Most of you who have a pet dog or have been bitten by a dog, may have been queried about the possibility of developing rabies, but there are still many out there who don’t seek immediate medical attention if the bite isn’t severe, or if the dog licked a cut or wound on their skin. Yes, just licked. Although less common, did you know that rabies also transmits through the saliva of the infected animal into an open wound?
Rabies is a viral zoonosis transmitted when the saliva containing the rabies virus is introduced into an opening in the skin, usually via the bite of a rabid animal. Though rare, transmission could occur through infected saliva contacting other openings in the skin, or a mucous membrane. In 99 percent of the cases in Thailand, the virus spreads from a dog bite. However, Rabies can spread by bites from infected cats, bats, foxes, monkeys, wolves, skunks, raccoons or mongooses. Any warm blooded animal is susceptible.
Rabies is almost always preventable if the person received a Post-Exposure Prophylaxis (PEP). If you are bitten by a stray dog or a pet, immediately clean to the base of the wound with water and soap for at least 15 minutes. Then apply alcohol, Betadine or an iodine solution that you have at home. After that, if you are unable to find out or unsure if the animal has been vaccinated, go see a doctor because if you get the PEP vaccination series in time, there’ll be no reason to worry.
If the animal turned out to be infected, and no immediate treatment was given, the chances of survival is extremely dim. Close to none survived a rabies infection and if they did, they spent weeks in induced comas and suffered from severe neurological damage needing years of rehabilitation. If you are even the slightest bit uncertain of the vaccination history of the animal, choose to get the PEP treatment.
Treatment for suspected contact is usually done with five doses of rabies vaccine given over 2-week to 28-day period and if needed one dose of rabies immune globulin to provide the body with antibodies against rabies. This depends on the site of the wound, the severity and your vaccination history. As with most vaccines the most common side effect is soreness and redness at the site of the injection. More severe reactions are rare and often related to allergies to the ingredients in the vaccine. If the dog is alive after 10 days of the bite, the vaccination series can be stopped. However, you should seek PEP as soon as possible. Do not wait to observe the dog for 10 days.
The average time from infection to the time the symptoms develop in humans is 30-90 days, but it may range from less than 10 days to several years. The virus travels along nerve cells to the brain and multiplies there very quickly. Gradually the affected individual becomes ill, developing a variety of symptoms, including high fever, confusion, agitation, and eventually seizures and coma. People with rabies tend to develop hydrophobia as well aerophobia. By this point, they are extremely ill.
Some behavioural patterns may help you to know if the animal is infected. Animals infected with rabies may appear sick, crazed, or vicious. However, animals infected with rabies may also appear overly friendly, docile, or confused. They may even appear completely normal, so you still can’t be entirely sure by just observing. By the time a creature is driven to bite others it often has just a few days left to live.
My suggestion for prevention is to start with making sure your pet is vaccinated, and if possible take a step towards helping those around you. In Thailand, we have millions of stray dogs, with almost half a million in Bangkok itself. As a community we should take the initiative to make sure the stray dogs in our area are vaccinated or better yet, adopted. Vaccinating dogs prevents not just them from rabies but the other animals that come into contact with them. Remember this is not just a charitable act but this will also protect your pet, your family and the people living around you and you. Children often play with animals, have open wounds and sometimes don’t report small bites. There are foundations and charity trusts out there for stray dogs. You could begin by contacting them.
Faculty of Medicine Siriraj Hospital, Mahidol University , 2008