RABIES

Rabies is an acute, invariably fatal, encephalitis caused by the rabies virus.

Transmission

• Via the saliva of an infected mammal - introduced by a bite, scratch, or lick of broken skin/mucous membrane.
• It cannot be transmitted through intact skin.
• Aerosol spread is rare but may occur in bat caves.
• Organ transplantation from an undiagnosed donor may result in rabies in the recipient.

Epidemiology + Risk Area

• Rabies occurs on all continents except Antartica. Individual countries within continents may be reported to be disease free.
• All mammals are susceptible, wild and domestic; carnivores and bats act as reservoirs of disease.
• In endemic areas dogs account for the majority (95%+) of human fatalities.
• Around 20 million people receive post exposure treatment following potential rabies exposures annually – and 59 000 people die; this is likely to be an underestimate.
• Around 95% of human deaths occur in the Indian subcontinent, Asia and Africa.
• Bats may carry a Lyssavirus that is closely related to rabies virus and causes a similar disease. It is endemic in bat populations in countries otherwise considered free from rabies, including the United Kingdom.

Vaccine Schedule

Ultra Rapid Schedule

• Full protection not given until final dose at 1 year. Will give adequate protection if leaving sooner.

Signs and Symptoms

• Incubation - 20 - 60 days (range 5 days up to 1 year).
• Invariably fatal once symptoms develop.

Risk of severe illness

• Incubation periods often shorter when bites sustained in nerve rich areas, for example on the head , neck, face and fingers

Signs and Symptoms

Clinical Illness begins with prodrome of fever, headache, malaise, anorexia and pain/paraesthesia at bite site. Clinical Rabies can present in two forms:

• Furious rabies:
  • most common form
  • characterised by fluctuating consciousness, hydrophobic spasms, signs of autonomic dysfunction
  • death occurs after a few days due to cardiorespiratory arrest.

• Paralytic rabies:
  • muscle paralysis gradually develops from bite site
  • slow development of coma that results in death.

RISK AREA MAP FOR RABIES

BOOK NOW