Rabies- Prevention, Precautions And Adherence To Medical Protocol Essential

Rabies can be treated
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Rabies is the only disease that had a 100% death rate in India in 2017, according to data from the National Health Profile 2018…

Despite being entirely preventable, an estimated 59000 people die from rabies every year in the world, with 90% of deaths occurring in children living in rural areas of Africa and Asia, according to Central Bureau of Health Intelligence (CBHI) edition of its National Health Profile 2018 (NHP).

Rabies can be prevented with efficient and timely medical assistance and care. Anti-rabies vaccine course, immunoglobulin, pre-and post-wound care are the methods that are known to be effective in preventing this communicable disease.

Dr Sagar Bhongle

According to leading Veterinary Surgeon, Dr Sagar Bhongale, rabies is fatal, but, if timely medical attention is given, it can be prevented with the vaccines and immunoglobulin within 24 hours of the exposure. The issue is that the history has to be clear and what kind of dog is to be checked. It is a myth that all domestic dogs also carry the rabies virus in their saliva and so on.

However, it is very difficult to determine whether the dog has any neurological symptoms or is infected unless the dog undergoes a brain mapping test.

“One shouldn’t wait for any symptoms to appear before starting treatment for rabies. If they suspect a dog bite, one should immediately go with the prescribed schedules of vaccines as directed by the attending doctors.

It can be fatal which is why people fear dog bites. Even if they are bit by a known domestic dog, they go with anti-bit courses, given the complexity to determine of the dog is infected or not.

Preventive Methods:
Pre-bite/exposure shots for prevention of rabies.
Post-bite vaccination course
If you suspect that the animal has rabies, then go with Immunoglobulin shots within 24 hours. If in doubt, take immunoglobulin anyway since it is the ideal treatment.

Even for people who volunteer and work for street dogs, we suggest that they take preventive anti-rabies course every year.  

“If the animal has salivation issues, suffering from neurological symptoms, is getting aggressive, biting people around then it should be isolated immediately, as there is no treatment for the infected animal either,” adds Dr Sagar.

Dr Neha Wankar

Dr Neha Wankar, Emergency Medicine Resident, Columbia Asia Hospital shares the immediate line of treatment for rabies prevention.

“If a patient comes with history of certain animal bite which are known to spread rabies, a series of shots is advised. However, the patient should come within 24 hrs of the bite, not later.

However, if the prophylactic treatment is not taken after the bite/scratch and the symptoms of rabies appear, then it isn’t possible to completely cure the disease.

What remains to be done is to keep the vitals and airway/breathing /circulation monitored.

There is no definite treatment as of now to completely cure the virus once it has thrived and yes, the mortality rates are high.

Immediate Care Post Exposure- Bite/Scratch :

  • He/she should wash the affected area under running water with soap for 15-20 min and no tight wrapping over wound.
  • It should be kept as open as possible till doctor sees it.
  • If bleeding is there then loosely cover it.

When quizzed about patients and relatives being open to the ideally suggested line of treatment, Dr Neha shares. “Usually, when counselled well, patient follows the line of treatment as far as city patients are concerned. however, as the cost of immunoglobulin is high, we face problems sometimes convincing the patient.

However, at a government facility, a patient can get these shots at low cost, adds Dr Neha.

Patient Category:

  • Category 1- Lick on uncut skin surface -only thorough wash
  • Category 2- Lick on cut skin surface /scratch/bite without bleed
  • Category 3- Multiple bite marks/bleeding after scratch/bite/bite above shoulder level/palms/soles or animal saliva in contact with eyes/tongue.
Treatment:

  • Category 1 -does not need vaccination
  • Category 2 – injection rabies vaccination intramuscular at days 0,3,7,14,28 with injection tetanus toxoid o.5 ml im
  • Category 3 -along with cat 2 treatment should receive immunoglobulin according to body wt .

 

Animals which can spread include rabies dogs, cat, monkey, racoons, wolf, fox, bats etc.

Preeti Agarwal, city-based animal activist opines that rabies is a major cause of worry in our country, the reason this deadly virus is on the rise is due to negligence of humans and only due to humans.

“Poor hygiene standards has led to rabies which is the reason our government is shouting slogans on Swachh Bharat is mainly to protect us from such deadly viruses.

Major carrier of rabies viruses are rats and bats. Stray animals like dogs and cats gets easily infected by these viruses. The fear of rabies is a major reason why people hesitate to touch or adopt a stray.

“Luckily, things are changing. The volunteers working on stray animals in different parts of the city not only feed the animals, they also get the strays vaccinated which is nipping this in the bud.

Rabies is a deadly virus. But it doesn’t mean all the strays that you see on the road is carrying this virus. An infected dog will not look normal-their jaw gets locked and they pant heavily.

“If you come across a case where the dog is behaving abnormally, you must report it to RESQ or any NGO near your vicinity. Strays are at risk that I agree, but it’s up to us to help them by keeping surrounding clean and the strays vaccinated.

As a society you can approach any local NGO and get your strays vaccinated. Remember it’s us who have encroached their habitat and we have to coexist.

Sharing on how can pet owners help in containing the spreading of rabies, he adds, “Every pet owner must keep a tab on the vaccination history and get their pets vaccinated on time.

Many veterinary doctors give reminders to the pet parents too. It’s always good to set a reminder on your own and take full ownership of your pets. They need to be de-wormed and vaccinated as per the schedule given by vets.

Effective Pet Care:

  • Keep your house clean, don’t let rats or bats come inside your house.
  • Don’t let your pet animals roam in an unknown area or with stray’s unknown to you.
  • Keep your pets vaccinated.
  • Take care of the strays in your area.
  • Get them vaccinated against rabies or help the volunteers by funding them for the vaccination or sterilisation

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Loveleen Kaur

Loveleen Kaur

A Dreamer, Traveler and All-time Foodie who is happiest in the company of Animals! loveleen@pune365.com
Loveleen Kaur

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