RABIES PREVENTION AND CONTROL

Rabies is a human infection that occurs after a transdermal bite or scratch by an infected animal, like dogs and
cats. It can be transmitted when infectious material, usually saliva, comes into direct contact with a victim’s
fresh skin lesions. Rabies may also occur, though in very rare cases, through inhalation of virus-containing spray
or through organ transplants.

Rabies is considered to be a neglected disease, which is 100% fatal though 100% preventable. It is not among
the leading causes of mortality and morbidity in the country but it is regarded as a significant public health
problem because (1) it is one of the most acutely fatal infection and (2) it is responsible for the death of 200-
300 Filipinos annually.

https://www.doh.gov.ph/national-rabies-prevention-and-control-program

Prevention
The prevention of human rabies is dependent upon the effective and verifiable control of the disease
within the domestic dog population, being the most common reservoir of the virus and cause of 99% of
human cases.

Public awareness, health education, dog vaccination and the availability and accessibility of PEP are key for
rabies prevention and control.

The elimination of rabies however, requires several components in addition to mass vaccination, including
the effective engagement of communities and policymakers, dog population assessment and management,
and surveillance capacity and legislation.

https://www.who.int/rabies/about/home_prevention/en/

How can you prevent rabies in animals?

First, visit your veterinarian with your pet on a regular basis and keep rabies vaccinations up-to-date for all
cats, ferrets, and dogs.

Second, maintain control of your pets by keeping cats and ferrets indoors and keeping dogs under direct
supervision.

Third, spay or neuter your pets to help reduce the number of unwanted pets that may not be properly cared
for or vaccinated regularly.

Finally, call animal control to remove all stray animals from your neighborhood since these animals may be
unvaccinated or ill.
How can you prevent rabies in people?
Understanding your rabies risk and knowing what to do after contact with animals can save lives. Any mammal
can get rabies

1. Leave all wildlife alone.

2. Know the risk: contact with infected bats is the leading cause of rabies deaths in people in the U.S.,
followed by exposure to rabid dogs while traveling internationally.
3. Wash animal bites or scratches immediately with soap and water.
4. If you are bitten, scratched, or unsure, talk to a healthcare provider about whether you need post
exposure prophylaxis. Rabies in people is 100% preventable through prompt appropriate medical care.
5. Vaccinate your pets to protect them and your family.

https://www.cdc.gov/rabies/prevention/people.html

The importance of vaccinating your pet

Vaccinations protect pets from potentially deadly diseases.

The injections contain a weak or man-made version of a disease. This triggers your pet’s body to produce
antibodies to fight the disease. If they catch the same disease in the future, their body will recognise it and
fight it off much more effectively.

Vaccinating your pet can also prevent the spread of certain diseases, such as rabies, to your family.

Rabies in the Philippines

Rabies continue to be a public health problem in the Philippines. The country is one of the top 10 countries
with rabies problem. It is responsible for the deaths of 200 to 300 Filipinos per year. In 2010, 257 died of
rabies, and in 2011, 202 deaths were reported.
Dogs remain the principal cause of animal bites and rabies cases.

http://www.wpro.who.int/philippines/areas/communicable_diseases/rabies/continuation_rabies_area_pa
ge/en/
Key facts
 Rabies is a vaccine-preventable viral disease which occurs in more than 150 countries and territories.
 Dogs are the main source of human rabies deaths, contributing up to 99% of all rabies transmissions to
humans.
 Rabies elimination is feasible through vaccination of dogs and prevention of dog bites.
 Infection causes tens of thousands of deaths every year, mainly in Asia and Africa.
 40% of people bitten by suspect rabid animals are children under 15 years of age.
 Immediate, thorough wound washing with soap and water after contact with a suspect rabid animal is
crucial and can save lives.
 WHO, the World Organisation for Animal Health (OIE), the Food and Agriculture Organization of the
United Nations (FAO) and the Global Alliance for Rabies Control (GARC) have established a global
“United Against Rabies” collaboration to provide a common strategy to achieve "Zero human rabies
deaths by 2030".
Rabies is an infectious viral disease that is almost always fatal following the onset of clinical symptoms. In
up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans. Yet, rabies can
affect both domestic and wild animals. It is spread to people through bites or scratches, usually via saliva.

Preventive immunization in people

Human rabies vaccines exist for pre-exposure immunization. These are recommended for people in certain
high-risk occupations such as laboratory workers handling live rabies and rabies-related (lyssavirus) viruses;
and people (such as animal disease control staff and wildlife rangers) whose professional or personal activities
might bring them into direct contact with bats, carnivores, or other mammals that may be infected.

Pre-exposure immunization is also recommended for travellers to rabies-affected, remote areas who plan to
spend a lot of time outdoors involved in activities such as caving or mountain-climbing. Expatriates and long-
term travellers to areas with a high rabies exposure risk should be immunized if local access to rabies biologics
is limited. Finally, immunization should also be considered for children living in, or visiting, remote, high-risk
areas. As they play with animals, they may receive more severe bites, or may not report bites.

Transmission

People are usually infected following a deep bite or scratch from an animal with rabies, and transmission to
humans by rabid dogs accounts for 99% of cases. Africa and Asia have the highest rabies burden in humans
and account for 95% of rabies deaths, worldwide.

In the Americas, bats are now the major source of human rabies deaths as dog-mediated transmission has
mostly been broken in this region. Bat rabies is also an emerging public health threat in Australia and Western
Europe. Human deaths following exposure to foxes, raccoons, skunks, jackals, mongooses and other wild
carnivore host species are very rare, and bites from rodents are not known to transmit rabies.
Transmission can also occur when infectious material – usually saliva – comes into direct contact with human
mucosa or fresh skin wounds. Human-to-human transmission through bites is theoretically possible but has
never been confirmed.

Contraction of rabies through inhalation of virus-containing aerosols or through transplantation of infected

organs is rare. Contracting rabies through consumption of raw meat or animal-derived tissue has never been
confirmed in humans.

Extensive wound washing

This involves first-aid of the wound that includes immediate and thorough flushing and washing of the wound
for a minimum of 15 minutes with soap and water, detergent, povidone iodine or other substances that kill
the rabies virus.

https://www.who.int/news-room/fact-sheets/detail/rabies

Rabies in Dogs

Rabies is a virus that may affect the brain and spinal cord of all mammals, including dogs, cats and humans.
Though preventable, there is good reason that the word “rabies” evokes fear in people.

How Would My Dog Get Rabies?

Since animals who have rabies secrete large amounts of virus in their saliva, the disease is primarily passed
to dogs through a bite from an infected animal. It can also be transmitted through a scratch or when infected
saliva makes contact with mucous membranes or an open, fresh wound. The risk runs highest if your dog-or any
pet-is exposed to wild animals.

most common carriers of the rabies virus in this country are bats, raccoons, skunks and foxes.

What Are the General Symptoms of Rabies?

Initially, a dog who’s become infected may show extreme behavioral changes such as restlessness or
apprehension, both of which may be compounded by aggression. Friendly dogs may become irritable, while
normally excitable animals may become more docile. A dog may bite or snap at any form of stimulus, attacking
other animals, humans and even inanimate objects. They may constantly lick, bite and chew at the site where they
were bitten. A fever may also be present at this stage.
As the virus progresses, an infected dog may become hypersensitive to touch, light and sound. They may eat
unusual things and hide in dark places. Paralysis of the throat and jaw muscles may follow, resulting in the well-
known symptom of foaming at the mouth. Disorientation, incoordination and staggering may occur, caused by
paralysis of the hind legs. Other classic signs of rabies include loss of appetite, weakness, seizures and sudden
death.
How Long After Infection Do Signs of Rabies Show?
The virus usually incubates from two to eight weeks before signs are noticed. However, transmission of the virus
through saliva can happen as early as ten days before symptoms appear.

Which Dogs Are Most at Risk for Contracting Rabies?

Unvaccinated dogs who are allowed to roam outdoors without supervision are most at risk for infection. They’re
exposed to wild animals and have a greater chance of fighting with infected stray dogs or cats.

How Is Rabies Diagnosed?

There is no accurate test to diagnose rabies in live animals. The direct fluorescent antibody test is the most
accurate test for diagnosis--but because it requires brain tissue, it can only be performed after the death of the
animal.

How Is Rabies Treated?

There is no treatment or cure for rabies once symptoms appear. Since rabies presents a serious public health
threat, dogs who are suspected of having the virus are most often euthanized.

How Can Rabies Be Prevented?

Keeping your dog up to date with vaccinations is not only essential to prevention, it’s the law. Check with your
veterinarian about the right vaccine and vaccination schedule for your dog. In many areas of the country, it’s
mandatory that all domestic dogs and cats are vaccinated after the age of three months.
Vaccinating your pet not only protects him from getting rabies, it protects him if he bites someone. Dogs who have
bitten humans are required to be confined for at least 10 days to see if rabies develops, and if the animal’s
vaccination records are not current, a lengthy quarantine or even euthanasia may be mandated. If you’re not sure
of the laws in your town, consult your local animal affairs agency.
Avoiding contact with wild animals is also necessary to prevention. You may greatly decrease chances of rabies
transmission by walking your dog on a leash, and supervising him while he’s outdoors.

What Should I Do If I Think My Dog Has Had Contact With a Rabid Animal?
Call your veterinarian for an immediate appointment! Report the incident to your local health department and
follow their recommendations. You’ll also need to contact local animal control officers if the animal who bit your
pet is still at large; they will be best able to safely apprehend and remove the animal from the environment. After
having contact with a rabid animal, the rabies virus may remain alive on your pet’s skin for up to two hours. It is
best not to touch your dog during this time. If you must handle your dog, wear gloves and protective clothing.
A dog who is up to date with his vaccinations and who has been bitten by a possibly rabid animal should also be
given a rabies booster immediately and kept under observation for 45 days.

What Should I Do If I Think I've Been Bitten by a Rabid Animal?

Call your doctor immediately for instructions! You may need to get a series of injections in order to protect your
health. Also, contact your local health department to report the bite.
 Note: Do not attempt to handle or capture a wild animal, especially if he is acting strangely (i.e., a nocturnal animal
who is out during the day, an animal who acts unusually tame). Report the animal to local animal control officers as
soon as possible.

What Should I Do if I Come Across a Rabid Animal?

Please do not attempt to capture any wild animals. In fact, it is wise to safeguard your home against wild animals in
the following ways:

 Cover or stuff holes larger than a quarter and caulk cracks that are 3/8-inch wide or larger.
 Make sure your screens have no rips or holes.
 Install chimney caps.
 Use screens to cover attic vents and make sure all doors are securely shut.

Contact your local animal control or fish and wildlife department for suggestions on how to handle nuisance
wildlife. If you find a dead wild animal in your home, call your local animal control agency or use thick work gloves
to place the animal in a small box. Seal the box with strong tape and contact your local health department for
information about where to take the animal for rabies testing.
https://pets.webmd.com/dogs/rabies-dogs#1

Some animals may act mad when they have rabies. They will be hostile and may try to bite you or other
animals. In movies, animals with rabies look like they are foaming at the mouth. What´s really happening is
that the rabies makes them have more saliva and that makes them drool.

Other animals may act timid or shy when they have rabies. This is the most common kind. A wild animal might
move slowly or act tame. You might be able to easily get close to it. Since that´s not the way wild animals
usually act, you should remember that something could be wrong.

https://www.cdc.gov/rabiesandkids/amy.html

Fast facts on rabies

 Rabies is a viral disease that is nearly always transmitted by an infected animal bite.

 Anyone who receives a bite in a geographical area where rabies occurs should seek treatment at once.

 For treatment to be successful, it must be given before symptoms appear.

 Symptoms include neurological problems and a fear of light and water.

 Following the vaccination requirements for pets helps prevent and control rabies.
 What is rabies?
Vaccinate dogs and cats to protect them from rabies.

Rabies is a viral infection that mainly spreads through a bite from an infected animal. It is an RNA virus of the
rhabdovirus family.

Without early treatment, it is usually fatal.

The virus can affect the body in one of two ways:

 It enters the peripheral nervous system (PNS) directly and migrates to the brain.

 It replicates within muscle tissue, where it is safe from the host's immune system. From here, it enters the
nervous system through the neuromuscular junctions.
Once inside the nervous system, the virus produces acute inflammation of the brain. Coma and death soon
follow.

There are two types of rabies.

Furious, or encephalitic rabies: This occurs in 80 percent of human cases. The person is more likely to
experience hyperactivity and hydrophobia.

Paralytic or "dumb" rabies: Paralysis is a dominant symptom.

Symptoms
Rabies progresses in five distinct stages:

 incubation

 prodrome

 acute neurologic period

 coma

 death
 Incubation period

This is the time before symptoms appear. It usually lasts from 3 to 12 weeks, but it can take as little as 5 days
or more than 2 years.

The closer the bite is to the brain, the sooner the effects are likely to appear.

By the time symptoms appear, rabies is usually fatal. Anyone who may have been exposed to the virus should
seek medical help at once, without waiting for symptoms.

Prodrome

During the prodrome stage of rabies, a person may experience coughing and fever.

Early, flu-like symptoms, include:

 a fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or above

 headache

 anxiety

 feeling generally unwell

 sore throat and a cough

 nausea and vomiting

 discomfort may occur at the site of the bite

These can last from 2 to 10 days, and they worsen over time.

Acute neurologic period

Neurologic symptoms develop, including:

 confusion and aggression

 partial paralysis, involuntary muscle twitching, and rigid neck muscles

 convulsions

 hyperventilation and difficulty breathing

 hypersalivation or producing a lot of saliva, and possibly frothing at the mouth

 fear of water, or hydrophobia, due to difficulty swallowing

 hallucinations, nightmares, and insomnia

 priapism, or permanent erection, in males

 photophobia, or a fear of light

Toward the end of this phase, breathing becomes rapid and inconsistent.

Coma and death

If the person enters a coma, death will occur within a matter of hours, unless they are attached to a ventilator.

Rarely, a person may recover at this late stage.

Why does rabies cause a fear of water?

Rabies used to be known as hydrophobia because it appears to cause a fear of water.

Intense spasms in the throat are triggered when trying to swallow. Even the thought of swallowing water can
cause spasms. This is where the fear comes from.

The excess saliva that occurs is probably due to the impact of the virus on the nervous system.

If the individual could swallow saliva easily, this would reduce the risk of spreading the virus to a new host.