A recent disturbing viral video of a young lady “barking like a dog” has brought to fore an issue that needs to be addressed urgently. While some might find this video funny or link it to witchcraft or yahoo-plus, until thorough investigations are carried out, this case might as well be Rabies. Rabies (Aarun digbolugi, Ara nkita, Ciwon kare) is a disease caused by a virus from the genus, Lyssavirus. This virus is bullet shaped, replicates in the saliva of an infected animal and gets to another host via a bite, scratch, or even licking of an open sore on the host. The virus enters the peripheral nerves and starts to make its way to the central nervous system (CNS), which are the brain and the spinal cord. The length of time it takes for the onset of symptoms is based on several factors, including the amount of virus deposited, distance from the wound site to the CNS, and the size of the host. So, if an adult is bitten on the foot, the time to onset of symptoms may be longer than a child bitten on the face.
Normally, incubation period, which is the time between exposure to a pathogenic organism and when clinical signs/symptoms are first apparent, can take anywhere from a few days to over a year, with the average time being one to 12 weeks, but a rare case of 19 years has been reported, long after the person had forgotten about being bitten by a dog. It is worth knowing that transmission of the virus, through saliva can happen as early as ten days, even before symptoms start showing in the infected animal. All mammals – animals that are warm-blooded, have hair, fur or mammary glands – are susceptible to rabies, but mainly dogs, cats, bats, raccoons, foxes and skunks act as carriers. However, over 95% of all known human rabies cases have been caused by contact with rabid dogs. Once rabies is confirmed in an animal or human, it is almost 100% fatal. Each year, rabies causes approximately 59,000 deaths worldwide, about 40% of which are children under the age of 15.
There are two forms of rabies; the furious form and the paralytic/dumb form. At first, an infected dog may show extreme behavioural changes or moods swings such as restlessness or apprehension, and aggression. Friendly dogs may become irritable, while normally-excitable animals may become more docile. The dog may bite or snap at any form of stimulus, attacking other animals, humans and inanimate objects such as rocks, walls or trees. As the virus progresses, an infected dog may become hypersensitive to touch, light, sound and water (hydrophobia), eating unusual things and hiding in dark places. Paralysis of the throat and jaw muscles may follow, resulting in abnormal vocalisation (dogs barking strangely) and foaming at the mouth. Disorientation, incoordination and staggering may occur, caused by paralysis of the hind legs. Other classic signs of rabies include loss of appetite, weakness, seizures and sudden death. Rabies in animals is, however, difficult to diagnose without laboratory testing as the clinical signs vary and can be confused with other diseases.
In humans, the initial symptoms of rabies are similar to those of the flu – fever, headache, and generally feeling unwell. In about 50% of people with rabies, they may start to itch around the area they were bitten or have pain. In the furious form, infected person will have agitation, hyperactivity, restlessness, thrashing about, biting, confusion, or hallucinations and may even “bark like a dog”. This barking, is caused by the spasms of the laryngeal muscles, making a sound very similar to barking. In the paralytic form, which can occur in 20% of people, the person may become paralyzed from the onset. Other symptoms include lack of appetite, sore throat, nausea, vomiting, diarrhoea, anxiety, insomnia (inability to sleep), hydrophobia and foaming at the mouth. The affected person, whether furious or paralyzed, may enter into coma within ten days, breathing becomes laboured and die. It is important to note that rabies symptoms can vary greatly, meaning that not every person will demonstrate all (or even many) of the typical symptoms.
The good news is Rabies is 100% preventable in humans and animals. Pet owners should endeavour to vaccinate their animals regularly and keep them confined. Unvaccinated pets that are allowed to roam outdoors without supervision are most at risk for infection, as they are exposed to wild animals and have a greater chance of fighting with infected or carrier stray dogs or cats. As such, stray animals in the locality should be reported to appropriate quarters. Unvaccinated dogs that have bitten humans, should not be given the jungle justice, but taken to the veterinarian where they are required to be confined for at least 10 days to see if rabies develops. The bite wound should be flushed with plenty of water immediately and the person taken to the hospital, where post exposure prophylaxis will be given. We need to remember that caring for your pet, vaccinating and keeping them safe, not only protects your pet from rabies, but is also of public health significance, if someone is bitten. This is sure a small price to pay.
This scenario presents a clear opportunity to educate the populace and ensure that rabies control programmes are being introduced in schools in endemic countries of Africa and Asia. Rabies is a particular issue for children, and there are simple messages that children can learn that could save lives – do not play with strange dogs, if bitten, wash the wound immediately with water and tell someone bitten they need to see a doctor right away. In 2015, a global goal of zero human dog-mediated rabies deaths by 2030 was put in motion, and relevant bodies and stakeholders developed a comprehensive strategic plan – United Against Rabies Collaboration Zero by 2030. Nigeria plays a pivotal role to lead efforts, leveraging on existing tools and expertise in a coordinated way to empower, engage and educate the people. As the World marks the World Zoonoses Day on July 6, a day which aims to shed light on diseases transmissible from animals to humans (zoonoses). On the way forward, don’t leave the issue unheard, do your part and educate the world about it. End Rabies!