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What is rabies?

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VOL: 100, ISSUE: 44, PAGE NO: 31

Rabies is a viral disease caused by the rabies virus, a member of the rhabdovirus family….


Rabies is a viral disease caused by the rabies virus, a member of the rhabdovirus family.



- It is mostly transmitted to humans by dogs.



- Once established in the body, the disease is fatal.



- Pre-exposure vaccination is recommended for at-risk individuals.



- Post-exposure vaccination must be obtained as soon as possible.



How is it spread?


- Dog bites are the most common source of infection.



- Other animals can also carry the virus including bats, cats, foxes, skunks and monkeys.



- The virus has in some cases been spread by an animal licking a fresh skin break.



- Animals may be infectious for five days before their symptoms develop.



- There is no evidence that rabies can be spread between humans.



- Before the introduction of screening protocols there were cases of rabies being contracted by corneal transplant.





- Human rabies is extremely rare in the UK - about 20 human cases of rabies have been imported into England and Wales since 1946.



- But the disease is common worldwide, causing an estimated 35,000 to 50,000 deaths each year, mainly in developing countries.



- One-third to one-half of deaths occur in children under 15.



- In the past few years rabies-like viruses known as European bat lyssaviruses (EBLs) have been found in bats in the UK.



- EBLs rarely cross from bats to humans. In 2002 a bat handler died in Scotland from an EBL.



- In September this year a bat infected with EBL was found in an alley in Staines. Members of the public were advised not to handle any sick or injured bat.





- Itching and tingling at the site of infection.



- Headache and fever.



- Spasm of the swallowing muscles, which may lead to hydrophobia.



- Delirium and convulsions.



- Paralysis.



- Respiratory failure.



The incubation period


- Generally 2-8 weeks, but it can be months or, in rare cases, years.



- The type and location of the bite is thought to influence the length of the incubation period.





- Clean all bites with soap and water. Encourage limited bleeding.



- Wounds on the head, face and neck require extra cleansing.



- Apply alcohol if available. Do not stitch the wound.



- Administer post-exposure vaccine without delay as the incubation period can be as short as four days.



- Travellers need to obtain a modern cell-culture vaccine. If necessary, contact the British embassy or consulate for a supply.



- Some countries offer locally produced vaccines, given into the abdomen, which are less effective.



- Five to six doses plus a human rabies immunoglobulin (HRIG) injection are needed.



- Travellers who have had pre-exposure vaccination only need two doses of post-exposure vaccine and no HRIG as the body is primed to respond.





- Do not approach or touch animals that are behaving strangely.



- Pre-exposure immunisation is recommended for at-risk groups. If bitten the body’s responses can be quickly activated by booster doses of vaccine.



- Two doses of the rabies vaccine a month apart give adequate cover for 6-12 months. High-risk groups such as vets and animal handlers need more intensive prophylaxis.



- At-risk groups must be educated about action to take if bitten.



- Dog vaccination programmes are effective. In areas where 80 per cent of the dog population is vaccinated, rabies cases fall radically.

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