AWARENESS ABOUT RABIES

Rabies is a condition in which a person suffers from delirium, aggressiveness and hallucinations.

Rabies is a Latin word meaning “rage” or “madness”.

It is a viral disease i.e. lyssavirus of rhabdovirus, encephalitis transmitted by infected saliva of animals that is transferred to body through animal bite.

It causes death of nerve cells by apoptosis or necrosis. It causes mild neuropathological changes and causes neuronal dysfunction. Therefore most of the symptoms are related to nervous system.

Virus enters saliva of the animal approximately 5 to 7 days before death from rabies.

The incubation period of virus ranges from 10 days to many years but it is usually 3-7 weeks depending on distance of wound from central nervous system.

DIAGNOSIS:

Patient is checked for animal bites. Headache, malaise, paresthesia, hydrophobia and delirium are common symptoms.

There are alternating periods of calm.
Convulsions paralysis and thick saliva are also seen.
Laboratory testing is done of saliva, serum and spinal fluid. Skin biopsy is also done.

SIGNS & SYMPTOMS:

Prodormal:

Pain is there at site of bite. Along with that fever, malaise, headache, nausea and vomiting are experienced. Skin becomes sensitive to air pressure (aerophobia) and temperature changes.

Myoedema can also be present and may remain throughout the disease.

CNS STAGE:

There are two ways in which this stage may appear.

Furious (encephalitic)

80% of cases are encephalitic and they experience delirium with periods of calm, extremely painful lyrangeal spasms, hydrophobia, hypersalivation and seizures.

Paralytic (dumb)

This causes acute ascending paralysis.
Both forms lead to coma, autonomic nervous system dysfunction and death.

PREVENTION:

Immunization of household dogs and cats should be done.
Immunization of people with animal exposure is also important.
Education, surveillance and animal immunization programs are preferable over mass destruction of dogs.

VACCINATION SCHEDULE FOR DOGS:

After the age of 1 year initial dose is given.
2^nd dose is given after 1 year of the initial dose.
After 2^nd dose the booster dose is given afterevery 3 year.
VACCINATION OF HUMAN (NO EXPOSURE)

The pre-exposure schedule for rabies vaccination is 3 doses. They are given as follows:

Dose1 is given as appropriate.
Dose 2 is given after 7 days of the 1^st dose.
Dose 3 is given after 21 or 28 days after the 2^nd dose.
POST EXPOSEURE HUMAN VACCINATION SCHEDULE:

If Person is not vaccinated before:

Dose 1 is given as soon as possible after the exposure.
Dose 2 is given after 3^rd day of exposure.
Dose 3 is given after 7^th day of exposure.
Dose 4 is given on 14^th day of exposure.
Dose 5 is given on 28^th day of exposure.
Immunoglobulin is given with the 1st dose.

If person is vaccinated before:

Only 2 doses are given to pre-vaccinated person.
Dose 1 is given as soon as the exposure happens.
Dose 2 is given on the 3^rd day of exposure.
Immunoglobulin is not required.

LOCAL TREATMENT OF ANIMAL BITE & SCRATCHES:

Bites and scratches are cleansed and through debridement. Wound is repeatedly cleaned and washed with plenty of water and soap.

Wounds caused by animal bites should not be sutured because infections may appear.

The physician decides whether to vaccinate or not. This decision is based upon the vaccination status of animal and category of exposure.

AWARENESS ABOUT RABIES