In some areas known as “mad dog disease” because the transmission of the disease is frequently associated with bites by infected dogs. Hydrophobia is the commonest name and relates to the major symptom.
This disease is endemic in most areas of the world but is very common in the tropics where control of animals is limited. A few island countries are free of the disease.
The disease is caused by an RNA virus of the rhabdovirus group which has a long incubation period.
The major source of infection is through the bite of an infected animal. Any warm blooded animal may be capable of transmitting the disease through their infected saliva. A few cases of airborne transmission have been reported. Congenital transmission is known to occur in some animals but human cases have not be shown. Again injestion of infected meat has been known to cause the disease in animals but not man. Human to human spread is possible in theory but has not been reported to date. All ages are at equal risk.
Supportive only, there is no cure for Rabies and it is generally fatal.
Since elimination of the rabies virus at the site of infection by chemical or physical means is the most effective mechanism of protection, immediate vigorous washing and flushing with soap or detergent and water, or water alone, is imperative. Following washing, apply either ethanol (70%) or tincture or aqueous solution of iodine or povidone iodine.
The Rabies vaccine is given on three occasions over a 3 to 4 week period. This is believed to provide excellent cover for about 3 years, however urgent post-exposure treatment remains essential whether or not patients have been previously vaccinated.
Patients who have been vaccinated prophylactically against rabies with a full course of cell-culture or duck-embryo vaccine can be given a shorter course of post-exposure treatment with fewer doses; they do not require Rabies Immune Globulin.