Fatal Fangs

Fatal Fangs

Summer brings not only scorching heat but also increased rabies risks

SOCIAL & LIFESTYLE
Fatal Fangs

Rabies is a killer disease. And the scariest part of it is that either with or without medical treatment, once you become infected you are at an extremely high risk of death.

"Almost 100% of patients falling victims to rabies infection will have no chance of survival," said Dr Thanomsak Anekthananon, an infectious disease specialist.

Even though in Thailand the number of rabies-related deaths has shrunk considerably _ from 370 deaths in 1990 to only four deaths last year, according to statistics released by the Ministry of Public Health _ the severity of this life-threatening illness simply cannot be underestimated.

According to Dr Thanomsak, rabies can be contracted by people all year round, although summer is the period that brings about an increased risk _ the number of rabies infection cases rises under the scorching sun.

"We all know well that in summer, heat comes into play, especially in Thailand," explained the specialist. "And the rising temperature not only affects humans, but also animals. While people tend to go out more in summer, animals at the same time tend to get moody easier when in the heat and this therefore increases the chance for people to be attacked by these angry animals."

In Thailand, dogs are responsible for most rabies infection cases. Cats come in at second place, while other animals such as wolves, skunks, raccoons, wild rabbits, mongooses, squirrels and rats are also possible sources of the disease.

In the United States, silver-haired bats are responsible for a large number of rabies infection cases but fortunately this species is not found in Thailand.

And because rabies is deadly, the best way to battle it is prevention. Vaccination has been available since the 1960s and, according to Dr Thanomsak, it should be encouraged as a preventative protocol against the fatal disease for both humans and animals.

For humans, once you are bitten, scratched or even licked by dogs, cats or other suspected rabid creatures, first see if they are pet animals or strays. In the case of pet animals, the first thing is to check if they are vaccinated. If the dogs or cats receive a rabies vaccination every year for two consecutive years and the last shot is still within the past year, there is a much smaller risk of them spreading the disease.

"But if you suspect the pet animal that attacked you had been bitten by other rabid animals, you can get them a booster shot and keep them under close observation for 45 days."

On the other hand, being bitten, scratched or licked by stray dogs and cats requires treatment and extreme caution. A rabies vaccine is immediately required, especially if the bites and scratches are on the face or hands.

"The virus can get to the brain faster if you are attacked at the areas of the face and hands," stressed Dr Thanomsak. "If that is the case, then you need to receive immunoglobulin _ an antibody that plays a crucial role in immunity _ along with a rabies vaccine to help prevent the infection."

Two types of rabies vaccine are currently available in Thailand. The first type comes from vero cells _ developed from cell culture _ while the second, called PCEC, is from purified chicken embryo cells. Both can be administered either into muscle or skin.

There is not much difference in price or effectiveness of either. A full course of vaccination comprises five shots which need to be administered on days zero (the day of the attack), three, seven, 14 and 28.

In cases of serious bites when immunoglobulin treatment is necessary, there are two kinds to choose from. The first is extracted from horse genes while the second one comes from human blood. Dr Thanomsak said horse-serum immunoglobulin is much cheaper than the human-blood version.

However, horse-serum immunoglobulin can trigger allergic reactions in some patients and a skin test is needed before the injection.

A word of advice from the infectious medicine specialist: once bitten by dogs or cats, cleansing the wound with soap and sanitisers as soon after attack as possible can help tremendously to remove the virus and can effectively prevent the onset of infection.

"And for those who are travelling to places where there is a high risk of rabies infection or those whose work with animals that pose some risks of being infected, such as veterinarians or even postmen, they should receive a pre-exposure vaccine to cut the risk of being infected." A full course of pre-exposure vaccine involves three shots.

One way to prevent rabies on a larger scale, he said, is for pet owners to be responsible for their own animals.

"Vaccinating pets regularly is the best way to go," the doctor concluded. "Keep small pets such as rabbits, rats or guinea pigs in a cage so that they are safe from larger animals. Also, it is important to accompany and supervise your pets when letting them outside the house. This can help prevent attacks that might occur to other people."

THE DISEASE

Rabies is a disease caused by a virus and can be transmitted from animals to humans through close contact such as saliva, bites and scratches.

According to infectious disease specialist Dr Thanomsak Anekthananon, rabies symptoms can be categorised into two groups. First, the symptoms of furious rabies include restlessness, irritability, difficulty in swallowing, fever and increasing blood pressure.

Patients in advanced stages are likely to suffer hydrophobia (fear of water) and aerophobia (fear of breezes).

The second form of rabies is referred to as paralytic rabies and the symptoms include such things as lethargy and muscle paralysis.

"Seventy percent of rabies cases are furious rabies while paralytic rabies is responsible for only 30% of all rabies infection cases," the doctor explained. "Yet, once rabies symptoms develop, most patients will be in coma and die within seven days regardless of the type of rabies." On the animal side, those infected are likely to develop symptoms like restlessness, aggression and irritability. In the advanced stage, infected animals might develop hypersensitivity to touch, light and sound, a loss of appetite, seizure and death.

"Once bitten by suspected rabid dogs or cats, it is of paramount importance that you observe their symptoms for 10 days in case they are actually infected. Rabies symptoms will develop or they will die within 10 days."

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