Special: 8 Things You Need To Know About Rabies

This got stuck in my draft box. Anyway, rabies, especially in summer, is still relevant. Be safe all.

Note: I highlighted some statements for emphasis.
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Credits to ABS CBN News.

8 things you need to know about rabies

Posted at Mar 21 2012 02:46 PM | Updated as of Mar 21 2012 11:57 PM

MANILA, Philippines – Did you know that 200 to 300 Filipinos die of rabies each year?

Dr. Raffy Deray, program manager for rabies at the Department of Health’s National Center for Disease Prevention and Control, said a patient bitten by a rabid dog may die within three to five days.

“The latest recommendation of the DOH is all bite victims should be provided immunization as early as possible,” Deray said in interview on “Mornings@ANC” on Tuesday.

Here are some things you need to know about rabies, as mentioned by Deray:

  1. Rabies is caused by a virus that infects the central nervous system. A patient may die within three to five days.
  2. Rabies accounts for about 55,000 deaths worldwide every year, and majority of the fatalities are children. In the Philippines, the disease is responsible for the death of 200 to 300 Filipinos annually.
  3. Rabies cases are usually higher in the Philippines during summer, when children spend more time playing outdoors.
  4. There are two ways that a person can get the rabies virus – through the bite of a rabid animal such as a dog, and by inhalation. The latter occurs only in special circumstances, such as when the patient is inside a laboratory.
  5. Here are some signs that you may have rabies: anxiety, stress and tension, delirium, drooling, convulsions, exaggerated sensation at the bite site, hallucinations, loss of feeling in an area of the body, loss of muscle function, low-grade fever (102 degrees Fahrenheit or lower), muscle spasms, numbness and tingling, pain at the side of the bite, restlessness, insomnia, and swallowing difficulty.
  6. Rabies cannot be cured, but it is preventable. There are two ways to prevent this disease – by vaccinating dogs, and by vaccinating humans. Traditional healers’ approaches to treating rabies have no scientific basis.
  7. When bitten by stray animals who may have rabies, do the following: 1) immediately wash the bite with soap and clean water. Antiseptics may be applied. 2) Consult a physician or go to your nearest animal bite center for immunization. 3) Consult a veterinarian for the management of the biting dog.
  8. The DOH is targeting a rabies-free Philippines by 2020 mainly through the vaccination of all dogs in the country.

Post-exposure prophylaxis (PEP)

Post-exposure prophylaxis (PEP) means the treatment of a bite victim that is started immediately after exposure to rabies in order to prevent rabies from entering the central nervous system which would result in imminent death. This consists of:

  • local treatment of the wound, initiated as soon as possible after exposure;
  • a course of potent and effective rabies vaccine that meets WHO standards; and
  • the administration of rabies immunoglobulin (RIG), if indicated.

Effective treatment soon after exposure to rabies can prevent the onset of symptoms and death.

Local treatment of the wound

This involves first-aid of the wound that includes immediate and thorough flushing and washing of the wound for a minimum of 15 minutes with soap and water, detergent, povidone iodine or other substances that kill the rabies virus.

Recommended PEP

Depending on the severity of the contact administering with the suspected rabid animal, administration of PEP is recommended as follows (see table):

 

Table: Categories of contact and recommended post-exposure prophylaxis (PEP)

Categories of contact with suspect rabid animal Post-exposure prophylaxis measures
Category I – touching or feeding animals, licks on intact skin None
Category II – nibbling of uncovered skin, minor scratches or abrasions without bleeding Immediate vaccination and local treatment of the wound
Category III – single or multiple transdermal bites or scratches, licks on broken skin; contamination of mucous membrane with saliva from licks, contacts with bats. Immediate vaccination and administration of rabies immunoglobulin; local treatment of the wound

All category II and III exposures assessed as carrying a risk of developing rabies require PEP. This risk is increased if:

  • the biting mammal is a known rabies reservoir or vector species;
  • the animal looks sick or displays an abnormal behaviour;
  • a wound or mucous membrane was contaminated by the animal’s saliva;
  • the bite was unprovoked; and
  • the animal has not been vaccinated.
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