Category : Health and you
Introduction
Rabies is one of the deadliest diseases known to humankind — 100% fatal once symptoms appear, yet 100% preventable with timely action. It is caused by the rabies virus, transmitted primarily through the bite or exposure to a rabid animal. More than 20000 people die with rabies in India every year.
How Rabies Spreads
In India, most rabies cases occur following bites from infected dogs. However, other animals such as cats, monkeys, mongoose, shrews, cattle (cows, buffaloes), sheep, goats, and wild animals like foxes and jackals can also transmit the virus. Importantly, rats, birds, and bats do not transmit rabies in India.
While bites are the most common route of transmission, rabies can also spread through:
- Scratches or licks from infected animals on broken skin or mucous membranes
- Handling secretions or meat from a rabid animal
- Drinking unboiled milk from infected animals
- Receiving organ transplants from rabies-infected donors
Immediate First Aid After Animal Bite/Exposure
If you are bitten or scratched by an animal, time is critical. Take the following steps immediately:
- Wash the wound thoroughly with soap (preferably detergent) and running water for at least 15 minutes.
- If soap is unavailable, wash the wound under running water alone.
- Gently apply an antiseptic solution such as Dettol or Savlon.
- Visit a doctor immediately for further management.
What NOT to Do:
- Do not apply irritants such as lime, chilli, turmeric, tobacco, coffee powder, or plant sap.
- Avoid bandaging the wound if possible — keep it open.
- Primary suturing (stitches) should generally be avoided.
- Do not rely on magico-religious practices.
Post-Exposure Prophylaxis (PEP): What You Need to Know
The treatment you receive after exposure depends on the category of the wound:
| Category | Type of Exposure | Recommended Action |
| I | Touching or feeding animals Licks on intact skin Contact of secretions on intact skin. | Wash thoroughly with soap and water for 15 mins.
No vaccination needed. |
| II | Nibbling of uncovered skin Minor scratches without bleeding. | Wash and disinfect as above.
Anti-rabies vaccination required. |
| III | Bites/scratches with bleeding Licks on broken skin Saliva on mucous membranes. | Wash and disinfect as above Rabies Immunoglobulin at wound site.
Anti-rabies vaccination required. |
Anti-Rabies Vaccination Schedule
Vaccines are given either intradermally (under the skin) or intramuscularly (into the muscle):
Intradermal Route: Day 0, Day 3, Day 7, Day 28 (4 doses)
Intramuscular Route: Day 0, Day 3, Day 7, Day 14, Day 28 (5 doses)
Important:
Adults: Vaccine should be administered in the deltoid (shoulder) muscle.
Children: Muscle on the side of thigh (anterolateral aspect of thigh)
Never inject in the gluteal (buttock) region.
Rabies Immunoglobulin (RIG)
Rabies Immunoglobulin injection is administered only once and only for Category III exposures (bites with bleeding). It is injected directly into and around the wound. Please remember that, this injection is given to provide immediate protection against rabies but can not replace full dose of antirabies vaccination.
Myths vs. Facts
- Only dog bites can cause rabies – Other animals can too.
- Puppy bites are harmless – Even puppies can carry the virus.
- 14 injections in the stomach are needed – We must take either four (in case of intra-dermal) or five (in case of intra-muscular) doses. Giving 14 doses of vaccine is no longer practiced in India
- One dose of anti-rabies vaccination is enough –We must take complete course of antirabies vaccination to get full protection.
- Rabies can be cured – Once symptoms appear, it is almost always fatal.
Recognizing Rabies Symptoms
In humans:
- Hydrophobia (fear of water)
- Aerophobia (fear of air)
- Photophobia (fear of light)
- Muscle paralysis
- Breathlessness
- Tingling or pain at the bite site
In animals:
- Unprovoked aggression and biting
- Excessive salivation
- Red eyes
- Restlessness and continuous roaming
Key Takeaways
- Rabies is 100% fatal but also 100% preventable.
- Wash any bite or scratch immediately with soap and running water for at least 15 minutes.
- Consult doctors immediately following animal bites
- Complete the full vaccination course — 4 doses (intradermal) or 5 doses (intramuscular).
- Rabies Immunoglobulin is essential for severe bites with bleeding.
- Report any suspected rabid animal to local authorities — do not attempt to chase or kill it.
- Vaccinate your pets regularly with rabies vaccine. Follow responsible pet ownership.
By,
Dr Praveen Kulkarni
Professor of Community Medicine & Vice Principal (Paraclinical)
JSS Medical College, JSS Academy of Higher Education & Research, Mysuru.