28th of September each year is recognised as World Rabies Day. Globally, efforts are being poured into eliminating dog-mediated human rabies by the year 2030, or as you may have heard or seen the hashtag - #Zeroby30. I’m sure that by now everyone knows that rabies is a zoonotic disease; it can be transmitted from animals to humans and once symptoms manifest, it is always fatal. There is no question as to why it is essential to eliminate this disease. But in order to do so, we must be equipped with as much knowledge as possible about rabies. Without further ado, let us dispel some myths, answer some questions, and increase our knowledge.
Q. When is a good time to vaccinate your pet against rabies?
A. Any pet dog or cat over the age of 45 days can be vaccinated against rabies. Orphaned puppies or kittens can be inoculated even sooner as they may not have received any maternal antibodies which could interfere with the immunity granted by the vaccine. A booster dose of the vaccine needs to be taken 21 days (3 weeks) after the initial dose. And of course, an annual booster must be taken every year after that.
Q. What about me? Do I need a vaccine against rabies?
A. If you are someone who has multiple pets at home, especially a mix of mammalian species, or if you are someone who works closely with dogs; for that matter, even if you are a concerned member of the community who feeds or looks after a large number of dogs or cats, it would be best to take the prophylactic dose of the anti-rabies vaccine. Talk to your general practitioner about the dates and doses. Pro tip: Take your vaccine around a public holiday, an anniversary or even a birthday. It will be an easy reminder for you when your annual booster is due. Mine is on Valentine’s Day!
Q. I’ve been bitten/scratched by a dog. Do I require a vaccine?
A. Let’s break down the necessity of a vaccine. It largely depends on the degree of the scratch or bite sustained. They are divided into CATEGORIES OF EXPOSURE.
A Category I exposure is when an animal licks intact skin. This can happen during playtime or during feeding. This means only external skin tissue has been exposed. No internal tissue has been exposed to animal saliva or any other bodily fluid.
Category I exposures do not necessitate the need to take a vaccine or immunoglobulins. The exposed site must be washed well.
A Category II exposure is when there occurs nibbling of uncovered skin, minor scratches or abrasions without bleeding. This means that the barrier of external skin has been compromised.
A Category III exposure is when there are one or multiple transdermal (exceeding the skin layer) bites and contamination of the mucous membranes or broken skin with saliva from animals’ licks.
Category II and III exposures necessitate taking the vaccine as well as immunoglobulins, the schedule for which can be very easily understood in this PDF prepared by the WHO here
Q. How can I recognise if an animal is rabid?
A. Some of the easiest to identify symptoms of rabies include:
- Nervous incoordination.
- Long, ropy salivation.
- Unexplained behavioural changes, like excessive aggression towards familiar people or family members.
- Hyperaesthesia or excessive reaction to ordinary external stimuli.
- A blank stare in the eyes accompanied by a slack or dropped jaw.
The reason the symptoms have such a wide range is that the rabies virus takes over the nervous system of the patient, manifesting in excessive OR dampened nervous function.
The same animal can start off with excitable symptoms, referred to as the “furious” form of rabies, but its condition can deteriorate to a completely dull, recumbent and unresponsive state, known as the “dumb” or “paralytic” form of rabies.
A rabid animal may still be able to retain cognitive function to an extent. In my personal experience, I have seen dogs that could consume food, drink water, respond to their names, even show some recognition and friendliness by wagging their tails; all to turn up positive for the virus. This is where the textbook lessons about the disease vary from my real-life experience.
I have seen animals reported to me for suspicions of toxicity, head trauma, automobile accidents, distemper, paralysis, lameness, encephalitis, ear infections, choking — all of whom have turned out to be rabies positive post mortem.
A simple Q&A does not need to turn so dark and we must not jump to the conclusion that rabies is anywhere. If you are familiar with how an animal behaves and you have even the slightest inkling that something seems wrong for an unexplained reason, talk to your local veterinarian about the possibility of it being rabies, especially if the animal does not have a clear vaccination history.
Q. I have received news that a dog in my locality has tested positive for rabies. What can I do?
A. Start by recounting any personal history with the animal. If you have interacted with the rabid animal within the past 72 hours and have Category II or III exposures, go ahead and take your post-exposure prophylaxis measures like vaccinations and immunoglobulins. If you are aware of any other individuals in your household or community who may have been exposed to the same animal, instruct them to take the post-exposure prophylaxis measures as well. If there are other animals in the household or vicinity, take them to a veterinarian for a booster dose of ARV, or the complete 5-injection post-bite course, especially if vaccination history is unknown.
Q. Eliminating rabies seems like a daunting task. How can it be achieved?
A. I completely understand and agree with you. It does seem like a daunting task. But here are a few simple things you can remember and do in your own small way:
- Rabies, while being 100% fatal, is also 100% preventable.
- Like most natural infectious diseases, a group of individuals can be protected if there is sufficient herd immunity in a group. Herd immunity occurs when a large portion of a community (the herd) becomes immune to a disease, making the spread of disease from individual to individual unlikely. For rabies, this portion or percentage is about 75%. To achieve herd immunity, here’s what you can do:
A. Vaccinate your pets and approachable street dogs as soon as they are of age and do not skip out on annual revaccinations
B. Get your community dogs sterilised to prevent the birth of any more puppies, adding to the street animal numbers.
C. Do not attempt to fraternise or feed unapproachable dogs or new dogs that have migrated into the area. Feeding an otherwise unapproachable or feral dog means you are proving this animal ample nutrients to be able to reproduce. Feral mothers give birth to feral and unapproachable puppies, which are difficult to catch for sterilisation or just for vaccination purposes. If a dog isn’t allowing you to touch or feed it a month after you’ve made your best efforts, do not feed that animal anymore. It will move on from the area and try to find a food source elsewhere, leaving the original community of animals protected.
- Even if you are not directly involved in feeding street animals, be mindful of the disposal of waste. Open garbage attracts feral dogs, whose population will proliferate before it can be checked. Contact your local governing body if there are sources of open garbage where you reside.
- Far too often, I have had to see pet dogs succumb to rabies. Pet owners take a decision to not vaccinate their own dogs with the justification that they intend to raise this dog within the confines of their house and there is no way it can contract rabies. But we are all humans at the end of the day; mistakes can be made by everyone. Dogs can run away if a door or window is left open or unchecked. A strange dog could enter your premises and get into a fight with your pet. If you have adopted a dog off the streets, you may not know the animal’s medical history or history of fights or bites before it came to reside in your home. It is just one injection in exchange for a happy lifetime your pet gets to spend with you. Vaccinate your pets against rabies.
- The more you learn, educate the community alongside you. A globally aware community will be what will bring us to our #Zeroby30 goal.