RABIES (HYDROPHOBIA, LYSSA) Rabies is an acute viral encephalomyelitis caused by the rabies virus, a rhobdovirus, of the genus lyssavirus.

It is fatal once signs and symptoms appear. There are two kinds: urban or canine rabies is transmitted by dogs while sylvatic rabies is a disease of wild animals and bats which is sometimes spread to dogs, cats and livestock. Rabies remains a public health problem in the Philippines. Approximately 300 to 600 Filipinos die of rabies every year. Philippines has one of the highest prevalence rates of rabies in the whole world.

Mode of Transmission Usually by bites of a rapid animal whose saliva has the virus. The virus may also be introduced into a scratch or in fresh breaks (very rare). Transmission from man to man is possible. Airborne spread in a cave with millions of bats have occurred, although transplant (corneal) taken from person dying of diagnosed central nervous system disease have resulted in rabies in the recipients. Incubation Period The usual incubation in 2 to 8 weeks. It can be as long as year or several years depending on the severity of the wounds, site of the wound as distance from the brain, amount of virus introduced and protection provided by clothing. Period of Communicability In dogs and cats, for 3 to 10 days before onset of clinical signs (rarely over 3 days) and throughout the duration of the disease. Susceptibility and Resistance: All warm-blooded mammals are susceptible. Natural immunity in man is unknown. Signs of Symptoms: y y y y y y y Sense of apprehension Headache Fever Sensory change near site of animal bite Spasms of muscles or deglutition on attempts to swallow ( fear of water/ hydrophobia) Paralysis Delirium and convulsions.

Without medical intervention, the rabies victim would usually last only for 2 to 6 days. Death is often due to respiratory paralysis.

Management/Prevention The wound must be immediately and thoroughly washed with soap and water. Antiseptics such as povidone iodine or alcohol may be applied. The patients may be given antibiotics and anti-tetanus immunization. Post-exposure treatment is given to persons who are exposed to rabies. It consists of local wound treatment, active immunization (vaccination) and passive immunization (administration of rabies immunoglobulin). Active immunization or vaccination aims to include the body to develop antibodies against rabies up to 3 years. Passive immunization the process of giving an antibody to persons ( with head, neck bites, multiple single deep bite, contamination of mucous membranes or thin coverings of the eyes, lips, and moth) in order to provide immediate protection against rabies which should be administered within the first seven days of active immunization. The effect of the immunoglobulin is only short term. Then consult a veterinarian or trained personnel to observed your pet for 14daysfor sings of rabies. Be a responsible pet owner Have pet immunized at 3months of age and every year thereafter Never allow pets to roam the streets Take care of your pet, bathe feed regularly with adequate food, Provide them with clean sleeping quarters Your pets action is your responsibility Consult for rabies diagnosis and surveillance of the area Mobilize for community participation National rabies is eliminated prevention and control program Goal: human rabies is eliminated in the Philippines and the country is declared rabies-free General objectives: To reduce the incidence of human rabies from 7 per million to 1 per million population by 2010 and eliminate human rabies by 2015.

 To reduce the incidence of canine rabies from 70 per 100,00 to 7 per 100,000 dog by 2010, eliminate canine rabies by 2015 The program is jointly implemented by the department of agriculture (bureau of the animal industry) department of health, department of education, culture and sports, department of interior and local government and non-government organization. Strategies: a. Manpower development Training of health workers veterinarian and laboratory management of animals bite cases. b. Social mobilization Organization meeting networking with other sector c. local program implementation establishing/reactivation of local rabies control committees enactment/enforcement of ordinance on dog control measures d. dog immunization pre-vaccination activities identification of priority areas procurement/ distribution of dog vaccines social preparation conduct of dog vaccination post-immunization evaluation technicians on