World Rabies Day is observed on September 28. Since 2007, it has been celebrated in 12 Asian countries, including Bangladesh. This day aims to increase public awareness, prevention, and eradication of rabies.
About 60,000 people die every year due to rabies, with around two thousand of them in Bangladesh. Each year, approximately three lakh people are at risk of rabies after being bitten by dogs and cats. You might be surprised to learn that the death rate of rabies patients in Bangladesh is the second highest in the world, following India. Experts suggest that the actual numbers are much higher because, in Bangladesh, no comprehensive system for data collection and storage regarding rabies has been developed. Once symptoms appear, the mortality rate in rabies cases is almost 100%. Therefore, it is crucial to understand some important aspects of rabies.
Rabies, also known as hydrophobia, is an acute viral infection that is almost always fatal. It falls under the category of infectious diseases and is transmitted by farm or wild animals, usually carnivores such as dogs, cats, foxes, and raccoons. It is most commonly found in Africa and parts of Southeast Asia. Islands such as Australia, New Zealand, Iceland, Taiwan, Japan, and Cyprus do not have rabies. It is classified as a zoonotic disease (zoonotic means related to animals).
Rabies in humans is caused by the bite of a rabid animal. The virus spreads through animal saliva. Farm animals such as dogs, cows, horses, goats, and rabbits, as well as wild animals like jackals, bats, coyotes, foxes, and hyenas, can transmit rabies.
Handling the rabies virus in a laboratory, exploring caves that may harbor bats, or camping in areas where wild animals are present are common situations where rabid animal bites occur.
Human-to-human transmission has not been documented. If a rabid animal licks an open wound on a person, the virus can be transmitted. Head and neck injuries are more dangerous because the infection can quickly reach the brain.
Signs and symptoms of rabies do not appear until late in the disease's progression, during which time the virus spreads to the brain, causing encephalitis and death. Rabies has an incubation period, meaning that it lies dormant in a person's body for several days before symptoms appear. Primary symptoms include:
Hoarse voice, Irritable mood, Tendency to bite or attack others unnecessarily, Aversion to food, Unusual speech, Wandering aimlessly, Fear of water despite thirst, Aggravation of fear when light comes into contact with air, Preference for solitude, hiding from others, in the dark, Convulsions and salivation.
If bitten by a stray dog or wild animal, it is wise to assume the animal has rabies, and the person should be vaccinated immediately to save their life. If the animal is a pet and it can be verified by the owner or veterinarian that it is not rabid, vaccination may not be necessary.
Securing or capturing the animal after a bite is extremely helpful, as it can be turned over to a local agency to determine if it has rabies.
Your doctor will ask you to describe the animal's behavior (was it friendly or aggressive?) because wild animals are unlikely to be friendly toward humans. They will also confirm how the bite occurred and the fate of the animal-did it run away or was it captured? If the animal is captured, it can be tested for signs of rabies, and if found healthy, the victim may be spared vaccination shots.
Caregivers should be cautious during treatment. Specifically, leftover food from the affected patient's plate should not be eaten. Items used by the patient should be washed carefully. However, if the caregiver has a cut on their hand, they should exercise extra caution in treating the patient, as germs can spread through the cut. Rabies antigen can be detected using a small tissue sample of the skin through a method called immunofluorescence. The virus can also be isolated from the saliva of an infected patient.
What to do if affected- If bitten by any wild animal, including dogs, cats, foxes, beggars, or monkeys, wash the wound with running water for at least 15-20 minutes using alkaline soap (the alkali dissolves the cells of the rabies virus). This kills 70-80% of germs. Apply any iodine/antiseptic cream within the 'zero hour' of the bite or scratch, i.e., as soon as possible to minimize risk. If the bite is deep or bleeding, antirabies vaccine along with rabies immunoglobulin (RIG) should be administered as soon as possible. In case of excessive bleeding, measures should be taken to stop it. Alleviate the fear of the affected person. The rabid animal should be killed and buried. Symptoms of rabies typically appear between 9 and 90 days after the bite. Therefore, treatment should occur before symptoms manifest.
What cannot be done- No saline, ice, sugar, salt, or other alkaline substances should be applied to the wound. Traditional remedies like batiprada, panparada, chiniprada, michariprada, jharfunk, etc., cannot save anyone from rabies. The wound should never be cut, suctioned, or bandaged with anything else, as this can cause infection. Ice or electric shock should not be applied to the wound. Hands and feet should not be tied.
Finally, rabies is a serious brain disease that cannot be neglected. Pregnant and lactating mothers, newborns, and elderly people can receive the vaccine. If there is any doubt or question, it is wise to get vaccinated, given the severity of the disease. We must remember that we should not bandage or stitch the wound. Since there is no treatment for this disease, it is not prudent to waste precious time on traditional remedies. Many countries have been freed from the scourge of rabies by adopting modern preventive measures.
The writer is Founder and Chairman, Jatiya Rogi Kallyan Society
