Rabies

Rabies and Australian bat lyssavirus (ABLV) are acute viral encephalomyelitis caused by a lyssavirus. Animals in Australia do not have rabies link. Outside Australia, rabies occurs in dogs, cats, monkeys and foxes. ABLV does occur in Australian bats. Rabies can be transmitted from rabid bats and rabid animals to humans via a bite or scratch. Animals most likely to transmit rabies in the United States include bats, coyotes, foxes, raccoons and skunks. In developing countries of Africa and Southeast Asia, stray dogs are the most likely to spread rabies to people. link

The virus attacks the central nervous system, causing progressive paralysis, encephalitis and coma. Once symptoms are present, rabies is invariably fatal. Rabies is entirely avoidable; vaccines, medicines and technologies have long been available to prevent death from rabies. Nevertheless, rabies still kills tens of thousands of people each year. Of these cases, approximately 99% are acquired from the bite of an infected dog. 

According to the World Health Organisation (WHO) rabies is estimated to cause 59 000 human deaths annually in over 150 countries, with 95% of cases occurring in Africa and Asia. Due to underreporting and uncertain estimates, this number is likely a gross underestimate. The burden of disease is disproportionally borne by rural poor populations, with approximately half of cases attributable to children under 15 years of age. link

According to the 2016 rabies surveillance report from the European Centre for Disease Prevention and Control only three cases of rabies in people who travelled to a non-EU/EEA country endemic for rabies were reported: a 46-year-old woman from Spain bitten by a dog in Morocco, a 57-year-old man from France infected by a canine strain of rabies virus in Mali (Africa), and a 35-year-old Dutch woman bitten by a dog in India. link

Prevention

To reduce your risk of coming in contact with rabid animals:

• Vaccinate your pets.  Cats, dogs and ferrets can be vaccinated against rabies
• Keep pets confined. Keep your pets inside and supervise them when outside. This will help keep your pets from coming in contact with wild animals
• Protect small pets from predators. Keep rabbits and other small pets, such as guinea pigs, inside or in protected cages so that they are safe from wild animals. These small pets can’t be vaccinated against rabies
• Report stray animals to local authorities
• Don’t approach wild animals. Wild animals with rabies may seem unafraid of people. It’s not normal for a wild animal to be friendly with people, so stay away from any animal that seems unafraid
• Keep bats out of your home. Seal any cracks and gaps where bats can enter your home. If you know you have bats in your home, work with a local expert to find ways to keep bats out

Symptoms

Rabies and ABLV show similar symptoms, such as;

• flu like symptoms
• headache, fever and tiredness
• progressing rapidly to paralysis, delirium, convulsions
• death within one to two weeks.

Given the rarity of infection, there is some uncertainty about when symptoms appear after contact with the virus.

Treatment

Immediate medical care should be sought if you’re bitten by any animal, or exposed to an animal suspected of having rabies.

Rabies and ABLV can be prevented by rapid and thorough cleaning of the wound and by vaccination. The WHO suggests two strategies for preventing rabies.

1. Pre-exposure prophylaxis (PrEP) which is the administration of several doses of rabies vaccine to high risk populations before exposure to rabies.

• wash the wound thoroughly with soap and water for at least 15 minutes
• apply an antiseptic with anti-virus action such as povidone-iodine, iodine tincture, aqueous iodine solution or alcohol (ethanol) after washing
• seek medical attention as soon as possible to care for the wound and to assess whether you are at risk of infection

2.Post exposure prophylaxis (PEP) which includes extensive and thorough wound washing at the rabies-exposure site, together with rabies immunoglobulin (RIG) administration if indicated, and the administration of a course of several doses of rabies vaccine.

Vaccination

Consider the rabies vaccine if you’re traveling. If you’re traveling to a country where rabies is common and you’ll be there for an extended period of time, ask your doctor whether you should receive the rabies vaccine.

Vaccination should be given 6 to 12 weeks prior to travelling. Three injections are required over the course of one month. The vaccine has very little side effects