Understanding Rabies 101 - Dog Bite Illness Symptoms, Treatment & Prevention

28th September is synonymously known as World Rabies Day. This statement is more nuanced than it leads on. How widespread does an illness need to be that an entire day is dedicated to spreading awareness about it? Well, looking at the numbers, you’ll be surprised.

According to WHO, “India is endemic for rabies, and accounts for 36% of the world’s rabies deaths…it causes 18,000-20,000 deaths every year. About 30-60% of reported rabies cases and deaths in India occur in children under the age of 15 years, as (dog) bites that occur in children often go unrecognised and unreported.”

In this article, we’ll focus on breaking down all that we know about rabies in humans caused by dog bites and how together we can transform India into a rabies-free nation:

        1. Dogs VS Humans - The juxtaposition

The numbers are a dismaying reality, especially for our community of animal lovers who have adopted thousands of street dogs across the country as their own families. While on the one hand we sympathise with the pain of the victims and their families, on the other hand, we’re conscious of the illness in dogs themselves and how staying unvaccinated robs them of a life well-loved and lived.

Rabies today is an unfortunate war pitted against the two species. Dog bites are a major reason why people in India are afraid of street dogs, even when time and again they’ve proven to be companions capable of caring and forming unbreakable bonds. Fear, as we all know, works as a wonderful threat - powerful enough to even instigate hate. Now, this statement isn’t to blame or point out faults. We understand some folks simply aren’t comfortable around dogs. What we do wish to do, is to highlight the unfamiliarity of the disease itself and through our efforts help eliminate the ostracisation our streeties suffer daily.

Rashi Narang, founder of The HUFT Foundation ardently believes, “When we understand something, we begin to care for it.” This is the reason why we wish for our society to take a step towards understanding health across species.

       2. What is rabies disease?

Rabies is one of the most fatal zoonotic diseases in the world, with 96% of the mortality and morbidity in rabies cases being associated with dog bites. What’s zoonotic? In short, it’s an infectious disease that spreads from animals to humans.

       3. What causes rabies in humans?

Lyssavirus, the causative agent of rabies in humans, is the most common variant which can be easily transmitted from a bite or a scratch. Once the virus enters the human body, it travels along the peripheral nerves to the spinal cord and brain causing inflammation. This inflammatory response is the hallmark of rabies and contributes to the severe and often fatal neurological symptoms associated with the disease.

In the majority of cases, the patient will exhibit rabies symptoms within 1-3 months after exposure, however in some cases it can extend beyond 3 months as well. This incubation period can be influenced by factors such as the location and severity of the exposed site and the individual’s immune response.

       4. What are the symptoms of rabies in humans?

The symptoms of rabies in humans can be categorised into two phases. Phase 1 has common symptoms that most ignore. Once the symptoms reach phase two, the results can be grim. Early recognition of rabies symptoms, coupled with prompt medical intervention, can make a significant difference in the patient’s life. Which is why it’s important to catch hold of the infection in the first phase itself. Here are the two phases at a glance:

       Phase 1: Prodromal Phase & Rabies Symptoms

In this phase, the patient may exhibit non-flu-like symptoms. The characteristic neurological symptoms of rabies are yet not evident, making the diagnosis challenging.

Duration of Phase 1 Rabies : -  2-10 days

Symptoms of Phase 1 Rabies : -  

• Fever
• Headache
• Malaise 
• Discomfort at the site of bite or scratch 
• Nausea 
• Vomiting 
• Loss of appetite / Anorexia   

       #The “Excitatory” Phase & Rabies Symptoms

As the prodromal phase progresses, there are often changes in behaviour that reflect the heightened neural activity. Rabies symptoms in this phase include agitation, anxiety, and irritability in affected individuals.

       Phase 2: Neurological Phase & Rabies Symptoms

This phase is often rapid and, unfortunately, irreversible. It can be further divided into two sub-phases with the characteristic rabies symptoms:

SUB-PHASE 1 FURIOUS FORM : - 

• Hyperactivity 
• Disorientation 
• Erratic behaviour 
• Hallucinations 
• Hydrophobia (fear of water) 
• Aerophobia (fear of drafts of air)
• Difficulty in swallowing (which contributes to the characteristic aversion to water).
• Seizures and paralysis may occur

SUB-PHASE 2 PARALYTIC FORM : -

• As the name suggests, progressive paralysis 
• Gradual decline of neurological functions 
• Weakened muscles 
• Difficulty in speaking, swallowing, and breathing 

       5. How to treat rabies in humans?

Regardless of the form, once the neurological symptoms become apparent, rabies is almost universally fatal. If a person is bitten, they ought to be timely given a rabies vaccine for dogs. This is called post-exposure prophylaxis (PEP) which is the most effective means of averting the dire consequences of a rabies infection. Rabies vaccine for dogs may also be given early on to veterinarians or those who work closely with animals. 

       6. Treating the root cause - rabies in dogs

It’s a simple logic - a dog without rabies cannot transmit rabies to other dogs or humans. Despite medical advances, rabies in humans does not have a cure but it sure is preventable. Vaccinating our street dogs is the most cost-effective strategy for preventing rabies from spreading. It’s also helpful if one notices symptoms of rabies in dogs early on.

HUFT Tip: It is important to note that general aggression in dogs is different from rabies in dogs. If you wish to learn more about aggression, read here.

      7. Common symptoms of rabies in dogs

Rabies in dogs spread if an infected dog bites a healthy dog. The incubation period of rabies in dogs is 3−8 weeks on average but may vary from 10 days to as long as 6 months but is rarely more than 4 months.

Following are 8 common symptoms of rabies in dogs one ought to look out for:

• Noticeable shift in behaviour where friendly dogs become aggressive, irritable, withdrawn or restless
• Excessive drooling 
• Difficulty in swallowing food or water leading to dehydration and weight loss over time
• Excessive barking or growling 
• Weakness and lack of body coordination 
• Photophobia (Fear of lights) 
• Fevers & seizures  
• Self-biting & inflicting serious injuries 
• Phases of hyperactivity or body paralysis starting in hind legs and progressing towards front legs

Once the clinical signs set in, the disease progresses rapidly causing the dog to suffer respiratory failure and ultimately death. This generally happens within the time span of 3-8 days.

Cats with rabies show signs of aggressive behaviour similar to rabid dogs, but they tend to hide more and can be fiercer. They might act like they’re swatting at imaginary mice in the air. After 2-4 days of this excited behaviour, the paralysis sets in, affecting the back part of their body.

HUFT Tip: If you notice these symptoms in your pet, we advise you to reach out to your vet immediately. However, if you notice them in your streeties, we advise you to stay away. Alert the local health authorities or animal control who can take necessary actions for everyone’s safety.

      8. Why is rabies most common in Indian children?

As we stated before, WHO says, “About 30-60% of reported rabies cases and deaths in India occur in children under the age of 15 years, as (dog) bites that occur in children often go unrecognised and unreported.”

One obvious reason for rabies disease being most common in Indian children is the lack of awareness about the disease. Street dogs with rabies can bite children unprovoked. However, we also believe that lack of proper socialisation between dogs and children might be a deeper reason behind the statistics.

Dogs in particular, aren’t fond of being constantly touched or having their hair pulled. Most dogs are also sensitive to certain areas such as the tail or ears. Our children being unaware yet curious, might approach dogs, unknowingly stepping in their comfort zone and triggering their fight response. High decibel voices also make our dogs uncomfortable. While some dogs in general can tolerate it, dogs suffering from the painful rabies disease might not be able to view who’s in front of them before biting.

By educating our children, we can equip them with the knowledge needed in emergencies. At the HUFT Foundation, we wish to build the gap and teach children about co-existence by partnering up with schools.

Watch how the HUFT Foundation celebrated Children’s Day

https://www.instagram.com/reel/CzoCIS8PEV7/?utm_source=ig_web_copy_link&igshid=MzRlODBiNWFlZA== 

      9. Indian government in battling rabies in India

The government of India has recently taken proactive steps in controlling rabies in India, recognising it as a threat to public health. National Rabies Control Programme (NRCP) is a part of The National Centre For Disease Control. The department has recently launched the National Action Plan for Dog Mediated Rabies Elimination from India by 2030 (NAPRE).

The vision of this action plan is “To achieve zero human deaths due to dog-mediated rabies by 2030.” and its mission is “To progressively reduce and ultimately eliminate human rabies in India through sustained, mass dog vaccination and appropriate post-exposure treatment.”

As concerned citizens, we play a crucial role in these efforts. Even if we’re not directly involved in policy-making, every step we take on a daily basis from understanding and caring for streeties, spreading awareness about timely vaccinations and learning how to be responsible pet parents, one can contribute significantly. We encourage everyone reading to participate in vaccination campaigns and educate those around you about rabies.

By fostering a collective sense of responsibility, we can contribute to the success of the government’s initiatives and help build a safer, rabies-free future for India and its human and furry children.