Rabies victims die with dreadful, tight, painful spasms of the limbs and back, difficulty in swallowing, rigid muscle contractions leading to cardiac arrest. Not a pleasant way to go. It is 100% fatal. The good news though is that modern vaccines do work. As well as for prevention the vaccine is also used for treatment inducing the body to manufacture antibodies quickly enough to neutralize the virus before it&'s too late.
Rabies is caused by a virus which on entering the body heads straight for nerve tissue and eventually the brain . It is primarily a disease of animals and humans are infected when bitten, scratched or licked by an infected animal. It is important to understand that the virus is present in the animal's saliva and can enter through a very small break in the skin. Although the majority of cases throughout the world are caused by dog bites, any animal bite is suspect; In Canada most cases are related to contact with bats!
During your visit at the clinic we will assess your risk of rabies and make some recommendations. High risk destinations include India – South East Asia – Nepal.
Detailed information on the distribution of Rabies including countries free of the disease is available on a special World Health Organization website called RABNET.
Bite avoidance is essential. While traveling avoid unknown animals including pets, monkeys, bat habitats. Travelers at risk and should be vaccinated . Expatriate workers and families ESPECIALLY children need to be protected as well as those who by the nature of their work are likely to come into contact with infected animals such as veterinary surgeons, naturalists or forestry workers. For others a decision must be based on length of stay and degree of perceived risk especially if there is a chance of being 48 hours or more away from medical facilities that can guarantee access to rabies immunoglobulin and vaccination. The dilemma you face can be expressed in the starkest terms: The chances of getting rabies are remote but if you are exposed and become symptomatic it is invariably fatal!
Well, first of all it is expensive. Then it involves three injections spaced over the period of a month. In you are still in areas of risk booster injections may be necessary after 2 – 3 years.
Children pose a special problem:
That the bite could be so small that it is not reported. They may also not report the bite if they have been told that any bite, scratch or lick will result in a number of injections from the doctor. Immediate medical treatment may not be available. If there has been no previous vaccination then passive protection is needed from a preparation which already contains antibodies called Rabies Immunoglobulin. This is very expensive and is not always available in small medical facilities. Treatment needs to be started quickly. If the bite was indeed from a rabid animal even early treatment may not be enough especially if the bite is in the face, neck or shoulder region.
A course of three injections is given over 3 to 4 weeks.
First aid treatment for bites
First wash wound thoroughly with soap and water remembering that the virus is in the animal’s saliva. Douse the wound with an antiseptic, then get to the nearest medical facility. Cancel whatever else you might have planned. In general the wound should not be sewn up unless it is extensive. If you have had the preventive course of vaccine (pre-exposure vaccination) you are still going to need a booster depending on the local protocol. You have bought some time but the quicker you can get to a doctor the better. If you have not had pre-exposure vaccination you need immediate treatment with rabies immunoglobulin, injected around the wound and a full course of vaccine on days 0,3, 7,14 and 30.
If you are considering a long trip or have taken up an overseas placement in a rabies endemic country – CONSIDER RABIES VACCINATION – also DON'T FEED THE MONKEYS. Monkey bites are frequently related to carrying food and feeding them.