Rabies

What is Rabies?

Rabies is an acute infection of the central nervous system caused by the rabies virus. The incubation period is usually 1-3 months, but may vary from less than 1 week to over one year. Initial symptoms include malaise, headache, fever and abnormal skin sensations. These are followed after a few days by anxiety, confusion, muscle spasm (especially of the throat leading to fear of water), paralysis, coma and death.

How does it spread?

When humans are bitten, scratched or licked over their broken skin by an infected animal, the virus in the saliva of the infected animal enters the human body through the wound and travels through nerves to the brain, leading to encephalitis.

How can you prevent it?

Travellers should avoid stray animals, including dogs, cats, and monkeys. Immunization (both pre-exposure and post-exposure), combined with thorough wound cleaning, is the most reliable method of preventing rabies.

Pre-exposure immunization is done by giving 3 doses of vaccine on days 0, 7, and 21 or 28, followed, if necessary, with the first booster dose in 12 months, and then later boosters every 2 years. Pre-exposure immunization is recommended for prolonged trips to endemic areas, particularly if travelling to remote rural regions without medical facilities. It is also recommended for people who travel for a short period in rabies affected areas but anticipate engaging in activities with special risks (e.g. hiking, biking, trekking and animal handling). Nevertheless, pre-exposure immunization does not eliminate the need for post-exposure immunization.

How is it treated?

Once symptoms of rabies appear, the disease is nearly always fatal, and treatment is supportive.

Therefore it is very important that after being bitten by animals, one must wash the wound thoroughly with clean water and soap or detergent immediately, and then seek medical attention at once. Standard treatment would include:-

• Thorough cleaning of wound, usually without suturing.
  
  
• Post-exposure immunization against rabies to be considered according to circumstances, e.g. whether the animal could be observed, presence of Rabies in the areas, etc.
  
  
• Tetanus booster or antibiotic may be needed in addition.