Rabies is a preventable viral disease of mammals transmitted through the bite of a rabid animal (spread through saliva of infected animals). It is highly fatal viral disease of the CNS caused by Lyssa virus type 1. In  majority of rabies cases, domestic dogs are responsible for rabies transmission to humans. Yet rabies can affect both domestic and wild animals.

Rabies is present on all continents except Antarctica. Rabies predominantly affects poor and vulnerable populations who lives in remote rural areas. Approx 95% of deaths from rabies occurs in southeast Asian and African countries. Children between the ages of 5-14 are frequent victims. Countries like Australia, Newzealand, and England are marked as free of rabies.


  1. Immediately wash the bite or scratch area (the wound) and surrounding areas with plenty of water and soap for 5 minutes under a running tape.
  2. Apply virucidal agents like alcohol, tincture and aqueous iodine solution to inactivate the virus remained in the wound.
  3. Suturing should be done after 24-28 hours, with minimum possible stitches. Immediate suturing is contraindicated.
  4. Anti-rabies serum should be applied locally around the wound.
  5. Manage some antibiotics and antitetanus.
  6. Manage anti-rabies vaccines.


In humans, symptoms usually develop after 3-8 weeks, but it may appeared as early as 9-10 days. Once a person begins showing signs and symptoms of rabies, the disease is almost nearly fatal. At first, there is a tingling, pricking and itching sensation around the bite. Further symptoms are classified into four stages. These are;

1.            PRODROMAL STAGE:

This first stage is 1-3 days period characterized by behavioral changes plus flu-like symptoms such as fever, headache, malaise, sore throat, loss of appetite, nausea and tiredness.

2.            EXCITATION STAGE:

Intolerance to bright light and noise, fear of light, muscle spasm. Sympathetic involvements like pupil dilatation, increased salivation and lacrimation, increased perspiration. Mental changes like anger, depression and irritability.

3.            FEAR OF WATER:

Hydrophobia (fear of water) is the pathognomonic of rabies. The patient failed to swallow liquids. Later, even sight or sound of water can provoke spasm of the muscles of deglutition.

4.            PARALYSIS & COMA:

The patient may die or pass to stage of paralysis and coma.


Some of them are pet animals like dogs, cats, cows, horses, goats etc. while others are wild animals like bats, beavers, coyotes, foxes, monkeys, skunks, raccoons etc.


  • Isolate the patient in a quiet place.
  • Protect the patient from bright light, noise and cold.
  • Use pain killer and sedatives, if needed.
  • Ensure the hydration condition of the patient.
  • Management of anti-rabies vaccines. These are
  1. Nervous tissue vaccine (NTV)
  2. Duck embryo vaccine (DEV)
  3. Cell culture vaccine


The following are some preventive measures to reduce the risk of rabies.

  • Proper vaccination of pets.
  • Avoid contact of pets with wild animals.
  • Animals with rabies may seem unafraid of people, so stay away from wild animals that seems unafraid.
  • Keep bats out of the residential areas.
  • Government should provide anti-rabies vaccines to each and every health centre in the state.

    Tetanus. Rabies. Bacterial infection. Cat scratch fever. Teeth can act like a needle, injecting bacteria into the wound.

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He is owner of this website. He is MBBS student in Bannu Medical College, Khyber Medical University Pakistan.

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