Is an animal dangerous? Is it rabid? Are you afraid of rabies? Let's talk about this!

We all love animals, don't we? But sometimes, something small can turn into a big problem when we don't think about it. That's what rabies is. Even hearing the name sounds a little scary, doesn't it? But if you are aware of it and take the necessary steps, it's not that difficult to stay completely safe from this dangerous condition. So, today, let's talk about what (Rabies) is, how it affects our bodies, and how we can protect ourselves from it.

What is Rabies? Simply put…

Rabies is a very dangerous and potentially fatal viral disease. It is caused by a virus called `(Rabies virus – RABV)`. This virus usually enters our bodies through direct contact with the saliva of an animal that has this disease, or with parts of the brain/nervous system. That is, perhaps through a scratch, bite, or through a skin wound, or through mucous membranes such as the eyes, nose, or mouth.

The important thing is that, although rabies is fatal, it is a completely preventable disease. It just requires early action.

This disease can be transmitted to humans and to pets (such as dogs and cats) in our homes, especially if an infected animal bites or scratches a wound.

What really happens when you get rabies?

Imagine that you are bitten by an animal that has rabies. The ``Rabies`` virus, which is in the animal's saliva, enters your body through the wound. Then, this virus travels very slowly, but steadily , along your nerves, to your central nervous system, that is, your brain and spinal cord .

The real problem begins when the virus reaches the brain. That's when the brain begins to be damaged, causing various neurological symptoms. Eventually, this condition can lead to a coma and death. That's why it's so dangerous.

How common is this condition?

If you look around the world, more than half a million, or about 59,000 people, die from rabies every year. But in countries like America, this is very rare, less than three people develop it every year. The reason for this is that many people get vaccinated immediately after being bitten by an animal. In our country too, awareness about this and prompt treatment are very important.

Who is most affected by rabies?

This disease is most common in rural areas of Asia and Africa. It is found on every continent except Antarctica. In the United States, it is most common in wild animals. However, in many other countries, such as Sri Lanka, it is most commonly transmitted by dogs. Young children are more likely to be infected with this disease than adults, because they play with animals and sometimes do not fully understand the danger.

How Rabies Affects Our Body

The journey of this virus from the wound to the brain takes place in several stages. Let's see what those stages are.

1. The period during which the virus remains in the body (Incubation Period)

This is the time it takes for the virus to enter the body and travel to the nervous system. This period can range from a few days to a few weeks, or even months. During this time, there are no symptoms. However, if treatment is given during this ``incubation'' period, that is, before symptoms appear, the development of rabies can be completely stopped.

2. Prodromal phase

Now the `(RABV)` virus travels along the nerve cells and enters the brain and spinal cord. As it does so, it damages the nerves. This `(Prodromal phase)` begins when the virus enters the nervous system. Then our body's immune system starts to fight it, which can cause symptoms of a cold such as fever and body aches . Also, you may feel numbness, pain, and itching at the site of the bite. This period can last from two to ten days. The sad thing is, once you reach this stage, there is almost no effective treatment.

3. Acute neurologic phase

At this stage, the `(Rabies)` virus begins to damage the brain and spinal cord. At this point, symptoms can appear in two main ways:

• Furious Rabies: This occurs in about two-thirds of people. It causes restless behavior, aggression, seizures , and loss of consciousness.
• Paralytic Rabies: This can happen to other people. The body becomes paralyzed and lifeless. It usually starts at the site of the bite and then spreads to other parts of the body.

Acute rabies can last from a few days to a week. Paralytic rabies can last up to a month.

4. Coma state

Many people fall into a coma in the final stages of the disease. Ultimately, death from rabies occurs.

What are the symptoms of Rabies?

The virus usually does not show any symptoms for several weeks after it enters the body. It is only when the virus reaches the central nervous system (that is, during the `prodromal phase`) that cold-like symptoms appear. In the final stages, symptoms related to the nervous system (brain) appear.

Prodromal symptoms

• Fever
• Fatigue​
• Animal bite wound inflammation, itching , numbness , pain
• Cough
• Sore throat
• Muscle pain
• NauseaAnd vomiting
• Diarrhea

Acute neurologic symptoms

These can be either ``Furious'' or ``Paralytic.'' Symptoms of severe rabies may come on suddenly, subside after a while, and then return.

Symptoms of Furious rabies

• Aggressive and restless behavior
• Restlessness
• Seizures
• Hallucinations, seeing /hearing things that are not there
• Muscle twitching (Fasciculations)
• Fever
• Rapid heartbeat (Tachycardia)
• Rapid breathing (Hyperventilation)
• Excessive salivation
• Difference in the size of the iris of the two eyes (Anisocoria)
• Facial palsy
• Fear of water/drinking water (Hydrophobia) – This is a key symptom
• Aerophobia is the fear of wind in the face.
• Delirium

Symptoms of Paralytic Rabies

• Fever
• Headache
• Neck stiffness
• Loss of body weight (especially starting at the site of the animal bite and spreading to other parts of the body)
• Numbness, a feeling like ants are crawling around
• Paralysis
• Coma state

Why do we get rabies?

The reason for this is a virus called `(RABV)`. This virus travels along the nerves in our body and damages the nerves. The special thing is that this virus hides from our immune system until it reaches the brain. It is only after reaching the brain that it causes damage and ultimately kills.

How is rabies transmitted?

Rabies is found in warm-blooded animals (mammals), especially in their saliva. It is usually transmitted through the bite of an infected animal.

It is most commonly found in animals like bats, skunks, raccoons, and foxes. However, it can also be found in pets like dogs and cats. Rabies can be contracted if even a small cut on your skin comes into contact with the saliva of an infected animal.

Very rarely, it has also been transmitted during organ transplantation (organ donation).

Which animals are most likely to transmit rabies?

It is mostly found in wild animals, especially bats. In developing countries, that is, countries like ours, many people get rabies from dogs in the house (especially stray dogs).

In countries like America, this is often caused by bat bites. The wound caused by a bat bite is very small, about the size of a pencil tip. So sometimes no one even knows that a bat has bitten them. Because of that,If you have had any kind of collision with a bat, or if you are in doubt about whether you were bitten or not, you should definitely see a doctor.

How do doctors diagnose rabies? (Diagnosis)

Unlike other illnesses, it's not a good idea to wait until you have symptoms to diagnose rabies. If you've been bitten or scratched by a wild animal or a pet that you think may have rabies, see a doctor right away. They'll examine your wound, ask questions, and decide if you need treatment for rabies.

The doctor may ask questions like these:

• How did you get injured?
• What kind of animal is alert or alert?
• Can you examine that animal or observe it for a few days?

If an animal is suspected of having rabies, the animal is observed for about 10 days, if possible, or tested (to test the animal, it must be killed).

Tests for diagnosis

After symptoms appear, the following tests may be done:

• Saliva test: A saliva sample is taken and sent to a lab to look for signs of rabies.
• Skin biopsy: A small piece of skin is taken from the back of the neck and sent to the lab.
• Cerebrospinal fluid test (Lumbar Puncture): This fluid is taken from the lower back with a needle and sent for testing.
• Blood tests: A blood sample is taken to check for antibodies.
• Magnetic resonance imaging (MRI) scan: Takes pictures of the brain to help find the cause of symptoms.

What are the treatments for rabies?

There is no approved treatment for rabies once symptoms appear. That's why we say, if you think you may have been exposed to the virus (by being bitten, scratched, or having contact with a sick animal), see a doctor as soon as possible.

Wash the wound thoroughly with soap and water for at least 15 minutes . If possible, use a 10% povidone-iodine solution. Ask your doctor for further advice on how to clean the wound.

The doctor will give you a series of vaccinations to prevent rabies caused by the rabies virus. If you have never had a rabies vaccine before, you will also be given an antibody treatment directly to the wound.

Medications for suspected contact

This is called post-exposure prophylaxis (PEP). These medications stop the virus from reaching the brain.

• Rabies vaccine:Four doses are given over a 14-day period. If you have previously received a pre-exposure vaccine, only two doses are given. This vaccine teaches your body to destroy the rabies virus before it can reach your brain.
• Human rabies immune globulin (HRIG): This is given around the wound. HRIG delivers antibodies directly to your body to kill the virus near the wound until your body's immune system starts working. HRIG is not given if you have been vaccinated before.

Side effects of treatment

Rabies vaccines can cause minor side effects:

• Pain, itching, swelling at the injection site
• Nausea
• Headache
• Muscle pain
• Dizziness

If you have severe side effects, tell your doctor.

What should I do if I am injured by an animal that has bitten or scratched me?

• Immediately wash the wound thoroughly with soap and running water (for at least 15 minutes). If possible, use a 10% `Povidone-iodine` solution.
• Contact a doctor or your local public health office as soon as possible. Explain what happened and give all the details you know about the animal (was it a wild animal? was it a pet? what kind of animal? how did it behave?).
• Ask the doctor how to best clean the wound and whether a rabies vaccine is needed.
• If an aggressive wild animal attacks, notify animal control.

Why is there no cure for rabies?

There is no cure for rabies once the virus has reached the brain, because it is protected by the blood-brain barrier .

The ``blood-brain barrier'' is a protective membrane between your brain and the blood vessels in your head. It's like a fine filter. It stops toxins and dangerous substances from entering your brain from your blood.

Although researchers are not yet sure, the rabies virus tightens this barrier even more, so drugs that could kill the virus cannot enter the brain.

How to protect yourself from Rabies? (Prevention)

Rabies is completely preventable.

• Make sure your pets (dogs, cats) are up-to-date on their rabies vaccinations.
• Don't let your pets out alone without someone to take care of them.
• Stay away from wild animals. Do not handle injured animals or attempt to handle wild animals.
• If there is a bat in a room where someone is sleeping, assume that the person was bitten by a bat. Bat bites are very small and fade quickly. So see a doctor.
• If you think you may have been bitten or scratched by a wild animal or otherwise exposed to rabies, see a doctor immediately.
• If you are at high risk of exposure to rabies (such as veterinarians, animal control officers), it is a good idea to get a series of vaccines before exposure (Pre-exposure prophylaxis – PREP).

Pre-exposure prophylaxis (PREP)

If you are at high risk of exposure to rabies, it is best to get vaccinated before you are exposed. This is called ``Pre-exposure prophylaxis (PREP)``. This is a series of two shots. How often you need a ``Booster`` shot depends on your risk.

People at higher risk:

• People who work with wild or domestic animals (veterinarians, wildlife officers, animal keepers).
• People who frequently go to places where bats live and caves.
• People who work in labs that work with the rabies virus.
• People traveling to areas where rabies is common among dogs.

What can you expect if you are exposed to rabies?

If you are exposed to rabies, you will need to get vaccinated about two weeks later. The vaccines may cause minor side effects, such as pain at the injection site and discomfort.

Can you survive rabies?

Yes, rabies can be prevented if you get treatment within a few days of exposure, before symptoms appear. However, once you have rabies, meaning you have symptoms, there is no effective treatment. Without prompt vaccination and antidote treatment, rabies is almost always fatal.

How long can you live with rabies?

People can remain asymptomatic for weeks, even months, after exposure. However, death occurs within a few days of the onset of symptoms.

When should you seek medical advice if you are injured by an animal bite or if you have been exposed to rabies?

It needs to be taken immediately. Exposure to rabies is an emergency.

In this case, see a doctor as soon as possible:

• If you are injured by a wild animal, such as a bite or scratch.
• If you are bitten or scratched by any animal that you think may have rabies.
• If there is a bat in a room where someone was sleeping.
• If you think you may have been exposed to rabies in any other way.

Be prepared to answer questions like how you were injured, what kind of animal it was, and whether you can observe the animal for a few days.

When should I go to the ER (Emergency Room)?

If the wound is deep, if the bleeding doesn't stop, or if the wound is on the face or neck, go to an emergency room immediately.

What questions should I ask the doctor?

• What is the best way to clean a wound?
• Do I need to get vaccinated because I was exposed to rabies?
• How is my vaccination schedule?
• What happens if I have to get a vaccine on another day?
• Am I at increased risk of exposure to rabies?
• Do I need to go on a pre-exposure prophylaxis (PREP) schedule?

Do all dogs have rabies?

Rabies is common in dogs in developing regions of Asia and Africa. However, in developed countries such as the United States, Canada, and Western Europe, rabies is not commonly seen in domestic dogs. In our country, it is very important to be careful of stray dogs and dogs that have not been properly vaccinated.

Finally, things to remember (Take-Home Message)

Rabies is a very serious, almost always fatal disease. But, fortunately, it is completely preventable if treated promptly. If you think you have been bitten by an animal and have been exposed to rabies , do not hesitate to see a doctor immediately. It will help save your life. Don't forget to vaccinate your pets on time.