Rabies (Hydrophobia) : Causes and Treatments

     Rabies or Hydrophobia (Rabies, Hydrophobia) is caused by the (Rabies Virus), which can be transmitted from warm-blooded animals and mammals to humans. Transmission can occur simply through a wound caused by the bite of an infected animal, as well as from scratches or licks on areas with existing scratches or open wounds. 

Severity of Rabies

     Rabies can be transmitted through the saliva of an infected animal via the mouth, nose, eyes, and wounds. The most critical animal vectors include dogs and cats, though it can also be found in other domestic animals such as pigs, horses, cattle, and buffalo, as well as wildlife like monkeys, gibbons, squirrels, and treeshrews. Once a person is infected and does not receive proper post-exposure prevention, symptoms usually appear within 15–60 days after exposure, though some cases may show symptoms in fewer than 10 days or even up to a year. Since there is currently no cure for rabies once symptoms appear, prevention is of the utmost importance.

Symptoms of Rabies

Infected individuals will initially develop headaches, low-grade fever, sore throat, muscle aches, loss of appetite, and fatigue.

• A common symptom is itching around the bite wound, which may have completely healed a long time ago but subsequently spreads elsewhere. Patients may scratch excessively to the point of bleeding. 
• Difficulty swallowing, accompanied by spasms of the throat and laryngeal muscles.
• A desire to drink water but an inability to swallow, leading to hydrophobia (fear of water), foaming at the mouth, and frequent spitting.
• Agitation, excitement, and irritability.
• Rapid breathing, with senses becoming hypersensitive to stimuli.
• Easily startled and prone to sudden spasms when exposed to wind or loud noises.
• Spasms and twitching of the arm and leg muscles.

In the later stages, the patient will experience paralysis, lose consciousness, and pass away within 2-7 days from the onset of clinical symptoms.

How to Observe Dogs or Cats with Rabies

The animal's behavior and temperament will noticeably change from normal.

Early Stage

• Agitated, easily startled, restless, or snapping at the air or insects.
• Eating unusual objects like wood chips, stones, soil, or sand, and biting anything in their path.
• Decreased appetite, dilated pupils, and hypersensitivity to light and sound.

Late Stage

• Paralysis sets in, causing an abnormal bark or howl, a stiff back, a dropped tail, a protruding tongue, and a dropped jaw.
• Continuous drooling, inability to swallow, and lockjaw.
• The mouth stays wide open, with leg tremors and an unstable gait.
• Paralysis spreads throughout the body, leading to collapse, seizures, and death within 10 days of symptom onset.

• However, some animals may exhibit the "dumb" form of rabies, skipping the aggressive stage entirely. They may appear lethargic, show mild tremors, or present no obvious symptoms, choosing instead to hide in dark, quiet places and refuse food.
• They might claw at their throat as if a bone is stuck, without showing signs of aggression, but will bite if disturbed. Therefore, close caution is required, and medical evaluation is necessary.

Prevention of Rabies

Prevention is the most critical aspect regarding rabies. Bites should be avoided as much as possible. If a bite occurs, remember the rule: “Dog bites: Wash the wound, apply medication, quarantine the dog, see a doctor, and complete the full vaccine series” according to the following steps:

1.  Vaccinate Domestic Pets

     Have your pets, such as dogs and cats, vaccinated against rabies at least 1 time per year. Under the Rabies Act, owners are required to bring puppies/kittens for their first vaccination between the ages of 2-5 months, with a booster shot administered 1-3 months after the initial dose.

2. Avoid Risk with the '5 Don'ts'  

     We can reduce the risk of animal bites by practicing the 5 Don'ts: “Don't tease, Don't step on, Don't separate, Don't pick up, Don't engage” Meaning: Don't tease dogs or other animals to provoke anger; Don't step on their tail, head, body, or legs, or startle them; Don't use bare hands to separate fighting dogs or animals; Don't pick up food bowls or move their food while they are eating; and Don't engage with unfamiliar or stray dogs and animals.

3.  Supervise Children to Prevent Close Play with Unvaccinated Pets

Avoid letting children play closely with animals that have not been vaccinated or whose vaccination history is unknown. Bring pets for vaccination as soon as possible, as animals develop proper immunity roughly 1 month after receiving the vaccine. Furthermore, if you wish to prevent unwanted litters, consider pet contraception methods such as spaying, neutering, or structural birth control.

4. Separate Garbage and Maintain Cleanliness

Dispose of trash and food scraps in tightly covered bins, or eliminate them through burial or burning to avoid creating food sources for stray animals. Keep your pets under responsible care and don't allow them to roam freely or cause nuisances to others.

5.  Reporting Suspected Animals

If you spot a dog or animal showing signs suggestive of rabies, immediately notify livestock officials, public health authorities, sub-district administrative organizations, or municipal offices. This allows for swift disease control to prevent spreading and ensures that anyone bitten or scratched by that animal can be traced and brought in for vaccination.

Treatment of Rabies Risk

When bitten by a dog or a mammal:

• The patient should promptly wash the wound with soap and clean water multiple times.
• Wipe it dry and apply a non-alcoholic iodine solution, such as povidone-iodine or other fresh wound care antiseptic treatments.
• Trace the owner of the biting animal to inquire about its rabies vaccination history and symptom history for ongoing monitoring.

Anyone in Close Contact with Animals Should Be Vaccinated

• Promptly visit the nearest physician or public health facility to receive professional guidance on vaccination and (Immunoglobulin) for rabies post-exposure prophylaxis.
  • Receive vaccines and immunoglobulins completely as scheduled.
  • Quarantine the biting dog or cat to observe its symptoms for at least 10 days. During this period, provide regular food and water to the animal, but remain cautious and avoid close physical handling.
  • If the animal displays abnormal behavior, seek medical attention immediately. If the animal dies during this observation period, notify officials to arrange for testing of the animal's brain tissue for the rabies virus.

Special thanks for information from: Department of Disease Control, Ministry of Public Health

You should avoid animal bites as much as possible. If a bite occurs, you must remember to: “Wash the wound, apply medication, quarantine the dog, see a doctor, and complete the full vaccine series.”