:: Rabies ::

What is Rabies?
Rabies is a viral disease of mammals most often transmitted through the bite of a rabid animal. Domestic animals reported rabies cases are cats, cattle, and dogs most often reported rabid. Human fatalities associated with rabies occur in people who fail to seek medical assistance, usually because they were unaware of their exposure.
Rabies virus infects the central nervous system, causing encephalopathy and ultimately death. Death usually occurs within days of the onset of symptoms. The rabies virus makes its way to the brain by following the peripheral nerves.

The incubation period of the disease depends on how far the virus must travel to reach the central nervus system, usually taking a few months. Once the infection reaches the central nervous system and symptoms begin to show, the untreated infection is almost inevitably fatal within days. From the source of wound of entry, the rabies virus travels quickly along the neural pathways to the central nervous system. There the virus further spreads to other organs. The salivary glands located in the tissues of the mouth and cheeks receive high concentrations of the virus, thus allowing for it to be further transmitted. Fatality can occur within anywhere from 2 days to 5 years from the time of initial infection.

What is the symptom of rabies in humans?
In the beginning stages, the symptoms in humans are nonspecific, consisting of fever, headache, and general malaise, while in later stages, neurological symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, hallucinations, acute pain, violent movements, uncontrolled excitements, depressions, and the inability to swallow water (hence the name hydrophobia). In the final stages, the patient begins to have periods of mania, lethargy, and coma. Death generally occurs due to respiratory insufficiency.
In non-vaccinated humans, rabies is almost invariably fatal after neurological symptoms have developed, but prompt post- exposure vaccination may prevent the virus from progressing. Rabies kills around 55,000 people a year, mostly in Asia and Africa.

How to prevent the disease?
Avoid exposure from suspected animals is the best, but it is difficult to do. Rabies can be prevented by vaccination, both in humans and other animals. In human, rabies prevention using 2 strategy,

  • Pre-exposure vaccination, by giving 3 injections of Human Diploid Cell Vaccine (HDCV) or Purified Chick Embryo Cell Vaccine (PCEC) or Purified vero cell vaccine (PVRV) at day 0, 7, 28. Booster for 1 and 5 years later.
  • Post-exposure vaccination (after confirmed or suspected exposure), by giving injections, vaccine at day 0, 3, 7, 14, 28 and human rabies immune globulin (HRIG) at day 0 (in different syringe and side). The wound must be wash by a large quantity of water and soap or detergent then aply with Povidone Iodine solution or 70% alcohol. Exposed mucous membranes such as eyes, nose or mouth should be flushed well with water. Patient needs adequate treatment in hospital if expose by suspected dog or animal. The dogs must be quarantined for 10 days for observation to prove rabid animal (according to WHO recommendation). Pregnancy and infancy are never contraindications to rabies post-exposure treatment.

Person suffer from rabies must be treated in rabies care center or hospital.