By Fatoumatta Trawally
5th Year (Dentistry), 21st Cohort
Rabies is a deadly viral disease that affects the brain and spinal cord of both humans and animals. Once symptoms appear, it is almost always fatal. However, with timely vaccination after exposure, rabies can be completely prevented.
What causes Rabies?
Rabies is caused by the rabies virus, a member of the Lyssavirus genus. It travels through the nerves to the brain, where it causes inflammation (encephalitis) and ultimately death if not stopped early.
In most cases, domestic dogs are the main carriers and transmitters of rabies to humans—especially in parts of Africa and Asia. Rabies is not just a wild animal problem; it’s a domestic threat living in our streets, neighbourhoods, and homes.
Mythical Beliefs
Many communities still hold myths about rabies:
·          Some believe it’s caused by witchcraft or spiritual possession.
·         Others delay hospital visits, seeking traditional remedies instead.
These beliefs have led to avoidable deaths. Rabies is a medical emergency, not a mystical one.
How Is It Transmitted to Man?
Rabies spreads through:
·          Bites or scratches from infected animals.
·          Saliva entering broken skin or mucous membranes (eyes, mouth).
·          Rarely, through organ transplants from infected donors.
The virus does not spread through unbroken skin or touching a rabid animal without a bite.
Clinical Signs and Symptoms
Symptoms usually appear 1 to 3 months after a bite but can show up earlier or later.
The early signs are:
·          Fever, headache- Pain or itching at the bite site
And later signs are:
·          Anxiety, confusion, aggression
·          Difficulty swallowing, fear of water (hydrophobia)
·          Excessive salivation
·          Paralysis, coma, and death
The Clinical symptoms of Rabies can also be presented as:
1. Furious Rabies:
·          Most common type. It is characterised by hyperactivity, aggression, hydrophobia (fear of water), hallucinations, and confusion. Infected persons may attempt to bite others, similar to rabid animals.
2. Paralytic Rabies:
·          Less common but often misdiagnosed. It’s characterised by gradual muscle weakness, starting from the bite site, leading to paralysis and coma. It is slower in progression and lacks the classic hyperactive signs.
Once symptoms start, there is no cure!
What to Do When Bitten by a Dog:-
We assume the animal can transmit any causative organism until proven otherwise with definitive and or clinical evidence also known as diagnosis. Thus we carry out the following procedures;
1. Wash the wound immediately with soap and running water for 15 minutes.
2. Apply antiseptic if available.
3. Go to the nearest health facility immediately.
4. Start Post-Exposure Prophylaxis (PEP)—a series of rabies vaccinations.
PEP must start as soon as possible—it’s the only way to prevent rabies after exposure.
Dagnosis (Lab):
Lab diagnosis includes:
·          Skin biopsy, saliva, or cerebrospinal fluid testing in specialised labs.
·          In humans, rabies is often diagnosed clinically, as lab confirmation may come too late.
In animals, testing is done after death on brain tissue.
Pevention / Vaccination:
·          Vaccinate pets, especially dogs and cats, starting from early puppyhood.
·          Control stray dog populations through sterilisation and vaccination campaigns.
·          Regular visits of dogs and puppies to a veterinary clinic.
·          Avoid touching wild or unfamiliar animals.
·          Vaccinate high-risk groups such as veterinarians, animal handlers, and laboratory staff. Pre-exposure vaccination is available for high-risk groups (vets, animal handlers).
·          Educate communities and schools on dog behaviour and how to prevent dog bites
Once symptoms begin, rabies is almost always fatal!
·          WHO recommends a comprehensive rabies control strategy, including mass dog vaccination and access to affordable post-exposure prophylaxis (PEP).
·          Vaccines used in rabies prevention and post-exposure treatment include:
o         PVCR (Purified Vero Cell Rabies Vaccine)
o         HDC (Human Diploid Cell Vaccine)
Management:
There is currently no known cure for rabies once symptoms appear.
Patients are usually admitted to the Intensive Care Unit (ICU) for supportive management.
In some advanced healthcare settings, the Milwaukee Protocol has been attempted, involving medically-induced coma and antiviral therapy, though outcomes are poor.
No Cure!
There is no cure for rabies once symptoms appear. This is why prevention is key.
Rabies should never be underestimated.
It kills, but it can also be stopped; and THAT is the SAD REALITY!
