Rabies
We tend to think of rabies as something belonging to the distant past or in far away places. While some of this is true it still costs over $300 million a year in rabies prevention, treatment and aftercare.
The term rabies derives from Latin meaning ‘to rage’. Rabies is a viral infection that is transmitted through the saliva of an infected animal, usually from a bite, cut or skin break. Wild animals such as bats, raccoons, foxes and skunks are the main sources of infection. In domestic animals, such as cats and dogs, the rates are low and seem to account for less than 10 percent of known cases. Infected bat droppings are also suspected of transmitting the disease.
Rabies affects the central nervous system and causes inflammation and infection of the brain. It is nearly always fatal once symptoms appear so treatment is only effective if it is given prior to symptoms of the disease.
There are two forms of rabies. So-called ‘furious’ rabies is associated with the mad dog. The virus attacks the brain of the animal and causes it to become aggressive and excitable. By contrast ‘paralytic’ rabies, sometimes called ‘dumb’ rabies, infects the spinal cord and causes the animal to become weak and semi-paralyzed.
Signs and Symptoms
It can take as long as 30-50 days for symptoms to appear. At first the person seems to have flu-like symptoms including headache, fever and a general feeling of being unwell. As the infection progresses the person becomes more agitated and anxious. They become confused, excitable and may experience hallucinations. The site of the infection becomes itchy and hot. The person has difficulty swallowing and produces excessive amounts of saliva. Fear of water is a prominent feature and is probably associated with difficulties in swallowing and fear of choking. Death follows within about two weeks of these symptoms and is normally due to respiratory or heart failure.
Treatments
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If symptoms are left to develop the only treatments are sedatives, painkillers and support. However, if the appropriate vaccination can be given prior to symptoms, treatment is nearly 100 percent successful. Vaccines have been available for more than 100 years so most deaths occur in places that have inadequate public health resources or people are unable to access them. In countries where treatments are unavailable or inaccessible rabid dogs account for over 90 percent of human exposure and 99 percent of human deaths.
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