By Tedler D. Depaynos, MD
The low profile lawyer is actually not fond of keeping pet dogs but because they serve as “doorbells” whenever somebody is in front of their gate he has been maintaining one. The dog has been with his family for quite some time and he observed that it is getting “unfriendly” and sometimes appear sickly. He used to bathe the dog regularly but the last time he did it, the dog seemed to be uncomfortable and it even tried to bite him when he was applying the dog shampoo. It was good he was wearing gloves so that it was only the hand glove that was torn and his skin was intact.
It was incidental that he met an old friend MD who was forced to become semi-retired because of the Covid problem. He then related to him his problem with his dog. The MD warned him then of the possibility of rabies affecting his “sickly pet dog”. Rabid dogs suddenly become aggressive and keep on salivating and some even bite their masters. Some appear sickly and if really affected, they die within 10 days. He then advised him to tie his dog securely and make sure it does not bite anybody. He has to keep it under close observation and hope that it survives beyond 10 days.
His friend MD then mentioned that although the mortality of rabies is 100%, he still never heard of any patient dying of rabies for the past several decades. The campaign for awareness and prevention which is the only treatment must be very effective.
Rabies is due to a virus which is usually transmitted thru the bite of an infected animal. The virus is contained in the saliva of the rabid animal and is deposited into the site of bite. It may multiply in the muscles and if uncontrolled it would invade the peripheral nerves and may travel towards the brain causing inflammation or encephalitis. Once it occurs, prayers are the only treatment.
It may be transmitted by different animals like cats, rodents and bats especially in other countries but in our locality, it is usually thru our pet dogs. The incubation period is said to be around 30 to 90 days but if the site of bite is on the upper body like the head and neck, it may be as short as 10 days or less.
Tying or confining the biting animal for observation is usually the first step and if nothing happens after 10 days, the animal is not rabid. Rabid dogs usually die within 10 days. If the new wild or sickly character of the dog is noticed during observation, treatment should immediately be commenced after being bitten for waiting for the animal to die is stupid. In some cases, the animal is suddenly killed and the brain is sent to a laboratory if available to be examined for signs of rabies.
Although he has not tried it yet, the lawyer mentioned that there are those who feast on canine brains because of the belief that it would make them brainy especially when they appear in court in front of strict and inquisitive judges. His friend MD just smiled and hoped that they are boiled well so that any viruses present are incapacitated.
In other cases if the biting animal ran away or it was a rat or a bat and even a snake and they cannot be observed, it is suggested that treatment should be started without any delay. Although transmission of rabies thru these animals may be rare or even unheard of, the treatment is sometimes started to remove the anxiety not only of the patient but also of the treating medical personnel. The concern is understandable and cannot easily be removed knowing that rabies mortality is 100%. All the risk details however are always explained in detail not only to the patient but also to their relatives.
Rabies prevention is now the main thrust so that anti- rabies vaccination of our pet animals is now an aggressive program of our veterinarians. Not only the animals are encouraged to be vaccinated but the animal lovers and zoo caretakers or those exposed to or have higher risks of incurring the disease like post men or meter readers as they visit individual homes.
Once again best treatment for rabies is prevention. Before vaccination, manually cleaning the wound is initially done to remove the deposited virus. Soap and water may be used at home before any antiseptic is applied. Letting the wound bleed is also done hoping to remove the virus before dressing is applied. Use of gloves when washing is advised.
During their elementary years, the lawyer mentioned that he accompanied a lady classmate who was bitten by a dog for her painful daily vaccine injection given alternately at her buttocks for 21 days at their local health center. The injecting nurses were motherly and they even reported and waited for them on Sundays for the vaccination. The MD mentioned that these were the earlier times. At present, the different types of rabies vaccines are injected on day 0 (first day), 3, 7, 14 and 28. The human immunoglobulin vaccines may be more expensive and are available in some hospitals but it is supposed to be a single shot. In special cases they are infiltrated around the wound when rabies suspicion is very high.
The lawyer after observing his dog for 10 days still felt uncomfortable. What if it will bite again? He was in severe quandary for his friend MD gave no further suggestions.**
