Introduction
Rabies is a fatal viral disease that affects the central nervous system of mammals, including humans. It is caused by the Rabies lyssavirus and is primarily transmitted through the bite or scratch of an infected animal. Once symptoms appear, rabies is almost always fatal, making prevention through vaccination and immediate medical intervention crucial.
Modes of Transmission
Rabies spreads mainly through the saliva of infected animals. The most common modes of transmission include:
- Animal Bites – The virus enters the body through broken skin after a bite from an infected animal, especially dogs, bats, foxes, raccoons, and skunks.
- Scratches – If an infected animal’s claws have saliva on them, scratches can introduce the virus.
- Mucosal Exposure – The virus can enter through mucous membranes (eyes, nose, or mouth) if exposed to infected saliva.
- Rare Cases – Organ transplantation from an infected donor has also been reported to transmit rabies.
Symptoms of Rabies
Rabies has an incubation period of 1 to 3 months, but symptoms can appear within days to over a year after exposure. Symptoms progress through the following stages:
1. Early Symptoms (Prodromal Phase)
- Fever
- Headache
- Fatigue
- Pain, itching, or tingling at the bite site
2. Acute Neurological Phase
- Anxiety, confusion
- Hydrophobia (fear of water)
- Aerophobia (fear of air movement)
- Excessive salivation
- Paralysis and convulsions
3. Coma and Death
- Once symptoms appear, the disease progresses rapidly to coma and death, usually due to respiratory failure.
Categories of Animal Bites and Post-Exposure Treatment
The World Health Organization (WHO) classifies rabies exposure into three categories:
Category I (No Risk – No Treatment Needed)
- Touching or feeding an animal
- Licking of intact skin
- No bite, scratch, or broken skin
Treatment: No vaccine or immunoglobulin needed.
Category II (Moderate Risk – Immediate Vaccination Needed)
- Minor scratches, abrasions, or licks on broken skin
- Nibbling without bleeding
Treatment: Immediate anti-rabies vaccine (ARV). No immunoglobulin needed.
Category III (High Risk – Urgent Vaccination & Sera Required)
- Deep bites or multiple wounds
- Contamination of mucous membranes (eyes, mouth) with infected saliva
- Bites from wild animals (bats, raccoons, foxes, etc.)
Treatment: Immediate ARV and Rabies Immunoglobulin (RIG).
Who Should Get the Rabies Vaccine and Serum?
Rabies vaccines are given in two situations:
1. Pre-Exposure Prophylaxis (PrEP) – Preventive Vaccination
- Veterinarians, animal handlers, and wildlife workers
- Laboratory personnel handling the rabies virus
- Travelers visiting rabies-endemic areas
- People living in high-risk regions with frequent exposure to stray animals
Schedule: Usually given in 3 doses on Days 0, 7, and 21 (or 28).
2. Post-Exposure Prophylaxis (PEP) – After Exposure Treatment
- Anyone bitten or scratched by a suspected rabid animal
- People exposed to the saliva of an infected animal on broken skin or mucous membranes
Treatment Protocol:
- Category II: Rabies vaccine on Days 0, 3, 7, and 14 (sometimes 28).
- Category III: Rabies vaccine + Rabies Immunoglobulin (RIG) injected into the wound area.
Prevention and Control of Rabies
- Vaccinating Pets – Routine rabies vaccination of dogs and cats.
- Avoiding Contact with Stray or Wild Animals – Do not handle unfamiliar or sick-looking animals.
- Prompt Wound Care – Wash bite wounds immediately with soap and water for at least 15 minutes.
- Seeking Medical Help – Visit a healthcare facility immediately for assessment and vaccination.
- Public Awareness Campaigns – Educating communities about rabies prevention and responsible pet ownership.
Conclusion
Rabies remains a significant public health concern, but it is 100% preventable through timely vaccination and proper post-exposure care. Understanding the risks, symptoms, and treatment options can help save lives. Anyone at risk of exposure should get vaccinated, and immediate medical attention is essential after an animal bite.
By following prevention strategies and increasing awareness, we can work toward eliminating human deaths from rabies.