Understanding
Rabies
Welcome…
Objectives:
Define Rabies
Know the Signs and Symptoms of Rabies
Discuss how Rabies is transmitted
Explain the treatment of Rabies
Emphasize prevention of Rabies
transmission
Key facts:
Rabies occurs in more than 150 countries and territories.
Worldwide, more than 55 000 people die of rabies every year.
40% of people who are bitten by suspect rabid animals are
children under 15 years of age.
Dogs are the source of 99% of human rabies deaths.
Wound cleansing and immunization within a few hours after
contact with a suspect rabid animal can prevent the onset of
rabies and death.
Every year, more than 15 million people worldwide receive a
post-exposure preventive regimen to avert the disease – this
is estimated to prevent 327 000 rabies deaths annually.
According to the World Health Organization, 28
September is World Rabies Day
It is celebrated annually to raise awareness about
rabies prevention
28 September also marks the anniversary of Louis
Pasteur's death, the French chemist and
microbiologist, who developed the first rabies
vaccine.
DEFINITION
Rabies is a zoonotic disease (a disease that is
transmitted to humans from animals) that is
caused by a bullet-shaped virus (Rabies
lyssavirus/ Rabies virus)
Zoonotic diseases are infectious diseases
caused by bacteria, viruses and parasites that
spread between animals (usually vertebrates)
and humans.
Thedisease infects domestic and wild
animals, and is spread to people through
close contact with infected saliva via bites
or scratches.
Signs and Symptoms
The incubation period for rabies is typically 1–3 months, but
may vary from <1 week to >1 year.
INITIAL symptoms of rabies are fever and often pain or an
unusual or unexplained tingling, pricking or burning
sensation (paraesthesia) at the wound site.
Signs and Symptoms
As the virus spreads through the central nervous system,
progressive, fatal inflammation of the brain and spinal cord
develops.
Signs and Symptoms
Two forms of the disease can follow. People with furious
rabies exhibit signs of hyperactivity, excited behavior,
hydrophobia and sometimes aerophobia. After a few days,
death occurs by cardio-respiratory arrest.
Signs and Symptoms
Paralytic rabies accounts for about 30% of the total number
of human cases. This form of rabies runs a less dramatic and
usually longer course than the furious form. The muscles
gradually become paralyzed, starting at the site of the bite or
scratch. A coma slowly develops, and eventually death
occurs. The paralytic form of rabies is often misdiagnosed,
contributing to the under reporting of the disease.
Transmission
People are infected through the skin following a bite or
scratch by an infected animal (Dogs are the main host and
transmitter of rabies).
Bats are the source of most human rabies deaths in the
United States of America and Canada
Transmission can also occur when infectious material (usually
Saliva) comes into direct contact with fresh skin wounds.
Human-to-human transmission by bite is theoretically
possible but has never been confirmed.
Treatment after exposure
Effective treatment soon (within a few days, but as soon as
possible) after exposure to rabies can prevent the onset of
symptoms and death.
Post-exposure prevention consists of local treatment of the
wound, administration of rabies immunoglobulin (if indicated),
and immediate vaccination.
Local treatment of the wound:
Removing the rabies virus at the site of the infection by chemical or
physical means is an effective means of protection
Recommended first-aid procedures include 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 post-exposure
prophylaxis for rabies infection
Category of exposure to suspect
rabid animal Post-exposure measures
Category I – touching or feeding
animals, licks on intact skin (i.e.
no exposure) None
Category II – nibbling of
uncovered skin, minor scratches Immediate vaccination and local
or abrasions without bleeding treatment of the wound
Category III – single or multiple
transdermal bites or scratches,
licks on broken skin; Immediate vaccination and
contamination of mucous administration of rabies
membrane with saliva from licks, immunoglobulin; local treatment
exposures to bats. of the wound
Today, safe and effective animal and human vaccines
are among the important tools that exist to eliminate
human deaths from rabies (TREATMENT=VACCINE)
While awareness is the key driver for success of
communities to engage in effective rabies prevention
(PREVENTION = AWARENESS)
Prevention
Eliminating rabies in dogs
The most cost-effective strategy for preventing rabies in people is by
eliminating rabies in dogs through vaccination; Vaccination of animals
(mostly dogs).
Preventive immunization in people
Safe, effective vaccines also exist for human use. Pre-exposure
immunization in people is recommended for travelers to high-risk areas in
rabies-affected countries, and for people in certain high-risk occupations
such as laboratory workers dealing with live rabies virus and other
lyssaviruses, and veterinarians and animal handlers in rabies-affected
areas. As children are at particular risk, their immunization could be
considered if living in or visiting high risk areas.
