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RABIES

  1. What is rabies?
    Rabies is an acute viral disease that causes fatal encephalomyelitis (inflammation of the brain) in virtually all the warm blooded animals including man.
  2. How is rabies spread?
    The virus is found in almost all the mammals and is transmitted to other animals and to human beings through their saliva following bites, scratches, licks on broken skin and mucous membranes.
  3. Can rabies be spread by drinking the milk of a animal which has died of rabies?
    Theoretically rabies virus can be present in any tissue of an infected animal and hence can be present in any secretion. Hence, it is advisable to treat handlers and persons consuming unpasteurised milk of rabid animals with post exposure prophylaxis (PEP) of rabies.
  4. Can rabies be transmitted from human to human?
    Human to human transmission is very minimal and there is no well documented case for the same. Transmission from human to human has been reported in organ transplant where the donor was suffering from rabies. However, people who have been exposed closely to the secretions of a patient with rabies may be offered PEP as a precautionary measure.
  5. Can a fully vaccinated pet dog/ cat transmit rabies?
    Animal vaccines may be unreliable and more importantly if the animal is exposed to other animals then there is a chance of the pet being at risk.
  6. Can rabies be cured?
    There is no known treatment for rabies till date and in almost all cases the disease is fatal.
  7. What are the symptoms of rabies?
    The typical triad of symptoms of rabies in humans is Hydrophobia (fear of water), Aerophobia (fear of air/wind) and photophobia (fear of bright light). However it is not necessary that a patient may suffer from all of the above though hydrophobia and aerophobia are typical. Rabies is probably the most painful and dreadful of all communicable diseases.
  8. What should I do if I am bitten by an animal?
    Wash the wound thoroughly with soap and water. You may apply an antiseptic if available. Do not apply irritants like chillies, oil, turmeric, lime, salt etc. to the wound as this will only spread the virus faster. Seek proper medical advice.

Advice to Medical Professionals:

a) Treat all animal bites as emergencies

b) Even cases reporting days after being bitten should be treated as Day 0.

c) Perform wound toilet and avoid dressing wounds if possible.

d) Avoid suture of wounds. If unavoidable first infiltrate the wound with Rabies immunoglobulin (RIG) and then apply loose sutures.

e) Categorise the bite as per the WHO classification and administer RIG in all category III cases. Details of administration of RIG can be found in the Antisera section in this website.

f) Administer anti rabic vaccine in all category II and III bites either by Intramuscular route (I/M) or intradermal route (I/D) as per the manufacturer’s instructions.

g) Schedule for I/M route is one dose each on Day 0, 3, 7, 14 and 28. Day 0 denotes the first day of administration of the vaccine. Vaccine is given I/M into the deltoid or anterolateral aspect of the thigh. Should not be given in the gluteal region.

h) Schedule for I/D route is 0.1ml given intradermally on two sites (preferably both deltoids) on day 0, 3, 7 and 28. Intradermal injections should be administered only by persons trained specifically for intradermal injections. Only vaccines (lyophilised vaccine along with the diluent of specified volume) approved by the DCGI for I/D administration should be used for intradermal route. Reconstituted vaccine should be used within 8hrs.

i) Pregnancy is not a contraindication for PEP and RIG and ARV should be administered as per classification of bite.

j) Avoid switching from one brand/ type of vaccine to the other or from one mode of administration to the other.