RABIES
Rabies is a disease that is transmitted to humans from animals and that is caused by a
virus. The disease infects domestic and wild animals, and is spread to people through
close contact with infected saliva via bites or scratches. Once symptoms of the disease
develop, rabies is nearly always fatal.
Symptoms
The incubation period for rabies is typically 1-3 months, but may vary from 1 week to 1
year.
The early symptoms or rabies are similar to that of many other illnesses, including fever,
headache, and general weakness or discomfort. As the disease progresses, more
specific symptoms appear and may include insomnia, anxiety, confusion, slight or
partial paralysis, excitation, hallucinations, hypersalivation (increase in saliva), difficulty
swallowing, and hydrophobia (fear of water). Death usually occurs within days of the
onset of these symptoms.
Diagnosis
No tests are available to diagnose rabies infection in humans before the onset of clinical
disease, and unless the rabies-specific signs of hydrophobia are present, the clinical
diagnosis may be difficult.
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. They are the source of infection in all
of the estimated 55 000 human rabies deaths annually in Asia and Africa.
Transmission can also occur when infectious saliva comes into direct contact with fresh
skin wounds.
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 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. Therefore, prompt local treatment of all bite wounds
and scratches that may be contaminated with rabies virus is important. 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, or other substances that
kill the rabies virus.
Recommended treatment
The recommended post-exposure prophylaxis depends on the type of contact with the
suspected rabid animal:
Category of exposure to suspect rabid
animal
Category I – touching or feeding animals,
licks or intact skin
Category II - nibbling of uncovered skin,
minor scratches or abrasions without
bleeding
Category III – single or multiple
transdermal bites or scratches, licks on
broken skin
Post-exposure measures
None
Immediate vaccination and local treatment
of the wound
Immediate vaccination and administration
of rabies immunoglobulin; local treatment
of the wound
Who is most at risk?
People most a risk live in rural areas where human vaccines and immunoglobulin are
not readily available or accessible.
Although all age groups are susceptible, rabies is most common in children aged fewer
than 15.
Prevention
Rabies is a vaccine- preventable disease. The most effective strategy for preventing
rabies in people is by eliminating rabies in dogs through vaccination.
Immunization in people is recommended for travelers to high-risk areas in rabies
affected countries (rabies is endemic in Afghanistan), and for people in certain high-risk
occupations such as laboratory workers, veterinarians and animal handlers in rabiesaffected areas.