Rabies – one of the most dangerous diseases. It kills almost 100 percent. How to protect yourself?

There are more and more cases of rabies among animals in Mazovia. Since the beginning of the year, 22 cases have already been detected. The dangers must not be ignored – rabies is one of the most dangerous diseases known to man. We cannot treat it, and the appearance of symptoms means that it is too late. What is rabies, why it kills, how to protect against it? Tells the specialist in infectious diseases and paediatrics, Dr. Lidia Stopyra.

1. Since the beginning of 2022, 22 cases of rabies in animals have been detected in the Mazowieckie Voivodeship. The local voivode decided to extend the area at risk of the disease to the whole of Warsaw
2. Rabies is a disease of the nervous system. It causes inflammation of the brain, spinal cord and damage to vital centers
3. People most often get rabies from dogs. Hence, vaccination of these animals is the most cost effective rabies prevention strategy in humans
4. In Poland, dogs over three months of age are subject to mandatory protective vaccination against rabies, and then at least every 12 months from the date of the last vaccination.
5. From December 31, 2021, in the province of Mazowieckie voivodship at risk of rabies in animals, it is obligatory to vaccinate cats against rabies (conditions as in the case of dogs)
6. More information can be found on the Onet homepage.

– In the area of ​​our voivodeship, we still notice new cases of rabies in animals, not only those living in the wild, but also domestic ones, e.g. cats – warned the Mazowiecki Voivode at the beginning of the year. By January 2022, 110 cases of this disease were confirmed in Mazovia, including seven in cats and five in dogs. «Most, because as many as 95, are free-living foxes», reported the Provincial Veterinary Inspectorate in Siedlce.

In connection with this situation, an appeal was issued “to be cautious in the event of encountering animals unknown to us on our way”. “Even if we see an injured animal and want to help it, don’t touch it.” Relevant services should be notified. Let us not act on our own. We should also remember that vaccination against rabies in dogs is obligatory, and cats are recommended, except for cats staying in the endangered area, where their vaccination is obligatory – reminded the Mazowiecki Voivode.

Currently, the situation in Mazovia is still not good. Since the beginning of the year, another 22 cases of infection have been confirmed there, and Warsaw was recognized by the minister’s decree as an area at risk of the disease.

What is the risk of rabies for humans? We recall a recent interview with the infectious disease, Dr. Lidia Stopyra.

Monika Mikołajska / Medonet: Rabies is not only one of the most dangerous zoonoses – zoonoses – in the world, but also one of the most dangerous diseases. There is no cure for it, and almost 100 percent. infected people die. Doctor, what is rabies really? Why is it killing?

Dr. Lidia Stopyra, specialist in infectious diseases and paediatrics: Rabies is indeed one of the most dangerous diseases known to man. It gives no warning signals, and when symptoms appear, it is practically too late to save a life. Because – as you noticed – We don’t have a rabies medicine. The disease can only be fought prophylactically through vaccinations.

What is important is that rabies is a disease of the nervous system. In its course, the whole brain is ill – it becomes inflamed and damaged centers necessary for living. Several cases of saving people infected with rabies from death were described in the literature, but these people were no longer fully functional.

Rabies is caused by a virus that is transmitted to humans through the saliva of a sick animal. Most often it occurs as a result of a bite or slinging of damaged – even to a minimal extent – skin or mucosa. As a result, it happens that it is enough to touch a sick animal, also dead, to become infected.

The name itself puts attention to attention – where does the term “rabies” come from?

The name “rabies” refers to the dominant symptoms of this disease. Already at the beginning, the patient begins to experience a feeling of anxiety that increases over time (headaches, fever may also occur). Then there is a disturbance of consciousness. The sick person is very excited, even crazy. It is difficult to approach him, such a patient beats, kicks, spits, may bang his head against the wall. When he hears sounds, especially when it is the sound of running water, he suffers greatly. The fear of space and fresh air appears.

In paralytic rabies (one of the two forms of the disease), the muscles are gradually paralyzed and paresis appears. They are accompanied by breathing disorders, swallowing problems, the patient falls into a coma. Then there is only death.

Photo Shutterstock/ Kateryna Kon

Due to rabies, around 60 people die worldwide. people. In Poland, the disease was almost eliminated. According to the National Institute of Public Health of the National Institute of Hygiene, no cases of rabies have been reported in humans for many years, and the last death due to rabies took place in 2002.

We are talking about situations in which cases of rabies are diagnosed. Certainly not all of them are discovered. Years ago in the US there was a lot of talk about one case. Several patients have had their organs transplanted from the woman who died in the accident. All of these recipients died, and all of them had just been diagnosed with rabies. It turned out that the donor was ill, but she had not been diagnosed with rabies before. In the medical interview, however, the episode turned out to be crucial. The woman ran into an animal. Wanting to remove them from the road, with her bare hands, she shifted the body to the side of the road. Then there must have been an infection.

I think there are cases that, without further investigation, are diagnosed as encephalitis, when in fact it is rabies. Consequently, we do not know for sure how many people actually died from undiagnosed rabies.

We said that with rabies, the appearance of symptoms means that you will be dead. That you have to react – that is, give the vaccine – as soon as possible. How much time do we really have for this?

It all depends on the place of the bite. We have the least time when we bite the area of ​​the face, neck and other very innervated places, e.g. the genital area. There is more time when injuries involve distal (distal) parts of the body, e.g. fingers.

The rabies incubation period itself can be very different. The longest as reported was almost a year, more than 200 days to be exact after exposure to the virus. However, this is an exceptional situation. Most often, however, this time is counted in weeks.

So we ask the most important question: what to do if we find ourselves in a risky situation? Is it then possible to somehow reduce the risk of rabies virus entering the body?

The risk of the virus entering the body will be reduced if we do not stop the blood flowing from the wound (of course, if it is not a serious hemorrhage) – this will facilitate the removal of potentially infected animal saliva from the wound. Second – immediately wash the wound thoroughly with soap and water. After that, we contact the doctor as soon as possible. The key is not to underestimate animal bites. I especially sensitize parents, because sometimes children do not admit that a dog has bitten them, and the parent discovers the wound only after some time.

What happens next? If an animal that we know has bitten us, we must subject it to veterinary observation. It usually lasts 15 days. If the animal is doing well during this time, rabies can practically be ruled out (otherwise it would have died). In a situation where the animal is unknown and escaped after being bitten, we cannot assess its health. Then the only solution is to vaccinate as soon as possible.

There is also another threat – related to the fashion for exotic travels. More and more often we visit countries where the risk of getting infected with rabies is not small at all, but where the quick administration of the vaccine can be a big problem.

This is especially true for travel to Asia and Africa. Remember that during such a trip it is not possible to observe a suspicious animal. Moreover, in these parts of the world access to vaccines is very limited, let alone serum. Besides, often the journey to the hospital, where there would be – at least in theory – a chance to receive them, may take a very long time. Before the COVID-19 pandemic, I happened to get phone calls from people vacationing in exotic places, such as Cambodia or Thailand, who said that they or their child had been bitten by a dog. They asked what they should do about it.

All these problems would be solved by a vaccine given before departure, the so-called pre-exposure. Vaccination is three-dose, after returning, it is still possible to vaccinate, but the doctor decides about it each time.

Fot. Getty Images/ Zhang Wenkui/VCG

Vaccinating dogs is known to be the most cost effective rabies prevention strategy in humans. And when it comes to human vaccinations, the preparation is used mainly after a bite, less often before. Why?

Most people do not have such a significant risk of being bitten by an infected animal as to pre-vaccinate all of them. With good availability of post-exposure vaccination and veterinary control of animals, this is a good strategy. However, you cannot underestimate any bite and see a doctor as soon as possible.

Who should be vaccinated against rabies?

Certainly people from risk groups, incl. foresters and veterinarians. We once had a situation where a child was bitten by a dog. The animal was known. The observation of the dog showed that it did indeed suffer from rabies. Of course, we took care of the bitten child earlier, but the vet, his children and the neighbor’s children also came to us from the contact. It turned out that the little ones played with the dog when he was in the clinic with suspected rabies. This shows how much still has to change in terms of consciousness.

How does the rabies vaccine work? Are there any known side effects after taking it?

It is an inactivated vaccine, i.e. a killed rabies virus. There are no contraindications for taking it, because we face the risk of a fatal disease.

Years ago, we had a situation that I still remember today. The child was diagnosed with severe pneumonia. Hospitalization was necessary. The child and his mother went home to pack their belongings, and shortly after leaving the clinic, the toddler was bitten by the dog. So we were brought to the ward a small patient with pneumonia, a fever reaching 40 degrees C, who had to be given a vaccine and immunoglobulin against rabies, as well as vaccinated against tetanus.

Of course, it was done in a hospital setting and there were no complications. Nevertheless, it was not the best time to get the vaccine, but there was no other option. Anyway, we do not observe post-vaccination reactions in the case of the anti-rabies preparation. The vaccine is safe.

Should we be afraid of rabies in Poland?

This disease exists and we have no cure for it, but that doesn’t mean we should be afraid of rabies. We just have to keep it under control. And it does. There is a detailed procedure of veterinary services, we have vaccines. If we vaccinate our animals and we do not underestimate any bites – there is nothing to worry about.

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