Rabies
Rabies
Rabies (also known as hydrophobia) is a contagious disease caused by the rabies virus that affects the central nervous system.
Source of infection
Infected animals, such as dogs and cats;
Wild animals, such as bats, raccoons, skunks, wolves, foxes, ferret badgers and crab-eating mongooses.
Ways of transmission
- Rabies is mainly transmitted through bites or scratches from infected animals; it can also be transmitted via the saliva of infected dogs that enters the body through a wound or damaged skin; in rare cases, it can be transmitted during the slaughter, skinning or cutting of infected dogs.
- Inhaling aerosols (tiny droplets) containing the virus in bat caves.
- In rare cases, it can be transmitted through transplantation of infected organs or human-to-human contact.
Incubation and infectious period
Incubation period: Usually 1 to 4 months, but can be as short as less than 2 weeks or as long as more than 1 year. The risk of infection may be related to the age of the patient, the severity of the wound, the amount and virulence of the virus invading the human body, whether the wound is promptly treated, whether a rabies vaccine is given, etc.
Infectious period: Contagious from 14 days before the onset of rabies until the end of the illness.
Susceptible groups
People are generally susceptible.
Symptoms
The initial symptoms of rabies are similar to those of a cold, including fever, headache, fatigue and loss of appetite. Some patients may also experience nausea, vomiting, and general discomfort; patients may notice unusual sensations such as itching, numbness, tingling pain, or a crawling sensation at the site of the wound. After a few days, patients may experience excitement and fear, followed by hydrophobia, spasms in the throat and delirium; as the muscles gradually become paralysed and progressive paralysis sets in, the patient will eventually fall into a coma and die. Once clinical signs of rabies appear, the disease is nearly always fatal.
Treatment
Symptomatic therapy is primarily used for treatment, including isolation of the patient and antiviral treatment.
Prevention
- Avoid contact with, teasing or capturing animals of unknown origin, including dogs, cats and monkeys;
- Do not pick up animal carcasses; if necessary, call the relevant authorities for assistance;
- Ensure that pets such as dogs and cats are licensed and receive regular rabies vaccinations.
When bitten by an animal
- Record the characteristics of the animal and the location of the attack;
- Thoroughly clean the wounds with liquid soap and clean water, and then disinfect the wounds with povidone-iodine, before seeking immediate medical attention;
- Take preventive measures deemed necessary by the doctor; get vaccinated after injury if necessary.
Treatment of attacking animals
- Notify the relevant authorities as soon as possible after being bitten by an animal so that the attacking animal can be caught and followed up as soon as possible.
Vaccines
Vaccines preventing rabies are currently available for emergencies. The Vaccination Programme of the Macao Special Administrative Region does not cover relevant vaccines.
Pre-exposure prophylaxis
- Those who have frequent, direct contact with animals should receive routine rabies vaccines;
- Travellers who need to stay in endemic areas for an extended period, especially in remote areas with limited medical facilities, or those engaging in high-risk activities in endemic areas (such as hiking and handling of animals) should consider receiving rabies vaccines after a doctor’s evaluation.
Post-exposure prophylaxis
- The injured person should receive rabies vaccines after a doctor’s evaluation;
- Human rabies immune globulin should be administered as soon as possible after injury.
For more details, please consult a doctor or visit the Immunisation page on the Health Bureau’s official website.
