This is a little belated, but for those who didn’t know, Monday September 28th was World Rabies Day. But what exactly is Rabies? I’m sure, for many, it conjures up images of dogs with foaming mouths and a manic disposition. And for lovers of the work of Stephen King, it probably makes you think of this guy:
Rabies is caused by a virus, part of the Lyssavirus family, and is a zoonotic disease, meaning it can easily travel between species. Rabies is typically transmitted between the host and the victim by saliva contamination, e.g a bite. For those of you who have read ‘Cujo’, the story paints a pretty good picture of how Rabies is transmitted. For those who aren’t familiar, Cujo is a family’s dog, who ends up getting bitten by a rabid bat, meaning cujo becomes infected.
Although bats are a primary reservoir of rabies infections in the Americas, Rabies can be found in many types of carnivores, and around 90% of cases around the world are caused by dogs. If you live in a developed country, you are probably lucky enough to have never faced the threat of rabies, with 90% of cases occurring in developing countries in Asia, Africa and the Middle East.
Rabies is a highly dangerous disease to contract, with a 99.9% mortality rate, and some horrible and unusual symptoms. Similar to Lyme disease, the symptoms of rabies can take months to become apparent, as the virus travels slowly through the nervous system before eventually reaching the brain. Initially, symptoms are mild and include fatigue, headache and general weakness. As the disease progresses further the host can suffer from insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations and agitation. Then there is the stereotypical foaming mouth associated with dogs in particular, known as hypersalivation and, as I said, the unusual symptom – a fear of water. The illness finally culminates in a coma and organ failure.
The scary thing is that there isn’t a guaranteed cure for rabies once the infection has set in. However the good news is that there is a rabies vaccine for both humans and animals that safeguards against the disease!
So what do you do if you are bit by an animal and suspect it is rabid? Firstly – don’t panic. Although the mortality rate is high, due to the long period the infection takes to become established, there are options. Although curing an established infection is incredibly difficult, curing a new infection is easier. The wound should be immediately washed with soap and water for 15 minutes, followed by irrigation with an antiseptic – ideally either concentrated ethanol or iodine. Then seek medical treatment as soon as possible. You can be given post-exposure prophylaxis (PEP) (a mix of rabies antibodies and rabies vaccines applied over time). In simpler terms, prophylaxis is a term for a pre-infection treatment, so PEP is this treatment, but post-infection instead. However, the length of time that rabies takes to reach the brain works in our favour. With washing the wound, and strict PEP initiated soon after infection, the prospects are a lot more positive!
If anyone wants to learn more, or about how you can help the fight against rabies, check out the Global Alliance for Rabies Control.
Stewart Barker The University of Sheffield @Stewart_Barker