• Rabies is a viral disease transmitted by animals.
• Rabies is 100% fatal.
• It is transmitted by rabid animal’s saliva either by a lick, bite or scratch.
• Licks to pre existing wounds, or grazed broken skin, or to the lining of mouth or nose can also transmit the disease.
• Animals which can transmit Rabies are:
(ii) Bats and monkeys, cats.
• Animals who do not transmit Rabies are:
(i) Domestic rats and rabbits.
• Rabies cannot be transmitted from humans to humans.
• Rabies in humans can be
(i) Frantic type
(ii) Paralytic type
• Frantic type is more common and is characterized by pain, itching, at site of wound, fever, malaise, headache for 2-4 days, hydrophobia (fear of water), intolerance to noise, bright light or are fear of impending death, anger, irritability and depression.
• Duration of illness varies from 2-6 days.
• Rabies is 100% fatal with no specific cure – only supportive treatment.
INDICATIONS FOR GIVING ANTI RABIES VACCINE
• All dog bites where there is a break in skin and visible blood.
• Or its saliva has come in contact with a mucous membrane like mouth eyes etc.
• All cat bites.
• All wild animal bites.
• All bat bites.
• Horses or monkeys bites.
NO VACCINE REQUIRED FOR
• Domestic rat bites.
• Squirrel and rabbit bites.
MANAGEMENT OF DOG BITES
• Local wound treatment
• Passive immunization
• Active immunization
LOCAL WOUND TREATMENT
• Wash and flush wound thoroughly with copious amounts of water and soap.
• After that apply POVIDONE IODINE/SPIRIT.
• Tetanus prophylaxis in those who have not received tetanus vaccine in routine vaccination schedule.
• Antibiotics and pain killers/analgesics if required.
• DO NOT SUTURE/STITCH wound for 24-48 hours.
• Avoid Bandaging Wound.
• Inject Immunoglobulin around the wound if required.
CATEGORY DEGREE OF BITES-
Category – 1
• Touching or feeding an animal.
• Licks on healthy skin.
IF NO EXPOSURE,NO TREATMENT IS TO BE GIVEN/REQUIRED.
Category – 2
• Nibbling of uncovered skin.
• Minor scratches – no bleeding.
• Do local wound treatment.
Category – 3
• Transdermal bite with bleeding.
• Contamination of mucous membrane like eyes, mouth, nose.
• Broken skin with saliva from animal licks.
• Local wound treatment. Give immunoglobulin/monoclonal antibodies as much as possible infiltrated in and around the wound and the rest to be given intra – muscularly.• This has to be done as soon as possible – at the time of bite or till day 7.
• Give antirabies vaccine on day 0,3,7,14 and 28 days.
All category 3 bites, all wild animal and bat bites and Class 2 bites in immuno compromised should be given immunoglobulin / monoclonal antibodies.
• Pet dog bites do not need antirabies vaccine if dog’s rabies vaccination is up to date.
• Pet dog bites need treatment only if category 3 bites.
• Antirabies should only be given in the deltoid or upper arm,
NOT TO BE GIVEN ON GLUTEAL REGION OR BUM.
• It is important to give all five doses even if the dog is well after 1o days – 14 days.
• Even if the dog bite is reported after a month, one has to treat it as a fresh bite depending on category of bite.
• The vaccine is safe and can be given even to an infant 3 weeks old.
Q1. Is it a good idea to take preventive doses?
Ans. There are no definite guidelines for that except people who deal with potentially rabid animals, Vets, animal handlers, should take 3 preventive doses.
Q2. What happens if one has had the full course of vaccine, 6 months, one year, or two years ago, and is bitten by a potentially rabid animal.
Ans. In that case, one needs to take 3 doses at 0, 3 and 7 days.
If there is a bite within 3 months – repeat vaccine is not required.