Every living person in this world would have encountered a situation where he/she is being chased by an animal. I often have that kind of dreams and wake up in my sleep with a sudden jerk. You can thank your lucky stars if you managed to escape a bite somehow. But not all persons are lucky enough. Some may even get an unprovoked trivial pet lick or bite at home and even that can lead to Rabies. Rabies can be easily prevented with vaccines, but once the disease develops in humans, it is incurable and will eventually lead to death. In fact, Rabies is the only communicable disease in man which is cent percent fatal.
In my previous article, I have briefly mentioned about Rabies, the virus transmission, it’s progression and the symptoms of Rabies. I highly recommend you to read that article first before going into this one.
This article contains the steps to manage and prevent Rabies caused by all animal bites and is not just confined to Dog bites alone.
There are certain things which you can do to prevent animal bites. Here, I have listed a few of them. If you are smart enough, you can definitely escape the unfortunate bite !
Do not provoke the animal in any means. Use your common sense to figure it out.
Run for your life. Yeah, not joking! Run as fast and as long as you possibly can and try to get into some place where the chasing animal can’t reach.
Do everything you can to prevent animal bites. That can include making loud noise, calling for help etc.
Stay away from wild animals like wolves, jackals, bats etc
If you get bitten even after all the failed attempts, here are the things that you should do immediately. Remember, these steps might sound simple but are really important and have a huge role to play in preventing one from getting Rabies.
1- Clean the area with soap and water preferably under running water for at least 15 minutes. Use plenty of water for washing the wounded area.
2- Use chemical agents which are capable of killing the virus like alcohol, tincture iodine etc. If these chemicals are not in hand, don’t waste your time trying to find it or buy it, proceed to step 3!
3- Go to your nearest hospital as soon as possible. There are few things which can be done only at the hospital and do not hesitate in seeking medical care. Do not casually ignore the bite as a trivial one, even if it’s not bleeding. Vaccines and Immunoglobulins can save your life and that has to be taken immediately after the bite incident. There is no cure for Rabies, but there is an effective preventive method available and that service are delivered only at the hospital level. So, if you care about your life, call 911 or go to the hospital yourselves.
The hospital staff will reassure you first of all and then take care of your wounds by cleaning them (if you haven’t already). Sutures might be required if the wound is a deep one. Wound suture is usually delayed by one to two days after the animal attack.
Antibiotics and Anti Tetanus injections will be administered at the hospital. If you want to know more about Tetanus, read this article.
Confirming Rabies in Humans
History is often sufficient to confirm an animal bite. If you have read my previous article, you would be familiar with the terms, Hydrophobia (fear of water) and Aerophobia (fear of air). These are some of the classical manifestations of Rabies in man. If you want to confirm the presence of the Rabies virus in your body, there are blood test available like the Immunofuorescence test that detects the viral proteins (antigen) in blood. Saliva can also be used to detect the virus.
Vaccines and Immunoglobulins
Anti Rabies Vaccines have been introduced for more than forty years and are thus time proven to be safe in humans. These vaccines have saved millions of lives worldwide and are thus very effective too.
All animal bites especially dog and cat bites should be considered as “suspected Rabid bites”. The main aim after a person is bitten is to neutralise the virus before it attacks the nervous system.
The following 3 categories have been defined for vaccination in a suspected Rabies contact :
mere touch of animals or contact with intact skin does not require any vaccination.
contact with broken skin, minor scratches or abrasions without any bleeding requires immediate local cleaning and vaccinations.
single or multiple bites; licks on broken skin; contamination of mucous membranes with saliva from licks; contact with bats – require immediate local cleaning and vaccination together with administration of Anti Rabies Immunoglobulins.
The process of giving vaccines and immunoglobulins to suspected persons is called “Post Exposure Prophylaxis”. It can be given as either Intra-muscular or Intra-dermal (skin) injections. The most common regimens used in post exposure prophylaxis includes the “2 site Intra-dermal” injections which are given on the following days : 0, 3, 7 and 28
Intra-muscular injections on the other hand are given at “single site” on the following days : 0, 3, 7, 14 and 28.
Post exposure prophylaxis may be discontinued if the suspected animals have been proven by laboratory examinations as Rabies free. In case of domestic animal bites, the prophylaxis may be discontinued if the animal can be traced or kept under observation for a 10 day period starting from the day of bite.
Post exposure prophylaxis is required in case of persons who have been previously vaccinated, but in fewer doses. They just require the 0 and 3 doses (for intra-muscular).
There is no contraindications to Anti Rabies Vaccines as Rabies is a lethal disease.
Immunoglobulins are administered locally to provide passive and instant immunity. Equine and Human forms of Anti Rabies Immunoglobulins are available. They are administered at the site, and remaining as Intramuscular injections. They should be given within 7 days of the bite because after that period, the active immunity starts working in response to the Vaccines which were given earlier (0, 3 days).
All persons who have been started on the post exposure prophylaxis should keep in mind to complete the full course of the regimen for maximum protection from the disease. Anti Rabies Vaccines and Immunoglobulins are made available free of cost to all persons in the public hospitals in Kerala. I hope this article was helpful. Don’t forget to hit the like button if you liked it. If you have any more queries regarding this topic, do post them in the Comments section below.
Stay away from bites!
Image Credit – Julianna
Latest posts by Dr Prasoon (see all)
- Handling Government Fund as the Medical Officer - February 17, 2018
- 99 DOTS, TB Control in India takes new road - February 10, 2018
- National De-Worming Day in India, February 8, 2018 - February 3, 2018