Understanding the signs, transmission, and crucial steps for prevention and treatment to combat this nearly always fatal disease
Aejaz Iqbal
Rabies is a viral Disease that affects the central nervous system, including the brain. It is caused by the rabies virus, which spreads to humans mainly through the bite or scratch of an infected animal, most often a dog. Once the virus enters the body, it travels through the nerves to the brain, leading to inflammation. Symptoms may take a few days to several months to appear, depending on the location and severity of the bite. Rabies is almost always fatal once symptoms appear, but it is 100% preventable if treated promptly after exposure. The key is to clean the wound immediately and seek medical care without delay.
Signs & Symptoms
The First symptoms of rabies can appear from a few days to more than a year after the bite happens.
At first, there’s a tingling, prickling, or itching feeling around the bite area. A person also might have flu-like symptoms such as a fever, headache, muscle aches, loss of appetite, nausea, and tiredness.
After a few days, neurological symptoms develop, including:
Irritability or aggressiveness
Excessive movements or agitation
Confusion, bizarre thoughts, or hallucinations, muscle spasms and unusual posture, seizures (convulsions)
Weakness or paralysis (when a person cannot move some part of the body)
Extreme sensitivity to bright lights, sounds, or touch
Someone with rabies can produce a lot of saliva (spit), and muscle spasms in their throat might make it hard to swallow. This causes the foaming at the mouth effect that has long been associated with rabies infection. It also leads to a fear of choking or Fear of Water (Hydrophobia)
Diagnosis
Healthcare professionals may perform multiple tests without concluding the individual has rabies. Laboratory tests may show antibodies, but these may not appear until later in the development of the disease. Doctors could potentially isolate the virus from a person’s saliva or through a skin biopsy. However, by the time they confirm a diagnosis, it is often too late to act.
For this reason, the individual usually starts a course of prophylactic treatment immediately without waiting for a confirmed diagnosis.
If a person develops symptoms of viral encephalitis following an animal bite, doctors should treat them as if they may have rabies
Incubation
Incubation is the time before symptoms appear. It usually lasts for 2 to 3 months and varies from 1 week to 1 year, depending on where the virus entered the body and the number of viral particles involved. The closer the bite is to the brain, the sooner the effects are likely to appear.
By the time symptoms appear, rabies is usually fatal. Anyone who has exposure to the virus should seek medical help immediately, without waiting for symptoms
Causes
The rabies virus causes a rabies infection. The virus spreads through the saliva of infected animals. Infected animals can spread the virus by biting another animal or a person.
In rare cases, rabies can be spread when infected saliva gets into an open wound or the mucous membranes, such as the mouth or eyes. This could happen if an infected animal licked an open cut on your skin.
Treatment
If a person has a bite or scratch from an animal that may have rabies, or if the animal licks an open wound, the individual should immediately wash any bites and scratches for 15 minutes with soapy water, povidone iodine, or detergent. This might minimise the number of viral particles. They must then seek immediate medical attention.
After exposure and before symptoms begin, a series of injections can treat potential rabies infections. Because healthcare professionals do not usually know whether the animal had rabies, it is safer to assume that they do and begin vaccination.
If a person has already begun to experience symptoms, the only option may be to make them comfortable and give them breathing assistance if needed.
Rabies vaccine
Healthcare professionals do not generally offer the rabies vaccine routinely. Instead, they reserve it for those at high risk of rabies exposure, such as laboratory staff working with the virus that causes the disease, veterinarians, and people likely to receive animal bites. These individuals may receive regular vaccinations.
Other people may receive the vaccine following exposure to the virus after an animal bite. This is called postexposure prophylaxis (PEP).
Rabies vaccine contains an inactivated or harmless version of the rabies virus, so it cannot cause the disease. It triggers the immune response to produce antibodies, which remain in the body and help protect against future rabies infections.
Doctors administer the rabies vaccine into the upper arm. Pre-exposure protection requires three dosesTrusted Source of rabies vaccine across 28 days.
For postexposure protection, previously unvaccinated people need four doses of the rabies vaccine, plus rabies immune globulin (RIG). Doctors administer RIG as soon as possible, close to the bite wound, to prevent the virus from causing infection in the individual.
The writer is a microbiologist
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