Rabies : Viral Disease – Treatment

Rabies is a zoonotic viral disease (i.e. it can be transmitted from animals to humans) which affects domestic and wild animals.

It is a viral disease transmitted to animals and humans through close contact with the saliva from infected animals through bites, scratches, or licks on broken skin and mucous membranes.

Rabies is usually spread to humans from infected stray dogs. In addition, some other animals can also spread rabies. These include cats, foxes, bats, raccoons and skunks.

Proper wound cleansing, immunization and administration of human rabies immunoglobulin can prevent the onset of rabies and death.

Rabies kills if it is not prevented or treated immediately. Effective treatment soon after exposure to rabies virus can prevent the onset of symptoms and death.

Treatment of rabies following infection comprises of:

(A) Local treatment of the wound
(B) Immediate vaccination
(C ) Administration of human rabies immunoglobulin (HRiG)

Local treatment of the wound- The wound should be washed thoroughly for a minimum of 15 minutes with soap and water, povidone iodine or other substances that kill the rabies virus.

Vaccination- An anti-rabies vaccine is generally given in 5 doses over 28 days. The first dose is given on the first day and subsequent doses on days 3, 7, 14, 28. One shot is given around the area of the bite. The rest are given in the arm. Sometimes, an additional shot is required on the first day if it is not possible to give all the vaccine around the site of the bite. The rabies vaccine produces an immune response, which helps the body fight off the virus. The shot makes the body produce antibodies that kill the virus.

Administration of human rabies immunoglobulin (HRiG) - HRiG is given on the day of the bite. Half of the HRiG should be injected around the wound and the other half should be given intramuscularly.

Once the disease is established, therapy is to relieve the symptoms as death is inevitable.

The patient should be isolated and nursed in a dark, quiet room.

(1) Nutrition, respiration, and heart condition should be monitored and supported.
(2) Drugs to sedate the patient, relieve pain and to reduce hallucinations can be given liberally.

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