World Rabies Day – 28th September 2017
Increasing awareness of an under-reported and deadly disease
About Rabies Infection
Rabies is a viral infection that is transmitted by the saliva of infected animals. The virus enters the body through a bite or lick onto broken skin. From the wound, the virus spreads to the brain and nervous system. The incubation period from infection to symptoms can range from 7 days to 1 year, but on average takes 2-3 months.
If treatment is not sought, the disease is invariably fatal. To date, the only survivors of the disease have received rabies vaccine before the onset of illness.
The disease presents as either:
- Furious Rabies – the most common presentation with symptoms of agitation, hydrophobia (fear of water), which then progresses to coma and death within a few days.
- Paralytic Rabies – this presents with gradual paralysis of the muscles leading to death from respiratory failure.
Children are much more vulnerable as they are more likely to approach animals and are less likely to report bites and obtain urgent lifesaving treatment. Additionally, the virus does not have far to travel from any wound to the brain so symptoms are more likely to develop leading to invariable fatality.
The Statistics (WHO data)
- Rabies causes 1 death every 15 minutes worldwide
- 1 in 4 bites and deaths occur in children under 15 years of age
- Rabies is found in over 150 countries and in every continent except Antarctica. However, 99% of the deaths occur in Asia and Africa and the majority of cases are due to dog bites
- In the Americas, Western Europe and Australia, transmission is mainly through bats.
- Around 29 million people seek lifesaving treatment worldwide each year to prevent rabies.
Vaccination before exposure consists of a 3 dose course given at day 0, 7 and 21 or 28 days. After completion of the three dose course, travellers have protection for 10 years, following which, single booster doses only are required.
The vaccine was first used by Louis Pasteur over 100 years ago and is safe and well tolerated. It is an inactivated vaccine and can be used for all ages from birth.
Full three dose vaccination prior to exposure or bite simplifies the post exposure treatment to a further 2 doses of the vaccine. Without pre-exposure vaccination, a 5 dose vaccination course is required as well as possible administration of Rabies immunoglobulin – a life-saving blood product which is in short supply and can be difficult to obtain in many areas.
It is very important that urgent medical attention is sought if a potential rabies bite occurs. The wound should be washed immediately with soap and water for 10-15 minutes and a disinfectant such as Iodine or alcohol should be applied.
Rabies infection is 99.9% fatal without treatment, but is 100% preventable with vaccination.