Lost love? To get vaccinated

During my long career as a doctor, I have witnessed many cases of rabies. It's a disease that I dread. This certainly leads to death; in the world, fewer than 10 people survived without vaccination. Sometimes a patient with rabies remains conscious and aware of his condition almost until the end.

Mumbai is kind to stray dogs and cats, though they are testing pedestrian patience by creating a mess on the sidewalks. Strays that are not properly vaccinated are a risk factor for rabies. An article in the British Medical Journal urges travelers to be vaccinated against rabies before embarking on the trip and to avoid any contact with animals in Africa, Asia and Latin America. He also recommends immediate medical attention after being bitten or scratched. The warning was issued after a British woman was bitten by a dog in Goa.

About 90% of rabies deaths occur in developing countries where municipal authorities can not vaccinate street animals, treat patients, and control their numbers. In a newspaper editorial, Professor Derrick Pounder said, "Ignoring dogs and cats in the wild can go against the instincts of animal-loving travelers in developing countries, but it is necessary precaution. Wildlife should be appreciated from a distance.

Rabies is caused by a virus that has an affinity for the brain. It kills more than 59,000 people worldwide each year, with most cases occurring in Asia and Africa. In about 99% of cases, rabies is transmitted by the bite of an infected dog. Cats, ferrets, monkeys, bats, foxes and raccoons, among other animals, can also infect humans. In the United States, most cases of rabies occur in wild animals. According to the American Veterinary Association cats have become the most commonly infected domestic animal through rabies. This is because many cat owners do not vaccinate felines.

Human-to-human transmission is theoretically possible but uncommon. Transmission of sylvatic rabies occurs by skunks, foxes, raccoons, mongooses, and wolves. In America, bats are also a mode of transmission. Bats with silver hair and tricolor have teeth so small that sometimes people do not feel the bite or do not consider it a fuss.

Compulsory vaccination of dogs and scientific control measures of the population have resulted in the virtual elimination of the problem in developed countries, including North America. Countries in South America have also reported great progress in eliminating rabies. But the problem persists in Africa and in most Asian countries. We should look at effective prevention models to improve the situation in India.

The incubation period of rabies is one to two months after exposure, but it can range from seven days to one year, depending on the viral load and the distance that the virus has to travel to get from the site of the bite to the brain. Therefore, a bite in the face is the most dangerous, while one of the legs the least. (In both cases, immediate vaccination is recommended.)

The clinical manifestations are varied and begin after four days with headaches, malaise, fear, nausea and vomiting, resembling the symptoms of any other viral disease. Then come brain inflammation, called encephalitis, badociated with a period of confusion, hallucination of seizures and paralysis. In the absence of a clear history of the bite, the diagnosis of rabies is delayed. People with aggressive rabies show signs of hydrophobia (fear of water) and aerophobia. Although hydrophobia is a very characteristic symptom and I have regularly observed, the medical literature tells us that it can only be present in two thirds of cases. Coma and death occur after a few days. Rabies survival without inoculation is extremely rare.

US Centers for Disease Control and Prevention recommend vaccination of persons at constant risk – veterinarians, animal handlers, rabies research laboratory staff and workers in the production of rabies biologics . Animal lovers who regularly feed stray animals in the streets of Mumbai should be vaccinated. If you are bitten, you should wash the affected area thoroughly with soap and receive four doses of rabies vaccine. The first dose immediately and the rest on the third day, the seventh and the fourteenth. If you have already been vaccinated and are stung later, you should receive one dose immediately and the next on the third day. If you do not feel well, you should not get vaccinated unless you are stung. If your immune system is weakened due to a serious illness, you should see a doctor.

The risk that the vaccine causes serious damage or death is very small, although a minor allergic reaction is possible. You will need an immediate hospitalization in case of severe allergic reaction.

I would advise walkers and animal lovers to be careful when handling stray animals. It's not just a bite, a scratch can also be the cause of rabies. The best way to stay safe is to get vaccinated. Do not forget that once a person contracts rabies, there is no treatment.