the bite, this injection is administered as close as possible to the location where the animal bit you.
- A series of Rabies shots prepares your body to recognise and combat the Rabies virus. The Rabies vaccine is injected into your arm. Those who have never had the Rabies vaccination will receive four doses over 14 days.
Animal control will likely try to track down the animal that bit you so that it may be Rabies-tested. You can skip the extensive Rabies vaccinations if the animal is not rabid; however, the safest action plan is to take preventive vaccinations.
Prevention of Rabies
It is possible to prevent Rabies. There are easy steps you can take to help against getting Rabies:
- Vaccinate your animals.
- Don't let your dogs wander outside.
- Contact animal control about stray animals.
- Stay away from wild animals.
- Avoid letting bats into your home or any nearby structures with living spaces.
- Notify animal control or health authorities in your area of any indications that an animal is infected.
Pre-exposure vaccination
The same vaccine used after a scratch or bite can be used before exposure (this is rare). People who should get pre-exposure vaccination include
- People who work in high-risk occupations, such as laboratories handling live Rabies and Rabies-related (lyssavirus) viruses.
- People (such as animal disease control staff and wildlife rangers) whose professional or recreational activities might put them near bats, carnivores or other mammals that may be infected.
Side effects of the Rabies vaccine
Rare side effects of the Rabies immunoglobulin and vaccine include:
- Injection site discomfort, bruising or itchiness
- Headache
- Nausea
- Muscle aches
- Dizziness
- Stomach aches
Who are at a higher risk of contracting Rabies?
Things that increase the risk of contracting Rabies are,
- Travelling to or residing in areas where Rabies is more prevalent
- Activities include camping without taking precautions to keep wild animals away from your campsite
- Exploring caves where bats live
- Places that are likely to put you in contact with wild animals that may have Rabies
- Working as a veterinary doctor
- Working in a lab with the Rabies virus
Pre-exposure prophylaxis would be advantageous for these people.
Even though you should treat all bites urgently, those who have been bitten on the head, face, neck or hand, especially if there is blood, are at the highest risk of developing clinical Rabies and typically have shorter incubation times.
When should you see a doctor?
If you are bitten by an animal or are exposed to one that may have Rabies, get medical help immediately. You and your doctor can decide if you need to get Rabies therapy based on your injuries and the circumstances surrounding the exposure.
Get medical attention even if you're unsure whether you've been bitten. For instance, a bat that enters your room while you are sleeping can bite you without arousing you. Consider yourself a bit if you awaken to a bat in your room.
Additionally, if you see a bat close to someone unable to disclose being bitten, like a young child or someone who is disabled, you should assume they have been bitten.
Conclusion
The saliva of infected animals transmits the deadly Rabies virus. It produces flu-like symptoms, then fever, muscle spasms, a coma and ultimately death.
Although there is no cure once symptoms show, Rabies vaccinations frequently work to stop infections. People must, however, get help right once and not wait for any signs.
Pre-exposure vaccinations, such as for veterinarians, are advised for people with a high risk of contracting Rabies. Anyone who has been bitten by an animal that might be infected has to seek prompt medical assistance and get post-exposure shots.
If they haven't already received the virus vaccine, they might also need fast-acting RIG.
