What is rabies and why are bites or scratches by family dog and cat dangerous?

In the interview you will be informed about the following: 

• The ways rabies spreads;
• Symptoms of rabies;
• Emergency first aid;
• Purpose of anti-rabies serum.

The viral-infectious disease progresses with irreversible damage to the central nervous system and unfortunately, is fatal.

Commonly, most frequently street dogs and cats are the ones spreading rabies. Also, fox, wolf, bat, and rodent might spread the infection. Horse, rabbit, bear, lion, pig, cattle and poultry might be affected by rabies.

Rabies is spread through the bite, scratch or saliva from an infected animal. The infection is spread even in cases when the saliva of an infected animal accidentally comes in contact with the mucosa of the eye, nose or mouth. The virus is transmitted through the peripheral nerve fibers of the body to the spinal cord, then to the brain and eventually affects the peripheral nerves and other parts of the body through the central nervous system.

Bites, scratches or saliva in the following areas are especially alarming:  head, face, neck, hand, fingers and toes, genitalia.

Rabiologist of Rabiology Services of National Center of Surgery, Maka Kutalia discusses the topic.

–How to recognize symptoms of rabies?  

– Frequently onset of disease presents itself with the usual varial infection image, particularly, it presents with:

• General weakness;
• Headache;
• High temperature.

The patient might detect a reddening of the bitten area, suffer from burning and pain.

These symptoms are gradually accompanied by insomnia, irritability, hydrophobia, and aerophobia.  A person affected by rabies develops an esophageal and respiratory muscle spasms at seeing water, releases excessive saliva.

Eventually, aphasia, hallucination, and paralysis develop.  The patient dies within 7-8 days after the first symptoms of the disease.

– Which one is more dangerous, a scratch or bite and why?

– Bite, as well as scratch and saliva, are harmful. Remember, the rabies virus is transmitted to the body not only through injuries but also through intact mucosa, albeit the deeper, larger and multiplex is the bite of any site, more dangerous is the injury!

It’s necessary to administer an immediate combined anti-rabies vaccine that comprises of administration of rabies vaccine, as well as anti-rabies immunoglobulin.

The dog bite, no matter the size, shouldn’t be sutured in the first 3 days unless it's vital. The reason for this is the fact that the suture creates the best condition for the rabies virus to spread to nerve endings. After 3 days, the anatomical integrity of the wound can be restored without any problems.

– First aid before the doctor’s appointment, how can we help the person affected by it?

–Firstly, the bite has to be cleansed several times with soap and tap water or a soap-based solution. If the size of the injury is big, it’s recommended to perform sanation with a soap-based water jet, for example, syringe. This process should last min. 10-15 minutes. Afterward, the injury should be cleansed with an appropriate solution and dressed with a sterile cloth pad.

If the injury is bleeding, don’t stop the bleeding right away, because it discharges animal saliva from the body.

–How long after a bite, scratch should you administer anti-rabies serum, how many hours after is it effective?  

– Anti-rabies vaccine should be administrated immediately for the body to generate immunity on time in a short period, before the rabies virus from the injury starts to damage the central nervous system.

It’s recommended to vaccinate no later than 14  days because the vaccine develops resistance to rabies only 2-3 weeks after the first vaccine.

Per modern guidelines, vaccination should start as soon as the patient is admitted and if possible, the animal should be monitored simultaneously. 

– Many believe that bite and scratch by a street animal are dangerous and the bite or scratch by family dog or cat aren’t. Is it a correct assumption?

– Yes, many people believe that and they’re wrong. Bite by any mammal, will it be a street animal or family pet, is dangerous. One fact should be taken into consideration – the probability of rabies in street dogs or cats is much higher, but a bite or scratch by domestic animals, vaccinated or not, is dangerous as well and requires a rabiologist’s consultation.

– Does animal affected by rabies present with any symptoms?

–  Yes, dogs affected by rabies have particular symptoms that develop in 12-20 days after the bite. Animal alters its’ behavior: avoids people, howls, is distressed, frequently gets angry, doesn’t eat, doesn’t drink water, might swallow unusual objects (a piece of wood, cloth, nail). After 1-2 days becomes aggressive, discharges an excessive amount of saliva, suffers from loss of coordination, runs away from home and in most cases gets lost, after 2-3 days it becomes paralyzed and dies on the 7^th or 8^th day.

Saliva is dangerous 10 days prior to the detection of disease signs, because it already is infected with rabies virus!

– When does it end fatally and what is the cause of it?

–  In case of a bite or scratch by an infected animal, medicine is futile when a patient doesn't promptly seek the rabiology services, consequently, doesn’t vaccinate and is affected by rabies.

It’s important for readers to comprehend that symptomatic rabies doesn't have any cure. Even nowadays, modern medicine has not discovered any drug with which, it will be possible to save a patient who has already been affected by rabies.

The only way of preventing rabies is prompt vaccination.

– How long after the vaccination is the vaccine active in the body, does it have any contraindications and what is prohibited for the patient?

– In 2 weeks after the vaccination, vaccine starts to produce antibodies that remain in the body for 1 year, albeit if within the year the patient again will be bitten by an animal, s/he will have to contact rabiologist who will choose the course of treatment based on symptoms In most cases, the follow-up anti-rabies vaccine is administered.

As for the contraindications, in rare cases patient might present following in 1-7 days after the vaccination:

• Local reddening, itching; 
• Quincke’s swelling;
• Elevated temperature;
• Rash;
• Very rarely anaphylactic reaction

Appropriate regime and diet are prescribed to reduce or completely prevent all the risks. Within the first 10 days after the first vaccination, the patient is prohibited to consume allergy-prone food (sour and bitter meals, egg, chocolate, coffee, pork, and mutton) and is prescribed an antihistamine drug.

The patient is prohibited to overtire, overstress, to stay under the sun for too long and to consume alcohol for 6 months.

Wish you health!