27SEP

Recognise rabies

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WORLD RABIES DAY 28 SEPTEMBER 2017

Rabies is found in more than 150 countries and territories. ER24 gives an overview of this widespread viral disease which can be prevented with a vaccine.

Symptoms

The incubation period for rabies is one to three months. Initial symptoms of rabies include a fever with pain and unusual or unexplained tingling, pricking, or burning sensation at the wound site. As the virus spreads to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops.

Kinds of rabies

Furious rabies: People with this kind of rabies exhibit signs of hyperactivity, excitable behaviour, a fear of water and sometimes of drafts of fresh air. Death occurs after a few days due to cardiorespiratory arrest.

Paralytic rabies: Muscles become paralysed, starting at the site of the bite or scratch. A coma develops, and eventually, death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.

Diagnosis

Current diagnostic tools are not suitable for detecting rabies infection before the onset of clinical disease. Unless the rabies-specific signs of fear of water or of air drafts are present, clinical diagnosis may be difficult.

Transmission

Dogs are the main source of human rabies deaths, contributing up to 99% of all rabies transmissions to humans. People are usually infected following a deep bite or scratch from an animal with rabies. Transmission can also occur when infectious material – usually saliva – comes into direct contact with human mucosa or fresh skin wounds. Rabies elimination is feasible through the vaccination of dogs and the prevention of dog bites.

Preventative immunisation

Human rabies vaccines exist for pre-exposure immunisation and are recommended for travellers to rabies-affected remote areas.

After exposure

The immediate treatment of a bite victim after rabies exposure prevents virus entry into the central nervous system. The treatment consists of:

Extensive washing and local treatment of the wound as soon as possible after exposure

A course of potent and effective rabies vaccine that meets World Health Organization standards

The administration of rabies immunoglobulin, if indicated

Effective treatment soon after exposure can prevent the onset of rabies.

For more information about rabies visit www.who.int/rabies/

Visit www.er24.co.za for more information about ER24’s emergency services.

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