What is rabies, treatment, transmission, prevention and vaccine

What is anger?

Rabies is an acute viral infection that is transmitted to humans from the bite, lick or wound caused by infected animals. The virus that causes the disease affects the host’s central nervous system, causing an encephalitis (inflammation in the brain that causes swelling in the brain) that usually evolves rapidly.

Because it is transmitted from animals to humans it is considered a zoonosis, in rare cases the virus can be transmitted between men, through organ transplantation where the donor was / is infected.

The disease is considered fatal because its lethality rate is approximately 100%. Infection with domestic animals is controlled in several parts of the world, but wild animals can also transmit the virus. It can reach any country, except areas where the disease is considered to be eradicated, such as in Antarctica, Japan, the United Kingdom and other islands.

Until 2006, only 6 cases of cure in humans were registered, among them, 5 had received vaccination treatment before and after exposure to the virus and only 1 did not receive the same treatment.

Recently, in Brazil, new cases of human rabies have been registered. In the state of Pará, up to the beginning of June, 14 cases of suspected rabies were reported, of which seven were confirmed in laboratories. A 10-year-old child died with suspicion of the disease on the first of this month. Among the confirmed cases, six patients died and one is hospitalized in a serious condition.

In 2017, rabies also sparked other cases in the northern region of the country. After being bitten by a blood-sucking bat, two children died from rabies and another, a survivor, remained with sequelae.

In view of these new cases, the State Department of Public Health (Sespa) made an alert for the disease and asked that the early identification of possible patients be intensified.

Read on to find out how to recognize symptoms and prevent this disease.

Human rabies cases in Brazil

Although the cases recently registered in the state of Pará are worrying, it is possible to say that the number of patients with human rabies in Brazil, in recent years, is relatively low.

Due to the fact that it has greater actions for the surveillance and control of rabies in animals in the last 30 years, Brazil has reduced mortality rates due to the disease.

Within the period from 2010 to 2017, 25 cases of human rabies were registered, with no cases reported in 2014. According to the Ministry of Health, the registered cases fall into sporadic and accidental cases.

Among the 25, 9 were caused by contact with infected dogs, 8 by bats, 4 by non-human primates, 3 by felines and 1 of them was not identified.

Causes of rabies

Caused by the virus of the genus Lyssavirus , of the family Rhabdoviridae , it is transmitted by the infected saliva of animals. This virus is attracted by the cells of the peripheral nervous system after being absorbed by the skin, from then on the parasite starts to move slowly in the nerves, about 12 millimeters per day, towards the central nervous system.

It can be transmitted by domestic animals, although these cases are already considered controlled, wild, and in rare cases, among humans, through organ donation with an infected donor.

Transmission of anger

The virus is transmitted by bites, licks or injuries caused by infected mammals. Contact with the animal’s skin does not pose risks. In most cases, contamination occurs by dogs or bats.

It can be transmitted between human beings, through organ donation with an infected donor, but these are isolated and poorly documented cases. The most common is transmission by domestic and wild animals.

Domestic and farm animals

  • Gatos;
  • Puppies;
  • Cows;
  • Ferrets;
  • Goats;
  • Horses.

Domestic animals have a transmission period of 2 to 3 days before the onset of clinical symptoms. And their death can happen between 5 and 7 days after the symptomatic manifestation.

Wild animals

  • Bats;
  • Beavers;
  • Coyotes;
  • Foxes;
  • Monkeys;
  • Guaxinins;
  • Opossums;
  • Marmotas.

Groups of risk

The disease is more common in individuals who have great contact with animals, such as professionals in the field. Other risk factors for rabies are:

  • Live in areas populated by bats;
  • Traveling to developing countries;
  • Living in rural areas with great exposure to wild animals and little or no access to vaccines;
  • Camping and exposing themselves to wild animals often.

Symptoms of anger

The incubation time of the rabies virus is varied, it can be from 10 days to up to 7 years, however, usually its average time is 12 weeks. Some of the symptoms may be similar in humans and animals.

Symptoms of rabies in humans

The initial symptoms of rabies can be compared to that of the flu , such as fever , muscle weakness, malaise and headache.

Other symptoms that the disease can cause are:

  • Seizure;
  • Excitability;
  • Muscle spasms;
  • Numbness and tingling;
  • Sensitivity and pain at the bite site;
  • Loss of sensation in some areas of the body;
  • Loss of muscle function.

As the disease progresses, it is also common for the individual to develop furious anger, a phase of anger in which the patient may become hyperactive and exhibit abnormal behavior. At this stage the common symptoms are:

  • Insonia;
  • Anxiety;
  • Confusion;
  • Agitation;
  • Hallucinations;
  • Excessive salivation;
  • Problems to swallow;
  • Hydrophobia, uncontrollable and inexplicable fear of water.

The last phase of rabies, called paralytic rabies, usually leads the patient to a coma and death. At this stage, the individual is slowly paralyzed and eventually falls into a coma, which leads directly to death.

Symptoms of rabies in animals

When the virus strikes a carnivorous animal, it most commonly has furious rabies, becoming aggressive. When it reaches herbivorous animals, the most common is to present paralytic rabies, leaving it paralyzed.

However, regardless of the manifested form of the disease, all animals suffer the same symptoms:

  • Difficulty swallowing;
  • Excessive salivation;
  • Behavior change;
  • Change in eating habits;
  • Paralysis of the hind legs.

In dogs the bark is like a hoarse howl, and bats, with changing habits, can be seen during the day, in unusual places.

How is rabies diagnosed?

If you have been bitten by an animal, you should always seek medical attention. Based on the injuries and how the bite occurred, the patient together with the doctor will decide whether treatment to prevent rabies is appropriate.

An isolated test is not enough to confirm the disease in humans, several tests are needed that are done with samples of saliva, spinal fluid, plasma and skin. A common test, done initially, is immunofluorescence, where the doctor or nurse will examine the patient and observe the bite.

Another test that can be used for diagnosis is done using a piece of skin from the neck, this same test can also be used to diagnose the disease in animals. Other tests, such as looking for the virus in saliva or spinal fluid, are not as sensitive and may need to be repeated.

Lumbar punctures can also be administered to look for signs of infection in the spinal fluid.

There are no tests to detect rabies in its early stages.

Is rabies curable? What is the treatment?

Usually this disease leads the patient to death, few cases of cure have been recorded to date. However, there are exceptions, some cases of cure involve patients who have received the rabies vaccine and others are patients who have undergone a treatment called the Milwaukee Protocol. This treatment consists of leading the patient into an induced coma to treat the disease, body would concentrate all the energy to eliminate the virus. Until 2008, this protocol had been applied to 16 individuals, but it was only successful in 2.

After being bitten and seeking the help of a professional, if there is a risk of rabies, the patient will receive a series of preventive vaccines, so that the infection does not spread, administered in 5 doses over 14 days. You may also receive a vaccine called human rabies immunoglobulin, which must be administered on the day of the bite.

Bites on the head or neck are considered more serious because they are closer to the brain, hands and feet are also dangerous regions because they are areas with a lot of innervation, facilitating the arrival of the virus to the peripheral nerves.

According to the Ministry of Health, the prophylaxis of this disease can be summarized in this table:

Conditions of the aggressor animal Dog or cat without suspected rabies at the time of aggression Dog or cat clinically suspected of rabies at the time of aggression

Angry dog ​​or cat;

Wild animals; 

Domestic animals

Types of exposure
Direct contact Wash with soap and water, do not treat Wash with soap and water, do not treat Wash with soap and water, do not treat
Mild accidents : superficial wounds, not very extensive, usually single, on the trunk and limbs (except hands and digital pulps and soles); they can happen due to bites caused by nail or tooth, skin licking with superficial lesions. Wash with soap and water, observe the animal for 10 days after exposure, if the animal remains healthy during the observation period, close the case. If the animal dies, disappears or becomes rabid, administer five doses of vaccine (days 0,3,7,14 and 28). Wash with soap and water, start the regimen with two doses, one on day 0 and another on day 3, observe the animal for 10 days after exposure. If the suspicion of rabies is discarded after the 10th day of observation, suspend the scheme and close the case. If the animal dies, disappears or becomes rabid, supplement the regimen with up to five doses. Apply a dose between the 7th and 10th day and a dose on the 14th and 28th. Wash with soap and water. Start the regimen immediately with five doses of vaccine administered on days 0, 3, 7, 14 and 28.
Serious accidents : injuries to the head, neck, hand, digital pulp and / or sole of the foot, deep, multiple or extensive injuries, in any region of the body, licking of mucous membranes, skin where there are already serious injuries, deep injury caused by a nail of animal. Wash with soap and water, observe for 10 days after exposure, start a two-dose schedule, one on day 0 and another on day 3. If the animal remains healthy during the observation period, close the case. If the animal dies, disappears or becomes rabid, continue the regimen, administering the serum and completing the regimen up to five doses. Apply a dose between the 7th and 10th day and a dose on the 14th and 28th. Wash with soap and water, start the regimen with serum and five doses of vaccine on days 0, 3, 7, 14 and 28. Observe the animal for 10 days after exposure, if the suspicion of rabies is discarded after the 10th day of exposure. observation, suspend the scheme and close the case. Wash with soap and water. Start the regimen immediately with serum and five doses administered on days 0, 3, 7, 14 and 28.

After the appearance of the symptoms of rabies, there are no known effective treatments for the disease, there are only forms of prevention as mentioned above.

What should I do when I am assaulted by an animal?

Whenever you are bitten or hurt by an animal, even if you are vaccinated against rabies, you should:

  • Immediately wash the wound with soap and water;
  • Seek medical attention;
  • If it is a domestic animal, leave it under observation for 10 days, to identify any signs of rabies;
  • If the animal becomes ill, dies, disappears or changes its behavior, immediately return to the doctor;
  • Never interrupt preventive treatment without medical advice.

Living with anger

Always follow the doctor’s advice to the letter and clean the wound constantly.

For individuals who have lost a loved one to the disease, support groups can be sought for people who are going through mourning or counseling with psychologists.

Complications of rabies

In some cases, the patient may develop allergic reactions to the vaccine for prevention. Failure to treat the disease can lead to death.

Rabies vaccine and how to prevent it?

There are some ways to prevent rabies, such as rabies vaccines. Other ways to prevent the disease are:

  • Vaccinate your pets;
  • Contact animal control when you find an animal without an owner on the street;
  • Avoid contact with wild animals;
  • Prevent bats from entering living spaces or other structures close to your home.

Vaccination for rabies prevention is only indicated for individuals at high risk of contamination, such as:

  • Veterinary doctors;
  • Biologists;
  • Agrotechnics;
  • Individuals working in virology laboratories;
  • Individuals working with wild animals;
  • Individuals involved in the capture and study of animals suspected of being rabies;
  • Individuals who are going to travel to areas where there is still no rabies control in animals.

Rabies, despite having a low incidence, is an extremely dangerous disease and when the patient develops its symptoms, it usually leads to coma and death. However, there are ways to prevent the disease. Share this text with your friends and family so that they also know the ways to prevent rabies!