Rabies is a fatal but preventable viral disease found in more than 150 countries across the globe, causing 59,000 deaths annually. India alone accounts for 36 percent of the world's total deaths due to rabies – roughly 18,000 to 20,000 deaths annually.
Dogs infected with rabies are recognised as the most common cause of human rabies deaths, responsible for up to 99 percent of all rabies transmissions to humans.
Lack of awareness and misunderstandings concerning rabies have given rise to several myths and superstitions surrounding dog bites and rabies transmission in India that are not good for dogs or people.
It was quite evident that vaccination of street dogs is crucial, but sensitising communities about rabies is equally important.
This World Rabies Day, let's break down some key myths and misconceptions about this potentially fatal disease.
Myth 1: Rabies Is Only Transmitted Through Animal Bites
Rabies is transmitted through contact with the saliva of an infected animal.
While bites are the most common mode of transmission, the rabies virus can also be transmitted when saliva enters any open wound or mucus membrane (such as the mouth, nose, or eye).
As a result, licks on an open wound or scratches from rabid animals can also transmit the virus.
Myth 2: Animals With Rabies Will Clearly Appear Ferocious and Sick
While most rabid animals will demonstrate some signs of illness and/or behavioral change, some may not have noticeable symptoms.
There are two different forms of rabies: dumb (paralytic) and furious.
Paralytic (or dumb) rabies accounts for approximately 20 percent of the total number of human cases. This form of rabies runs a less dramatic but longer course than the furious form. There will be decreased or complete lack of muscle movement and the affected body part will become floppy. Dogs will appear weak early in the course of infection and gradually they may be unable to stand or even lose consciousness.
Furious rabies results in signs of hyperactivity, excitable behavior, hydrophobia (fear of water), and sometimes aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest.
Myth 3: Symptoms of a Rabies Infection Will Appear Shortly After a Bite
After the bite of an infected animal, rabies symptoms may take weeks, months, or in some cases, years, to appear in humans (this is known as the incubation period).
The length of time before symptoms appear can vary based on where you were bitten (arm, leg, face, etc.), the type of infection (dumb or furious), and if you were vaccinated against rabies before the bite.
The long incubation period of rabies can make diagnosis and treatment difficult because patients may assume no infection occurred until symptoms develop, at which point the disease becomes fatal.
If you suspect you were exposed to the rabies virus, always seek prompt medical care and vaccination.
Myth 4: You Can Only Get Vaccinated Against Rabies After a Bite
The rabies vaccine is administered in a series of doses, which can be given before potential exposure as a preventive measure or after a bite from an infected animal.
So, you do not have to wait until you get bitten. Rabies vaccines are available as a preventive measure.
These are recommended for individuals at substantial risk of getting bitten, whereas the rabies vaccines you will require after a bite or a scratch will depend on whether you were vaccinated before exposure or not.
If you were not vaccinated against rabies, you need a series of 4-5 vaccines and the Human Rabies Immunoglobulin (HRIG) over a period of 14 days after the bite or scratch.
If you were vaccinated with a series of 3 pre-exposure vaccines, you have some initial protection. If you are bitten or scratched, you only need 2 post-exposure vaccines. HRIG is not required.
Myth 5: Home Remedies or Native Medicines Are Curative
People with bite wounds that are only treated with traditional medicine are at greater risk of death from rabies.
Once a person shows clinical symptoms, death is unpreventable.
There have been cases of individuals in communities in our rural areas using turmeric power or even chili powder to cure dog bites.
To date, there is no traditional medicine that has proven to be effective against the rabies virus.
You should always proceed to a medical centre or hospital so the wound can be properly cleaned and disinfected, and you can get a post-exposure rabies vaccine.
In fact, superstition continues to complicate response to rabies in many rural and tribal communities.
In Gujarat alone, more than 100 temples to the Goddess of Rabies (Hadkai Maa) exist, where thousands of people who are bitten by dogs come and seek a blessing to get healed, only to delay the process of the lifesaving treatment their situation actually demands.
Myth 6: Rabies Vaccines Only Work for a Few Months in Dogs
Rabies vaccines are quite effective in animals and last about a year.
Therefore, it is important to schedule a regular annual veterinary health checkup for your pet and community animals in your care.
A veterinarian can help to immunise the animals against rabies and other diseases and help you to keep yourself and others safe.
Myth 7: Indoor Dogs and Cats Do Not Need Rabies Vaccines
It is important to follow your veterinarian's advice about whether your indoor animals need to be vaccinated. An indoor pet could escape and be bitten by a rabid street dog.
Also, pets are often required to have rabies vaccination by law for public safety reasons. Check with your veterinary about relevant local regulations.
Myth 8: If I Was Bitten by a Vaccinated Dog, I Do Not Need a Post-Exposure Human Rabies Vaccine
Even if the dog is vaccinated against rabies, you should still go to the doctor for an examination. The doctor will evaluate the bite wound and advise on whether a post- exposure vaccine is necessary.
If you do not seek medical care, you are risking your life.
Myth 9: Rabies Is Not Life-threatening or Fatal to Humans
Rabies is ALWAYS life-threatening and can result in death if the bite wound is not washed immediately and the post-exposure vaccination is not given in a timely fashion as public health requirements demand.
Immediate and thorough washing and cleaning of a bite wound is ESSENTIAL.
Flush the wound with a strong stream of water. Wash well with soap or detergent. Next, apply a disinfectant to the wound and surrounding tissue, taking care to get it under skin flaps.
Immediately afterwards, take the person to the hospital or vaccination point.
Myth 10: All Dogs Are Rabid Dogs
Although in up to 99 percent of the cases, dogs are responsible for rabies virus transmission to humans, not all dogs are carriers of virus.
A normal healthy dog does not carry rabies virus and he will only get infected if he gets bitten by rabies infected dogs or animals.
These myths and misconceptions present serious challenges to those working in the field to eradicate rabies. Rabies is non-curable but a 100 percent preventable by proper vaccination of dogs.
We can ensure a rabies-free future for India by focusing on the vaccination of street and pet dogs, creating more awareness, and eliminating the myths that surround it. Working together, we can make our society a safer and more humane one for humans and animals alike.
(Dr Piyush Patel is the Senior Program Manager for the dog management work at HSI/India. He has been working with street dog programs for the past 13 years and has done over 50,000 surgeries and trained hundreds of veterinarians.)
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