Rabies

• Rabies is a deadly viral infection of the central nervous system, primarily transmitted through the bite of an infected animal.
• Initial symptoms in humans can be non-specific, progressing to neurological signs like hyperactivity, hallucinations, and fear of water.
• Immediate wound care and post-exposure prophylaxis (PEP) are critical after potential exposure.
• Vaccination of domestic animals and wildlife management are key to preventing rabies.
• Once symptoms manifest, rabies is almost universally fatal, underscoring the importance of early intervention.

What is Rabies?

Rabies is a zoonotic viral disease caused by the rabies virus, a member of the Lyssavirus genus. This neurotropic virus primarily infects the central nervous system, leading to acute encephalitis (inflammation of the brain) in warm-blooded animals. While preventable through vaccination, it remains a significant public health concern globally, particularly in regions where dog rabies is endemic. The disease is characterized by progressive and fatal inflammation of the brain and spinal cord.

Rabies Transmission and Symptoms in Humans

Rabies is primarily transmitted to humans through the deep bite or scratch of an infected animal, most commonly dogs. The virus, present in the saliva of rabid animals, enters the body through broken skin or mucous membranes. Less common modes include organ transplantation, though rare. Bat bites, often unnoticed, are a significant source of human rabies in some regions. The incubation period typically ranges from a few weeks to several months, but can vary from days to over a year, depending on factors like bite location and severity.

Once symptoms appear, the disease progresses rapidly. Rabies symptoms in humans often begin with non-specific signs: fever, headache, and general weakness. Pain, tingling, or burning sensations may occur at the bite site. As the virus spreads to the central nervous system, severe neurological symptoms develop, including:

• Hyperactivity and agitation
• Hydrophobia (fear of water)
• Aerophobia (fear of drafts)
• Hallucinations and confusion
• Paralysis

Eventually, coma and death occur, usually from respiratory failure. The World Health Organization (WHO) reports tens of thousands of rabies deaths annually, predominantly in Asia and Africa, with children disproportionately affected. (Source: WHO)

Preventing and Treating Rabies

Effective rabies prevention and treatment strategies are crucial. The cornerstone of prevention is vaccinating domestic animals, especially dogs, responsible for up to 99% of human cases. Public awareness about avoiding wild or stray animals and reporting suspicious behavior is also vital.

For individuals potentially exposed, immediate post-exposure prophylaxis (PEP) is highly effective. PEP consists of:

• Wound washing: Thorough cleaning of the wound with soap and water for at least 15 minutes immediately after exposure. This step significantly reduces the virus at the infection site.
• Rabies vaccine: A series of vaccinations to stimulate antibody production.
• Rabies immunoglobulin (RIG): Administered into and around the bite wound, if indicated, providing immediate passive immunity.

Once clinical symptoms appear, there is no effective treatment, and the disease is almost invariably fatal. This underscores the critical importance of prompt and complete PEP. Pre-exposure vaccination may be considered for travelers to high-risk areas and certain occupations (e.g., veterinarians).