Their is a funny & scary story I wanna share about my scooty riding after sunset. On my way back home after the gym there is a constant group of scary though cute street furr buddies guiding the colony, they seems quite over protective over there territory; they barked at me try to catch me.

It was live or dead situation but I went out alive. I felt so heroic 😁

Joke’s apart !!

A thought kept running into my mind as a physician I know what to do, basically everybody know about Rabies vaccine & when to get a shot; but the confusion arises when you took all complete Rabies vaccine & unfortunately on the next day or in-between it again bites you.

Horrifying na but I make it simple to understand.

What is Rabies: (Rabdoviridae family, genus: lyssavirus serotype 1)

In simple ( layman) term Rabies is a deadly virus, invariably fatal caused by the bite of infected animal (all warm blooded animals) typically wolves, jackals, foxes >> bats, cats > Dogs & human.

( In India bat is not associated with transmission of Rabies ).

Every year 60000 death occur due to Rabies virus & 1/3 occur in India.

Mode of infection ( How the disease causing virus enters the Body & spread )

How it causes Disease:

As the virus reach to the human contact via any mode, it spread along the neurons ( the nerve cells ).

Viral replication occur in muscles , binds at the neuromuscular junction then travel ascend to brain & there it spread along nerves to salivary glands, skin, cornea & other organ. ( In simple terms it the virus multiples in the muscles then travel to the brain via various nerve cells of our Body ).

15% of infected individual develops Rabies. Incubation or latent perion could be between 1-2 months. ( incubation period is the period between you exposed to a disease causing virus or bacteria & when you start showing symptoms. During this time the organism multiples but you don’t feel sick in-between ).

JOT DOWN: The risk increases if the bite is on the face or there are multiple bites.

How it present:

There are two presentations, one is the furious (anxious) & the other one is the paralytic(unable to move).

• 80% cases are of furious disease. The infected person may be agitated(restless), hydrophobic(afraid of water), aerophobic(fear of air), bizarre or with bitting behavior.
• 20% cases are of paralytic(unable to move) disease, the ascending flaccid paralysis (it travels up the limbs from fingers and toes towards the upper body).

Fatality( Death ):

Unfortunately it is 100% fatal disease, no available treatment in the world.

There are some Rabies free countries: European countries, Australia, Japan, Antarctica .

Prophylaxis ( Measures taken to Prevent the Disease ):

Yes there is a prophylaxis treatment available for both pre exposure ( action to be taken before beingexposed ) & post exposure ( action taken after being exposed ).

According to Ministry of Health & Family Welfare, Government of India (2019) exposure is divided into 3 categories & accordingly treatment & other measures are available.

Note: In India along with suspected or confirmed rabid animal if a vaccinated house hold dog or cat bites then also it is prescribed & suggested to get rabies vaccines.

( Because of the non liability efficacy of the drugs that are given to the pets; exclusion of the high price pets ).

Immunisation

Pre exposure prophylaxis (PrEP): ( Before any bite or exposure)

PrEP can be given & considered in the following conditions:

• -High risk groups: Veterinarians, animal handlers, travel to endemic regions, Wildlife wardens, Laboratory staff.
• -Any remote area or endemic area where access to post exposure prophylaxis is difficult.
• -where incidence of dog bite is >5% per year.
• -areas where vampire bat Rabies is known to be present.

It is consist of 3 intramuscular (im) or intradermal (id) doses. These are given on 0, 7 & either on 21 or 28 day.

Post exposure prophylaxis : ( after bite or exposure)

Category	Non immunised	Previously immunised (Including PrEP)
Category 1	Wound washing	Wound washing
Category 2	Wound washing + Post exposure prophylaxis (PEP)	Wound treatment + (PEP) booster on day 0 & 3 im/id
Category 3	Wound washing + PEP+ RIG (Rabies immunoglobulin )	Wound treatment + (PEP) booster on day 0 & 3 im/id

Jot down:

Here comes the main part: for exposed or re exposed patients (who are previously immunised) preservation of documentation is very necessary then only following guidelines would be applicable:

• -one site ID or IM vaccination administration on 0 & 3 day ( only 2 injection )
• -wound management.
• -There is no need for administration of RIG ( rabies immunoglobulin ).

Only adequate wound washing in continue running tape water for upto 15-20 mins is required in case of re-exposure occur within the 3 months but you must have to present the documented as a proof of the completed PEP ( post exposure prophylaxis ) & PrEP ( pre exposure prophylaxis ).

And if encounter happens after 3 months the above mention guidelines would be applicable.

What to do:

• -if you get a scratch or a bite do as the above mention guidelines.
• -When our older says na ki hath do lo kutta chuye ho (wash your hands you touched the dog) Don’t get offended they are saying it for a reason. It is good to love a stray dog or cat but have precautions wash your hands after petting them or giving them food.
• -If you really love the strays (not just for your instagram post) take them to the vet, the government veterinary hospital, the vaccinations are almost free, they charge you only for the receipt.
• -if you are more into animal exposure its better to take pre- exposure prophylaxis. The high risk group that includes :Laboratory staff, Wildlife wardens, Veterinarians, Animal handlers ,Travelers to endemic regions, Areas where vampire bat Rabies is known to be present & where Incidence of bite is >5% per year.

Hope you succeed in spreading the love, joy & gaining trust of your all furr Buddies who can’t speak but always ready to shower their unconditional love.

Know more-Rabies (who.int)