Rabies: precaution and treatment

Studies indicate that in India, 18,000 - 20,000 deaths occur due to rabies. Whereas 30% -60% cases are among children less than 15 years of age.

KOCHI: Studies indicate that in India, 18,000 - 20,000 deaths occur due to rabies. Whereas 30% -60% cases are among children less than 15 years of age. As the cases are on the rise in Kerala, extra attention should be given.

Compared to last two and a half years, with the reopening of schools, more children are moving in public places Rabies is a crucial issue that children should have awareness and most deaths from rabies occour in children under the age of 15. In most cases they do not disclose such incidents to their parents or others due to their ignorance. An important fact that everyone needs to understand is that rabies infection is 100% preventable if treated on time.

How does rabies occur in humans?
In India, dog has been and still is the main reservoir of rabies. The infection is transmitted from the saliva of animals (as the virus grows in their salivary glands). Rabies is caused only when a dog bites and its saliva gets mixed with the wound, the virus is not transmitted through a dogs blood or faeces. The infection spreads to the muscles and then through our nerves to the brain and other parts of the body.

What are the symptoms of rabies?
The patient will experience symptoms within 10 - 20 days of a dog bite, such as fatigue, headache, nausea, and fever. In 20 - 90 days of infection, symptoms such as fear of water, fear of darkness, difficulty in throat while drinking water and eating food will start to appear.

How to prevent rabies?
The possibility of infection from a dog bite can be categorised into several levels.

• Stray dog ​​bites are more likely to cause infection.
• If bitten by a domestic dog, the chance of infection is very low especially if the dog is properly vaccinated. However, it is better to consult a doctor for diagnosis.
• If you have been bitten by a pet dog and the dog has had any recent changes in its behavioural patterns (increased aggression, being unusually gloomy, trying to attack when approached) you should definitely seek medical attention and take the dog to a veterinarian.
• Bites from other animals such as cats, mice and squirrels are less likely to cause rabies. Bat-borne rabies has been found in foreign countries.

The intensity of infection can be categorised in 3 stages

Category 1: Skin contact with the saliva of dog is considered at a very low risk.

Category 2: If there is a scratch on the skin or a small cut, and if the the dog licks or gnaws on the cut.

Category 3: If the bite is deep and it bleeds, the risk of infection is very high. Whereas bites on the hand or face are the most serious as it can spread to brain very quickly,.

First aid for dog bite

• Wash the affected area thoroughly with soap and water for about 15 minutes.
• Washing the wound with betadine solution and water ensures further protection.
• Get to the hospital as soon as possible.
• Seek proper treatment for infection prevention (Post Exposure Prophylaxis).

Two types of post exposure prophylaxis

• Immunoglobulin
• Injection

It takes some time for the immunity to show up in the body if the vaccine is taken in the normal course. Therefore, for quick effect the immunoglobulin should be taken to prevent the virus from spreading in the body. Human immunoglobulin (HRIG) is commonly used. The dose of immunoglobulin injection is given according to the body weight of the patient.

The amount of passive antibody increases in the body within 24 hours. This prevents the virus from spreading to the nerves and brain. 5 doses of injection should be taken within 28 days. It is necessary to pay attention to all these factors and create awareness about rabies in children. Basic knowledge will help one face such situations.