Must read, Breaking the Myths about Rabies in Indonesia

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Myths about rabies and its treatment prevent people seeking proper medical care, and many of them still believe that Post Exposure Prophylaxis consist of a series of very painful injections in the abdomen.

The belief that witchdoctors, herbal extracts, gems and stones, a change in diet or religious practices can prevent rabies stops people seeking effective treatment and even they believe that one vaccination dose is sufficient or the dietary or other activities can reduce vaccine effectiveness.

Rabies is a highly fatal viral disease of the central nervous system and it is caused by Lyassavirus family type. It is primarily a zoonotic disease of warm-blooded animals e.g. dogs, cats, jackals and wolves mainly.

It is prevalent in more than 150 countries and territories. 99 percent of human infection is caused by rabies in dogs and it poses a potential threat to more than 3.3 billion people which shows its high prevalence.1According to a report by WHO, worldwide human deaths from endemic canine rabies were estimated to be 55000 in a year and in India, it is estimated that, around 20,565 to 30,000 persons die due to rabies, with incidence of 1.7 per 100,000 population2.

The annual animal bite load is estimated to be 17.4 million (1.7%) and among them, around 46.9% takes antirabies vaccination as post-exposure prophylaxis.  India is very diverse country, especially for its social and cultural background.

People’s belief and practices vary by states and even districts. There is a wide range of myths and misconceptions related to different diseases/illnesses and people have great faith in it even though efficacy is unproven.

These types of socio-cultural factors and influences are in practice for centuries and many attempts have been made to change these factors responsible for misbeliefs but it often failed due to the defiant community perception.

One such belief is based on prevailing myths and misconceptions. Multiple myths are associated with the disease and they determine the post-exposure treatment seeking behavior of animal bite victims.

The rabies virus infects the body’s central nervous system, causing brain disease and death1. Early signs of rabies infection may seem like general illness, such as fever, headache and general weakness or discomfort. Shortly thereafter, however, more specific and recognizable symptoms begin to emerge1. Insomnia, anxiety, confusion, paralysis, hyper salivation, difficulty swallowing, agitation and hydrophobia are among the most common symptoms1.

Within days of these symptoms appearing, death is likely to occur. Despite the thorough knowledge we currently possess about the virus, there is a vast amount of misinformation that has spread throughout communities. It is the goal of this post to quickly clarify some of these misconceptions in order to ensure the safety of you, your family, and your pets.

The following 7 rabies myths in Indonesia

  1. Many people believe that an animal who is bitten by another animal with rabies doesn’t have the disease until the infection spreads to the brain.

The reality is that your pet would have rabies from the moment of contact with an infected animal. The disease has an incubation period ranging from 10 to 60 days. Not only does the infection reach the brain in that time, it can also spread to your pet’s central nervous system and muscle tissues.

The location and severity of the bite can affect the length of the incubation period and where the infection spreads.

Unfortunately, a bite from an animal infected with rabies is not the only way your pet can acquire it. The other animal can transmit rabies just by having saliva on the claws and scratching your pet. Many pet owners are unaware of this and continue to believe a direct bite is the only method of transmission.

  1. Another common fallacy people believe about rabies is that stray dogs are the only carriers. Any unvaccinated pet can potentially be a carrier, as can wild animals such as foxes, wolves, and racoons.
  2. The media often portrays a dog with rabies foaming at the mouth, which means some people are only familiar with this symptom. This is a late-stage rabies symptom and animals this far advanced need to be euthanized for their comfort and the safety of others. A domestic pet infected with rabies will show other symptoms long before this. The most common ones include abrupt changes in behavior, lack of appetite, seizures, disorientation, and paralysis in the hind legs.
  3. Indoor cats don’t need the rabies vaccine. While your kitty may never step outside your house, she still need to be vaccinated against rabies. There’s still the risk that she could or that a rabid animal could escape to the great outdoor get into your home.

Suppose you have to give her up or she escapes and she winds up in a shelter? There are so many possible scenarios that could make your cat at risk for rabies that it’s much safer to get her vaccinated. Plus, many cities and states require that cats be vaccinated against rabies. And if your unvaccinated cat were to bite a guest in your house, she will most likely need to be quarantined.

  1. Once you’re exposed to rabies, there’s nothing you can do to reduce the risk of infection. If you are bitten by a suspected rabid animal, wash the wound immediately with soap and water for 15 minutes. You’ll also need immediate medical attention and may receive post-exposure prophylaxis (PEP), which is a course of vaccines that help prevent the symptoms of rabies in people.
  2. Rabies is only transmitted through an animal bite. Rabies is spread through an infected animal’s saliva can be transmitted through a bite or more rarely, transmitted when scratches, abrasions, open wounds or mucous membranes of the mouth or oral cavity come into contact with a rabid animal’s saliva or brain tissue.

While you should never do this, petting a suspected wild animal will not expose you to rabies (unless, of course, the animal bites you). Neither will contacting a rabid animal’s feces, urine or blood. Rabies is mostly transmitted through saliva, although rarely, some people may be exposed to rabies by contact with a rabid animal’s brain tissue, inhalation of aerosolized rabies viruses or through organ transplants from an infected person.

  1. If an animal is foaming at the mouth, it definitely has rabies. While excessive drooling is one of the signs of rabies, it can also be a sign of a number of other health issues such as heatstroke, dental problems and anxiety. Plus,certain dog breeds like Mastiffs, Bloodhounds and Saint Bernards tend to drool a lot anyway.

Rabies virus is transmitted through direct contact (such as through broken skin or mucous membranes in the eyes, nose, or mouth) with saliva or brain/nervous system tissue from an infected animal.

People usually get rabies from the bite of a rabid animal. It is also possible, but rare, for people to get rabies from non-bite exposures, which can include scratches, abrasions, or open wounds that are exposed to saliva or other potentially infectious material from a rabid animal. Other types of contact, such as petting a rabid animal or contact with the blood, urine or feces of a rabid animal, are not associated with risk for infection and are not considered to be exposures of concern for rabies.

Other modes of transmission—aside from bites and scratches—are uncommon. Inhalation of aerosolized rabies virus is one potential non-bite route of exposure, but except for laboratory workers, most people won’t encounter an aerosol of rabies virus. Rabies transmission through corneal and solid organ transplants have been recorded, but they are also very rare.

There have only been two known solid organ donor with rabies in the United States since 2008. Many organ procurement organizations have added a screening question about rabies exposure to their procedures for evaluating the suitability of each donor.

Bite and non-bite exposures from an infected person could theoretically transmit rabies, but no such cases have been documented. Casual contact, such as touching a person with rabies or contact with non-infectious fluid or tissue (urine, blood, feces), is not associated with risk for infection. Contact with someone who is receiving rabies vaccination does not constitute rabies exposure, does not pose a risk for infection, and does not require postexposure prophylaxis.

Rabies virus becomes noninfectious when it dries out and when it is exposed to sunlight. Different environmental conditions affect the rate at which the virus becomes inactive, but in general, if the material containing the virus is dry, the virus can be considered noninfectious.

 

 

 

 

 

 

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