Rabies: A Silent but Preventable Killer – Expert Weighs in on Prevention and Management

By Muhammad Sani Muazu,

Rabies remains a serious public health concern globally, especially in regions where contact between humans and animals is frequent. In a comprehensive interview, Dr. Sani Abdulkarim Giade, a resident doctor from the Department of Medicine at the Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), sheds light on the causes, symptoms, and prevention of this deadly disease. His insights emphasize the need for public awareness and vaccination as key strategies to curb rabies transmission.

Understanding Rabies: A Viral Threat

Rabies is a zoonotic viral disease primarily transmitted to humans through the bite of an infected animal, particularly dogs. “Rabies affects the central nervous system, primarily the brain and spinal cord of an individual,” explained Dr. Giade. “The virus is most commonly spread by a rabid dog’s bite, but other animals such as cats, foxes, raccoons, and skunks can also transmit the disease.”

In 99% of human rabies cases, a dog bite is the mode of transmission. The virus can enter the body through the animal’s saliva, which may come in contact with broken skin or mucous membranes through bites or scratches. Once inside the body, the virus travels through the nerves towards the brain, where it causes inflammation, leading to the onset of symptoms.

From Bite to Symptoms: The Incubation Period

One of the critical aspects of rabies is its incubation period—the time between exposure and the appearance of symptoms. Dr. Giade noted that this period can range from two to three months but may vary depending on several factors such as the location of the bite, the viral load, and the person’s immune response.

“After the bite, the virus replicates at the site and gradually moves toward the brain,” Dr. Giade explained. “When the virus reaches the brain, it causes inflammation, and that’s when symptoms begin to appear.”

Rabies Symptoms: Furious and Paralytic Types

The early symptoms of rabies are often non-specific and can be mistaken for other illnesses. These include fever, weakness, and body aches. “A tingling or burning sensation at the site of the bite is one of the more unique signs,” said Dr. Giade.

Rabies manifests in two main forms: furious rabies and paralytic rabies. The furious form, which accounts for 80% of cases, is characterized by hyperactivity, hallucinations, and extreme aggression. “The individual may experience hydrophobia—a fear of water—due to the severe inflammation of the brain,” Dr. Giade elaborated. If untreated, death usually occurs due to respiratory or cardiac failure.

The paralytic form of rabies, though less common, is also dangerous. It involves muscle paralysis, starting from the legs and gradually progressing to the diaphragm, which controls breathing. “The paralytic type runs a slower, less dramatic course, but it is equally fatal if not treated,” Dr. Giade warned.

Prevention: The Role of Vaccination and Public Awareness

Despite the fatality of rabies, the good news is that it is preventable through vaccination. Dr. Giade stressed the importance of vaccinating domestic animals, particularly dogs, to stop the disease at its source. “Every dog owner should ensure their dogs are vaccinated. This is the surest way to prevent the spread of rabies,” he emphasized.

In addition to vaccination, public health education plays a critical role in prevention. Raising awareness about how rabies spreads and what individuals should do after exposure is crucial to curbing the disease. “Knowing the risks and taking prompt action after exposure can save lives,” Dr. Giade advised.

Post-Exposure Prophylaxis (PEP): A Life-Saving Measure

For individuals exposed to rabies, Dr. Giade outlined the importance of immediate medical intervention through Post-Exposure Prophylaxis (PEP). This treatment involves a series of rabies vaccinations administered after exposure to prevent the virus from reaching the central nervous system.

“PEP includes thorough wound washing with soap and water for at least 15 minutes, followed by a course of rabies vaccinations,” Dr. Giade explained. In some cases, rabies immunoglobulin—a solution of rabies-fighting antibodies—may be administered to neutralize the virus.

Exposure is categorized into three levels, with the treatment varying accordingly:

Category 1: Low risk, involving touching or feeding an animal with no skin breakage or exposure to saliva. Only wound washing is necessary.

Category 2: Moderate risk, involving minor scratches or abrasions without bleeding. Thorough wound washing and immediate vaccination are required.

Category 3: High risk, involving bites or scratches that break the skin, or exposure to mucous membranes or open wounds. These cases require wound washing, vaccination, and the administration of rabies immunoglobulin.

Raising Awareness for Rabies Prevention

Dr. Giade emphasized that continuous education on rabies is key to reducing the disease’s prevalence. “Health education, raising awareness, and advocating for vaccination are essential in curbing rabies in our population,” he said. He also highlighted the need for individuals at high risk, such as veterinarians, dog handlers, and travelers to endemic areas, to receive pre-exposure prophylaxis (a preventive vaccination before exposure).

Conclusion

Rabies is a deadly yet preventable disease. Through vaccination, prompt treatment after exposure, and public awareness, the incidence of rabies can be significantly reduced. Dr. Giade’s insights underscore the importance of collective action in combating this threat. “By vaccinating our pets, educating the public, and ensuring timely treatment, we can save lives and eliminate rabies as a public health concern,” he concluded.