The World Rabies Day is celebrated annually in a bid to raise awareness regarding the manifestations and prevention of rabies, while still highlighting the strides made in combating the dreadful and neglected disease globally. 28 September was chosen so as to mark the anniversary of the demise of Dr. Louis Pasteur, the French chemist and microbiologist who developed the rabies vaccine. This global health observance began in 2007 and has enhanced prevention and control efforts worldwide. This day presents an opportunity for each of us to augment the endeavors of major health organizations in eliminating the disease and preventing death among those infected. The theme, Rabies: Facts not Fear, has been chosen this year to tackle myths about rabies (vaccines and treatments) and fear of the disease, by using scientific facts on the role of vaccines and treatment to prevent fatalities.
Rabies is a virus infection which is transmitted to humans by bites from infected dogs, and primarily causes inflammation of the brain (acute encephalitis). The incubation period, the time between the exposure (dog bite) and occurrence of symptoms, may be protracted lasting for weeks or even months. It accounts for the time the virus is travelling through the body to the brain. By affecting the central nervous system, the disease causes neurologic symptoms once it progresses, and is almost invariably fatal if untreated. They include seizures, uncontrolled excess salivation, insomnia, muscle spasms or paralysis with weak muscles, difficulty swallowing, sensitivity to light, mental confusion, delirium, hallucinations, pins and needles feeling, coma and stiff neck. However, the initial symptoms may be nonspecific, such as general weakness, fever or headaches.
When should you seek care from a doctor? Do this as soon as you are exposed to the virus from a possibly rabid dog by direct contact with its saliva or brain tissue, such as through broken skin, or mucous membranes in the eyes, nose or mouth. This means it could not only be a dog bite but also scratches, abrasions or wound exposure. Wash any wounds right away with soap and water, and see your doctor to attend to any trauma due to attack by the animal. The doctor should then assess whether to begin Post-Exposure Prophylaxis (PEP) based on the type of exposure, the animal you were exposed to and if it’s available for testing.
How can we achieve sufficient prevention? The primary mechanism is pre-exposure vaccination, which simplifies management in case one gets exposed later on. It is of particular significance for persons at high risk for exposure. These include: those whose occupation is laden with contact with the animals, such as biologists, veterinarians or agriculture specialists; those visiting remote areas where obtaining medical care would be difficult in case of exposure; or when visiting regions with high prevalence of the disease. Those with the highest risk should be tested regularly to gauge the strength of their immunity, and a decision made whether to get booster doses.
If you have a pet, visit your veterinarian regularly and ensure the rabies vaccination is updated. Watch over the pet and limit interactions with stray animals which may be unvaccinated or ill. Rabies infection will be eliminated by ensuring adequate animal vaccination and control, public education of those at risk, human vaccinations and augmenting access to medical care for those exposed to the virus. Let us mobilize awareness and resources to support human rabies prevention, as well as animal rabies control globally.