What is RabiesRabies is a fatal but preventable viral disease. It can spread to people and pets if they are bitten or scratched by a rabid animal. In Philippines dogs and cats still carry rabies, and most rabies deaths in people around the world are caused by dog bites or cat scratches.
The rabies virus infects the central nervous system. If a person does not receive the appropriate medical care after a potential rabies exposure, the virus can cause disease in the brain, ultimately resulting in death. Rabies can be prevented by vaccinating pets, staying away from wildlife, and seeking medical care after potential exposures before symptoms start.
Rabies is considered to be a neglected disease, which is 100% fatal though 100% preventable. It is not among the leading causes of mortality and morbidity in the country but it is regarded as a significant public health problem because
(1) it is one of the most acutely fatal infection.
(2) it is responsible for the death of 200-300 Filipinos annually
How is rabies transmittedRabies virus is transmitted through direct contact (such as through broken skin or mucous membranes in the eyes, nose, or mouth) with saliva or brain/nervous system tissue from an infected animal.
Rabies virus becomes noninfectious when it dries out and when it is exposed to sunlight. Different environmental conditions affect the rate at which the virus becomes inactive, but in general, if the material containing the virus is dry, the virus can be considered noninfectious.
What are the signs and symptomsAfter a bite or other rabies exposure, the rabies virus has to travel through the body to the brain before it can cause symptoms. This time between the exposure and the appearance of symptoms is called the incubation period, and it may last for weeks to months. The incubation period may vary based on the location of the exposure site (how far away it is from the brain), the type of rabies virus, and any existing immunity.
The first symptoms of rabies may be very similar to those of the flu including general weakness or discomfort, fever, or headache. These symptoms may last for days.
There may be also discomfort or a prickling or itching sensation at the site of the bite, progressing within days to acute symptoms of cerebral dysfunction, anxiety, confusion, and agitation. As the disease progresses, the person may experience delirium, abnormal behavior, hallucinations, hydrophobia (fear of water), and insomnia. The acute period of disease typically ends after 2 to 10 days. Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive. To date less than 20 cases of human survival from clinical rabies have been documented, and only a few survivors had no history of pre- or postexposure prophylaxis.
Rabies PreventionPets: There are several things you can do to protect your pet from rabies:
- visit your veterinarian with your pet on a regular basis and keep rabies vaccinations up-to-date for all cats, ferrets, and dogs.
- maintain control of your pets by keeping cats and ferrets indoors and keeping dogs under direct supervision.
- spay or neuter your pets to help reduce the number of unwanted pets that may not be properly cared for or vaccinated regularly.
- call animal control to remove all stray animals from your neighborhood since these animals may be unvaccinated or ill.
Rabies in dogs is still common in Philippines, so find out if rabies is present in dogs or wildlife at your area.
Because pets can get rabies from wildlife and then could spread it to humans, preventing rabies in pets is also an important step in preventing human rabies cases.
If you do come into contact with a rabid animal, rabies in humans is 100% preventable through prompt appropriate medical care. If you are bitten, scratched, or unsure, talk to a healthcare provider about whether you need PEP.
TreatmentPostexposure prophylaxis (PEP) consists of a dose of human rabies immune globulin (HRIG) and rabies vaccine given on the day of the rabies exposure, and then a dose of vaccine given again on days 3, 7, and 14. For people who have never been vaccinated against rabies previously, postexposure prophylaxis (PEP) should always include administration of both HRIG and rabies vaccine. The combination of HRIG and vaccine is recommended for both bite and non-bite exposures, regardless of the interval between exposure and initiation of treatment.
People who have been previously vaccinated or are receiving preexposure vaccination for rabies should receive only vaccine.