[ Takhe Konya ]
Rabies is a devastating and societally important zoonotic disease caused by lyssavirus, which is transmitted principally to humans through the bite of infected dogs.
This acute, progressive viral encephalitis has the highest case fatality of any infectious disease and kills tens of thousands of people annually.
Low awareness of the need to seek health care after a dog bite claims the lives of more than 55,000 people each year, mostly in Asia and Africa. India is endemic for rabies, and accounts for 36% of the world’s rabies deaths. As per available information, it causes 18,000-20,000 deaths every year. About 30-60% of reported rabies cases and deaths in India occur in children under the age of 15 years as bites that occur in children often go unrecognized and unreported.
There are two main forms of rabies in dogs: Furious form and paralytic form. Furious form is characterised by hyperactivity, hallucinations and aggression, while paralytic form leads to depression, paralysis and coma.
Rabies deaths in human are 100% preventable through prompt and appropriate medical care. Vaccinating dogs is the most cost-effective strategy for preventing rabies in people.
Anti-rabies vaccination schedule for dogs is follows:
Newly acquired animals should be vaccinated after consulting a veterinarian.
For humans, the World Health Organization (WHO) recommendations for post-exposure treatment divide rabies exposure into three categories:
Category I (and least serious): When the victim has been touching or feeding infected animals, but shows no skin lesions.
Category II: When the victim has received minor scratches without bleeding or has been licked by an infected animal on broken skin.
Category III: When the victim has received one or more bites, scratches or licks on broken skin or has had other contact with infected mucus.
Anti-rabies vaccine is recommended for Categories II and III, while anti-rabies immunoglobin – a liquid or freeze-dried preparation containing rabies antibodies extracted from plasma – should be given for Category III contact, or to people with weakened immune systems.
What to do in case of a dog bite?
Wound management: Administer rabies immunoglobulin and anti-rabies vaccines at the earliest.
Wash the wound, apply an antibacterial ointment, put on a dry sterile bandage. If the bite is on head, neck, face, hand, finger, feet, etc, call your healthcare provider right away. Avoid home remedies and consult a doctor.
Remember, even if the dog bite looks harmless, it can lead to serious infections or rabies, and eventually lead to death. If the dog is properly vaccinated against rabies and the efficacy of the vaccine is confirmed by laboratory evidence, there is no need to worry; otherwise an appropriate PEP (post exposure prophylaxis) needs to be administered. Shots are necessary if there are minor scratches or abrasions without bleeding, single, multipletransdermal bites scratches, nibbling of uncovered skin, contamination of mucous membrane with saliva if the bite is on injuries.
Complete treatment or PEP (post exposure prophylaxis): Follow-on anti-rabies vaccine schedule – 0, 3, 7, 14 and 28 days after a dog bite. Vaccines develop protection against the virus in the body after 6-7 days after the first vaccine is taken and other vaccines are taken as scheduled.
Vaccines are given by intradermal route. (The contributor is a student of the College of Veterinary Science and Animal Husbandry, Selesih, Aizawl, Mizoram)
