BE AWARE OF RABIES
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Rabies is a dreadful viral disease that kills an estimated 55,000 people every year around the world. It’s endemic in many Asian countries, including Thailand, where it caused 13 deaths in the first half of 2010 – six of them in Bangkok.
Because of the severity of the disease if left untreated – and the fact that rabies in humans is 100 per cent preventable – you should be aware of the risks and what to do if you’re bitten by a rabid animal.
The virus is usually transmitted by a bite, but can also come from infected saliva that contacts an open wound or your mucous membrane via the mouth or eyes.
Any pet or farm or wild mammal can transmit the virus, but Thailand’s stray dogs are most often involved. The risk of infection following contact is about 15 per cent, but it depends on the number and severity of bites and the location of the wounds. The head and upper body are the highest-risk areas.
Among wild animals, bats warrant special attention because their bites and scratches can be almost unnoticeable. If you find a bat in your bedroom when you wake up, consider yourself exposed to rabies.
Children are more exposed because they’re more likely to be bitten and might not report a minor bite. The World Health Organisation says children under 15 account for 40 per cent of people bitten by suspected rabid animals.
The first symptoms to appear resemble those of flu – fatigue, fever and headache. Later there are serious neurological signs of encephalitis – abnormal behaviour, violent gestures, hallucinations and eventually coma, respiratory failure and death.
Once such signs appear, rabies is almost always fatal. Fewer than 10 documented cases of human survival have been reported.
It’s important to remember that the incubation period for rabies is usually 20 to 60 days, but it can last more than a year. Therefore it’s never too late to get treatment before the clinical symptoms develop.
Rabies is a medical urgency, but not an emergency. Although treatment should not be delayed, there’s enough time to weigh the options based on the animal and the bites inflicted.
Treatment begins anyway if there is any doubt. It involves fast-acting rabies-immune globulin, injected near the wound to eliminate the virus before it can infect the brain tissue.
You get five injections over 14 days. Vaccination triggers an immune reaction, leading to the production of antibodies to destroy the virus.
Prevention requires vaccination of pets and their supervision outside the home. Stray dogs should be avoided and authorities should be called to deal with these animals.
With proper knowledge on the risk of rabies and how to deal with it in case of bite, this disease should be once again completely preventable in a country with easily accessed medical facilities.
Dr Gerard Lalande is managing director of
CEO-Health, which provides medical referrals
for expatriates and customised executive medical check-ups in Thailand. He can be contacted
