What Is Rabies And Why You Should Be Really, Really Careful

Many Malaysians probably just got to know of the existence of a disease called rabies, sadly, after two of three children in Serian, Sarawak, died upon being infected with it on 4 July.

Even if they knew about it, many were shocked that rabies could actually lead to death.

However, this ‘ignorance’ should not be surprising and almost forgivable because these are the country’s first rabies related deaths in almost 20 years.

According to Health Minister Datuk Seri Dr S. Subramaniam, the disease could have spread from Kalimantan to the Serian district that borders Indonesia, and that the country had previously seen rabies infections in Perlis, Kedah and Penang as a result of dogs crossing over from Thailand at the common border.

The good news is, no new cases of rabies have been reported after 1 July in the Serian district of Sarawak.

So, what is rabies and why is it life-threatening?

The World Health Organisation (WHO) has included rabies in its neglected tropical disease roadmap and said as a zoonotic disease, it requires close cross-sectoral coordination at the national, regional and global levels.

Rojak Daily spoke to the Director General of Health, Datuk Dr Noor Hisham Abdullah to learn more about the fatal disease.

Here are some of the things that you should know about rabies:

1.What is rabies?

Rabies is categorised as a zoonotic disease. A zoonotic disease simply means that it is a disease that is transmitted to humans from animals. The disease is caused by the rabies virus. The disease infects domestic and wild animals, and is spread to people through close contact with the infected animal.

2. Which group of people usually gets infected with the disease?

According to WHO, 40% of people bitten by an infected animal (rabid animal) are children, usually under the age of 15-years-old.

3. How does the disease spread?

Transmission occurs when an infectious material, usually saliva from the infected animal, comes into direct contact with human mucosa or fresh skin wounds via bites or scratches.

4. What are the symptoms of rabies?

The incubation period for rabies is from one to three months, but may vary from less than one week to more than a year. The initial symptoms of rabies are fever and often pain or an unusual or unexplained tingling, pricking or burning sensation (paraesthesia) on the wound site.

As the virus spreads through the central nervous system, progressive and fatal inflammation of the brain and spinal cord (encephalitis) develops which can lead to mortality. During this time, patients may experience insomnia, agitation, confusion, seizures and coma.

5. Is there any way to prevent this disease?

According to WHO, rabies is a vaccine-preventable disease. Vaccinating dogs is the most cost-effective strategy for preventing rabies in people. Dog vaccination reduces deaths attributable to rabies and the need for post-exposure prophylaxis (PEP) as a part of dog bite patient care.

Anyone in the affected area (rabies outbreak area), for example Serian, Sarawak, should also avoid contact with sick pet animals or any stray animals, including dogs or cats.

6. What are the treatments available in our country to treat rabies?

Those who are bitten by a suspected rabid dog or animal must first be subjected to a doctor’s assessment and proper treatment. Proper treatment consist of local treatment of the wound, administration of rabies immunoglobulin (if indicated) and immediate vaccination of anti-rabies vaccine based on the level of exposure (severity of wound and history of contact with rabid dog/animal).

Rabies is prevented by giving anti-rabies vaccine and immunoglobulin (when indicated) if a person is suspected of being bitten by a rabid dog/animal. If a person infected by rabies develops clinical symptoms and no treatment was given prior to it, there is no medication to prevent it from worsening and usually the infected person will succumb to death.

7. What should you do right now?

The Ministry of Health would like to advice the public who live in Serian District, Sarawak especially, to take these precautionary measures to prevent getting infected with rabies:

• Seek early treatment in the nearest health clinic or hospital if bitten by a dog (pet dog or stray dog) • Make sure to vaccinate your dog with anti-rabies vaccine in the nearest veterinary clinic and avoid contact with stray dogs • If your dog gets sick or behaves abnormally, get treatment from a veterinary clinic and report it to the nearest veterinary service department; • If there are any stray dogs living in your area, immediately report to the local authority. • Ensure good general hygiene by washing your hands with soap and water frequently, especially after aby contact with your pet or stray dogs.

Key Facts About Rabies from WHO: • 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, mostly in Asia and Africa. • Immediate, thorough wound cleansing with soap and water after contact with a suspect rabid animal is crucial and can save lives. • Every year, more than 15 million people worldwide receive a post-bite vaccination. This is estimated to prevent hundreds of thousands of rabies deaths annually. For inquiries about rabies, the public can call Sarawak Health Department’s hotline at 082-443 248 or 441 780.