Rabies

Rabies is an almost always fatal viral infection of the nervous system, transmitted through the bite or scratch of an infected animal, most often dogs. Once symptoms begin, rabies is virtually untreatable, making prompt post-exposure care after any suspicious bite essential.

• Early symptoms: fever, headache, and unusual tingling, pain, or itching at the bite site
• Progresses to anxiety, confusion, agitation, and abnormal behaviour
• Difficulty swallowing and fear of water (hydrophobia)
• Muscle spasms and eventually paralysis
• Once symptoms appear, the disease almost always progresses to death

• Caused by the rabies virus, transmitted through the saliva of an infected animal, usually via a bite, scratch, or contact with broken skin or mucous membranes.
• Dogs are the most common source of human rabies transmission; bats and other wild animals can also transmit the virus.
• Risk is highest with bites to the head, face, neck, or hands, and with deep or multiple wounds.

• Diagnosis of rabies in an animal or deceased patient is confirmed through specialised laboratory testing, but in a living, exposed person, management decisions are based on the type of exposure and the biting animal's vaccination and observation status, not on waiting for test results.
• All animal bites, especially from dogs of unknown vaccination status, should be assessed promptly for the need for post-exposure treatment.

Immediate wound care is critical: thoroughly wash the bite or scratch wound with soap and running water for at least 15 minutes, then apply an antiseptic.

Post-exposure prophylaxis is started as soon as possible after a bite from a suspected rabid animal, consisting of a course of rabies vaccine given on a defined schedule.

Rabies immunoglobulin is given, infiltrated around the wound where possible, for severe exposures — such as bites to the head, face, or hands, deep wounds, or multiple bites — in addition to the vaccine course.

The biting animal, if a dog or cat, should be observed for 10 days where possible; if it remains healthy throughout, this can support a decision to stop further doses, but treatment should not be delayed while awaiting this observation.

Once neurological symptoms of rabies develop, treatment is supportive only, as the disease is almost always fatal at that stage; the priority is always prevention through prompt post-exposure care.

• Ensure prompt vaccination of pet dogs and cats against rabies.
• Wash any animal bite or scratch immediately and thoroughly with soap and water.
• Seek medical care immediately after any animal bite, especially from an unknown or unvaccinated animal — do not wait to see if symptoms develop.
• Avoid contact with wild or stray animals, and teach children not to approach unfamiliar animals.
• Report animal bites to local health authorities to support rabies surveillance and control.