by Dr. Milton Lum
I read recently of the rabies epidemic in Bali. It seems there are many rabid dogs around that are biting children and causing them to die. What is rabies? Is it common in Malaysia?
Apparently, more than 55,000 people die from rabies around the world every year, mostly in developing countries. Luckily for us, Malaysia is rabies-free, as declared by the WHO! This is because we have eliminated rabies from dogs, thereby eliminating rabies in people.
However, it is still prevalent in other South-East Asian countries, Africa, and Latin America.
Rabies is actually a disease caused by a virus and is transmitted from animals to humans via infected saliva. The virus can be transmitted only if it gets into open cuts in your skin, or your mucous membranes such as your mouth or eyes.
Bites by the infected animal are the most common way to transmit the virus. Scratches are less likely to transmit.
Is rabies transmitted only by dogs?
Actually, no. Almost any mammal can get rabies, wild or domestic. Worldwide, dogs are the most common domestic animal that carry it.
However, in US, bats are the most common animal responsible for transmission, causing half the human cases. Cats are the most common domestic animal that spreads rabies in the US. Rabies is however rare in rats and other rodents.
It is not clear that the bat has to bite you in order to transmit rabies. Apparently, close contact with a rabid bat is all it takes for you to get rabies.
How will I know I have rabies?
First, you usually develop pain, tingling or itching at the site of the bite. Then you may get flu-like symptoms, such as fever, fatigue, muscle aches. (All these are symptoms of a viral illness.)
The rabies virus usually needs one to two months to incubate, though some people get rabies within 10 days of the bite. Then you become very ill. Your fever spikes. You may have confusion, be very agitated. You may have fits and eventually fall into a coma as the rabies virus affects the brain.
A very classical symptom of rabies is developing spasms of your breathing muscles when you are exposed to water. This is called hydrophobia. The same thing may happen when you are exposed to a puff of air (aerophobia.)
There are two types of rabies :
1. Furious rabies – where you are hyperactive.
2. Dumb rabies – where you are paralysed.
In both cases, you will eventually progress to complete paralysis, a coma and death by respiratory failure.
Once you get rabies, it is 100% fatal. There is nothing anyone can do for you, even if you are put on a ventilator and given the best supportive care in the world.
Am I at risk of rabies? I have four dogs at home, and we live near Batu Caves, where there are bats!
In Malaysia, we have eradicated rabies (as far as we know). But if you travel to developing countries in Asia and Africa, be careful. Poor people in these countries, especially children, are the most at risk. Children usually play with animals and are less likely to tell you if they were bitten or scratched.
Veterinarians or people handling animals are also at risk, especially when you don't know where the wildlife animals came from.
How do I recognise a rabid animal so that I can run for my life?
You don't have to run for your life! But yes, you have to be careful. And do not pat strange animals that you are unsure of.
Look out for these symptoms and signs in an animal :
* The animal looks sick, crazy or vicious (this is what they call a 'mad dog'). However, this is not a 100% must in a rabid animal. Some rabid animals may appear normal, friendly, or merely confused,
* When you see a nocturnal animal during the day, such as a bat or a fox, or when a normally shy wild animal appears friendly, or strange.
If I do get bitten by what I suspect is a rabid animal, what do I do? Am I doomed to die?
No. What you do now is to prevent the rabies virus from spreading to your organs. There is a vaccine against rabies. You need to seek medical treatment immediately. Your wound must be cleaned and repaired, and the doctor will have to give you a rabies shot (anti-rabies vaccine). If you do this as soon as possible after the bite, prevention of rabies is 100%.
You will also have to notify the authorities where the rabid animal is, so it can be captured or shot.
Your pets must undergo the immunisation schedules mandatory for all pets, because these include the rabies vaccine.
More info on RABIES here.
8:05 AM Rabies