CUVET Answers All Your Questions Related to “Rabies” while Campaigning for Vaccination in High-Risk Groups to Prevent Fatal Communicable Disease

Chula Veterinary Science joined the World Rabies Day campaign on September 28, to educate and raise awareness about rabies, and organize vaccinations for veterinarian science students who volunteered in the community, while emphasizing that people at risk should be vaccinated regularly against rabies.

Rabies is a life-threatening contagious disease that is almost always fatal. So, prevention is the best medicine. The World Health Organization (WHO) announces September 28 as World Rabies Day to promote awareness of the severity and dangers of the disease and the importance of eradicating rabies through the cooperation of the public.

“COVID-19 is a life-threatening disease, and so is rabies.  If left until the symptoms manifest, it is sure to lead to death.  However, if it is treated from the start, there is a way to survive, and most importantly, it can be prevented,” said Assistant Professor Dr. Tilladit Rungruangkijkrai, Faculty of Veterinary Science, Chulalongkorn University, reiterated while unveiling the rabies vaccination program for veterinary students organized by the Anti-rabies Club, Faculty of Veterinary Science, as part of the rabies prevention and control campaign.

“Every year, our club runs two main groups of programs: 1) Inoculating veterinary students with rabies vaccines, which requires practical education and working closely with dogs and cats; and 2) the rabies campaign camp activities, in which participating students must be trained to hone their skills and experience in the veterinary profession, as well as raising their awareness in volunteering to vaccinate dogs and cats in the community, and to provide knowledge and information that will reduce the risk of rabies in the community,” said Asst. Prof. Dr. Tilladis while explaining the activities and goals of the project.  Although the vaccination is focused on the students, the program also wishes to address vulnerable groups, such as those working closely with animals, caregivers of dog and cat farms, pet grooming operators (also including postal workers and couriers), etc. to promote awareness of the importance of receiving rabies vaccines regularly. 

In addition, both the Anti-Rabies Club and the Faculty of Veterinary Science of Chula are public education agencies on rabies prevention and treatment if bitten or scratched by mammals, especially dogs and cats. Publicity is available through various media and channels, including the Facebook page of the Anti-Rabies Club, Facebook: CURabies club, with the ultimate goal of making Thailand free of rabies-related deaths.

What is rabies?

Rabies is a neurological infection caused by the Rabies virus that can cause disease in all mammals, from dogs to cats to cattle to pigs, rats, rabbits, bats, and goats. It is also known as “mad dog disease” because it was first found in dogs, and according to statistics, over 95 percent of the deaths from the disease in Thailand are caused by dogs, followed by cats.

Rabies is transmitted to humans when bitten, scratched or licked by dogs or cats.  The virus will enter the body through the wound, and mucous membranes of the mouth, nose or eyes. However, rabies cases have also been reported from the consumption of raw meat from rabies-infected cattle.

There are two types of manifestations in rabies-infected animals.

1. Aggressive behavior is a common symptom, with animals predominantly appearing fierce, anxious, and running wildly and biting people or animals in their way. Also clearly noticeable is the salivation due to the paralysis of the jaw muscles, body spasms, and drooping tail. Later, there will be paralysis.  Their legs will be exhausted, they will become unconscious, and die within a few days up to 2 weeks.

2. Passive behavior is more difficult to spot.  The infected animals have symptoms like other diseases, keep to themselves, and seem harmless.  They may bite people or other animals when disturbed, and then eventually become paralyzed and die.

Symptoms in animals

There are 3 stages of rabies symptoms, which can be treated in the early stage, but if the disease progresses to the second and third stages, then one should be prepared to say goodbye.

Stage 1

The animal’s temperament changes, either it becomes aggressive or feeble.

Stage 2

Onset of nervousness, irritability, restlessness, and lack of balance.  The animal would manifest strange symptoms such as random bite attempts of people, animals, or things.  They would start to have partial paralysis of the body in the muscles of the neck and larynx. Notice the dangling tongue, drooling, and inability to swallow water, and food.

Stage 3 or the final stage

is characterized by rapid paralysis and eventual death from neurological and respiratory paralysis and respiratory failure.  The total period including the disease onset is only 10 days.

Is it true that rabid animals are afraid of water according to the name “hydrophobia”?

This is a misunderstanding, because, in the past, you may have noticed that rabid animals have a fear of water by screaming and a show of distress when they drink water. That’s why it’s called hydrophobia. Rabid animals are, in fact, not afraid of water, but cannot swallow water or food, because of the paralysis of the throat muscles, larynx, and esophagus, making them choke and causing a lot of pain, resembling fear of water.

What to do when bitten or scratched by a dog or a cat?

Once you have been bitten or scratched by a dog or cat, whether it’s your own, someone else’s”, or “a stray” dog, remember this tip well, “wash the wound, apply the medicine, cage the dog, and see the doctor”.  Quickly wash your wounds with clean water and soap to remove any saliva, then apply antiseptic.   This can be a tincture, iodine, or betadine. If it is an unknown animal or even a pet that has been vaccinated, keep watch of the animal by locking or grounding it for about two weeks. If the animal has unusual symptoms or dies, immediately notify the treating physician. Once you have applied the antiseptic, seek immediate medical attention and get a rabies vaccine and tetanus shot.

In case of major and deep puncture wounds or the bites are in an area with a large number of blood vessels, such as the face or near the brain, the doctor may consider injecting immunoglobulin to destroy the virus more effectively.  Although rabies is a lethal disease, immediate medical attention can save lives.

Cure for rabies

In the past, we have probably heard that the only treatment for rabies is the 21 shots around one’s belly button.  Currently, the treatment is only 4-5 shots (on days 0, 3, 7, and 28) and injections do not have to be done around the navel.  It’s the physician’s discretion if intramuscular, intradermal, or immunoglobulin injection is needed.

When can I get a rabies vaccination?

The best prevention is rabies vaccination. Pet owners should take their pets to have their rabies vaccines annually, as determined by a veterinarian.  Dogs and cats of 3 months and older can be vaccinated and boosted annually. In addition, people need to be in regular contact or those who are at risk of being bitten, such as veterinarians, animals groomers, animal farm keepers, and people who are in close contact with animals regularly, (including many occupations that are at risk of being bitten, such as postal workers or home delivery workers) should also receive rabies vaccines (but a different kind from animal vaccines).

Can I get a rabies vaccine during COVID-19?

Getting rabies vaccines in case of dog bites during the COVID-19 vaccination appointment can be done alongside each other. There is no need to wait for a different period.  Only have the vaccines administered to different parts of the body, because they are both dangerous diseases.  Therefore, if you need to get rabies vaccines, don’t worry about the effect of the COVID-19 vaccines.   However, Asst. Prof. Dr. Tilladit warns us that “While protecting yourself from COVID-19, be sure to protect yourself from rabies as well, as they are both dangerous diseases.”

The record of rabies deaths in 2018 was as high as 18.  The number of animals that tested positive for rabies is 1,476 which was the highest in 10 years. But in 2020, the number of deaths was reduced to 3, while there were 236 infected animals. The data up to August 2021 showed that there were 3 rabies-related deaths and 128 infected animals. This lower rate of infection may be due to people quarantining at home and did not come in contact with rabid animals.  However, public awareness campaigns on how to prevent and treat rabies are necessary to save the lives of animals and people from the disease that is still not eradicated from Thailand.  There are still many stray dogs (which are the main carriers of rabies) in Thailand, and controlling the homeless dog population, and giving rabies vaccination to paranoid and frightened stray dogs is difficult to achieve.  In addition, many provinces have forest areas that are a hideaway for stray dogs, and Thailand borders many countries.  So, controlling the rabies epidemic cannot be achieved alone, but regional cooperation is needed.

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