Rabies

Rabies is a disease of viral origin that affects both wild and domestic animals. In developing countries, where it is transmitted mainly by rabid stray dogs, rabies is still considered a major public health concern and continues to cause 55,000 human deaths each year. (24)

Symptoms of rabies
Following infection, the virus replicates within muscle cells surrounding the wound. It then reaches the central nervous system and eventually spreads through the entire body. The mean incubation period is two to three months, but may range from several days to years. The first signs of the disease include pain or an abnormal sensation at or around the wound, followed by other non-specific symptoms such as fever, anorexia, nausea, vomiting, headaches, malaise, and lethargy. In the acute stage, rabies symptoms mimic encephalitis. The disease may evolve as one of two clinical forms: furious rabies or paralytic (dumb) rabies. In both cases, the outcome is coma followed by death within a few days.

Epidemiology and vaccination against rabies
Rabies is usually transmitted through a rabid animal’s saliva by a bite, scratch, or licking of damaged skin or mucosa. To date, vaccination remains the only effective treatment against rabies and acts by neutralizing the virus before it actually reaches the central nervous system. Indeed, once the nervous system is infected, the outcome of the disease is inevitably fatal.

Rabies
From Wikipedia, the free encyclopedia This article is about the disease. For the virus, see Rabies virus.

Rabies
Classification and external resources

Dog with rabies virus ICD-10 DiseasesDB eMedicine MeSH A82. 11148 med/1374 eerg/493 ped/1974 D011818

Rabies (pronounced /ˈreɪbiːz/. From Latin: rabies, "madness") is a viral disease that causes acute encephalitis (inflammation of the brain) in warm-blooded animals.[1] It is zoonotic (i.e., transmitted by animals), most commonly by a bite from an infected animal. For a human, rabies is almost invariably fatal if post-exposure prophylaxis is not administered prior to the onset of severe symptoms. The rabies virus infects the central nervous system, ultimately causing disease in the brain and death. The rabies virus travels to the brain by following the peripheral nerves. The incubation period of the disease is usually a few months in humans, depending on the distance the virus must travel to reach the central nervous system.[2] Once the rabies virus reaches the central nervous system and symptoms begin to show, the infection is effectively untreatable and usually fatal within days. Early-stage symptoms of rabies are malaise, headache and fever, progressing to acute pain, violent movements, uncontrolled excitement, depression, and hydrophobia.[1] Finally, the patient may experience periods of mania and lethargy, eventually leading to coma. The primary cause of death is usually respiratory insufficiency.[2] Worldwide, roughly 97% of rabies cases come from dog bites.[3] In the United States, however, animal control and vaccination programs have effectively eliminated domestic dogs as reservoirs of rabies.[4] In several countries, including Australia, Japan, and the United Kingdom, rabies carried by animals that live on the ground has been eradicated entirely.[5][6] Concerns exist about airborne and mixed-habitat animals including bats. A small number of bats of three species in the UK and in some other countries have been found to have European Bat Lyssavirus 1 and European Bat Lyssavirus 2.[citation needed] The

symptoms of these viruses are similar to those of rabies and so the viruses are both known as bat rabies.[citation needed] The economic impact is also substantial, as rabies is a significant cause of death of livestock in some countries.[citation needed]

Contents
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1 Signs and symptoms 2 Virology 3 Diagnosis 4 Prevention 5 Management o 5.1 Post-exposure prophylaxis o 5.2 Blood-brain barrier o 5.3 Induced coma 6 Prognosis 7 Epidemiology o 7.1 Transmission o 7.2 Prevalence 8 History o 8.1 Etymology o 8.2 Impact 9 In other animals 10 See also 11 References 12 External links

[edit] Signs and symptoms

Patient with rabies, 1959

The period between infection and the first flu-like symptoms is normally two to twelve weeks, but can be as long as two years. Soon after, the symptoms expand to slight or partial paralysis, cerebral dysfunction, anxiety, insomnia, confusion, agitation, abnormal behavior, paranoia, terror, hallucinations, progressing to delirium.[2][7] The production of large quantities of saliva and tears coupled with an inability to speak or swallow are typical during the later stages of the disease; this can result in hydrophobia, in which the patient has difficulty swallowing because the throat and jaw become slowly paralyzed, shows panic when presented with liquids to drink, and cannot quench his or her thirst. Death almost invariably results two to ten days after first symptoms. In 2005, the first patient was treated with the Milwaukee protocol,[8] and Jeanna Giese became the first person ever recorded to survive rabies without receiving successful post-exposure prophylaxis. An intention to treat analysis has since found that this protocol has a survival rate of about 8%.[9] The results of this study are, however, under serious contention and clinical rabies should still be regarded as incurable at present.

[edit] Virology
Main article: Rabies virus

TEM micrograph with numerous rabies virions (small, dark grey, rodlike particles) and Negri bodies (the larger pathognomonic cellular inclusions of rabies infection). The rabies virus is the type species of the Lyssavirus genus, in the family Rhabdoviridae, order Mononegavirales. Lyssaviruses have helical symmetry, with a length of about 180 nm and a cross-sectional diameter of about 75 nm.[1] These viruses are enveloped and have a singlestranded RNA genome with negative-sense. The genetic information is packaged as a ribonucleoprotein complex in which RNA is tightly bound by the viral nucleoprotein. The RNA genome of the virus encodes five genes whose order is highly conserved: nucleoprotein (N), phosphoprotein (P), matrix protein (M), glycoprotein (G), and the viral RNA polymerase (L).[10] From the point of entry, the virus is neurotropic, traveling quickly along the neural pathways into the central nervous system (CNS), and then further into other organs.[2] The salivary glands receive high concentrations of the virus, thus allowing further transmission.

Germany.[citation needed] New causes of viral encephalitis are also possible. from which the virus in the nerve tissue was weakened by allowing it to dry for five to ten days. and the patient's age. urine and cerebrospinal fluid samples. well-known viruses may be introduced into new locations.[13] In addition.[15] Epidemiologic factors (e.[20] . travel history. however. polioviruses. and arboviruses (e.[14] Likewise. France. and the United States to prevent outbreaks of rabies in wildlife. and possible exposure to animal bites.g. Cerebral inclusion bodies called Negri bodies are 100% diagnostic for rabies infection. Cheaper rabies diagnosis will become possible for low-income settings: accurate rabies diagnosis can be done at a tenth of the cost of traditional testing using basic light microscopy techniques. enteroviruses. The diagnosis can also be reliably made from skin samples taken before death..[11] It is also possible to make the diagnosis from saliva. and human enteroviruses 68 to 71. varicella-zoster virus. as was evidenced by the recent outbreak in Malaysia of some 300 cases of encephalitis (mortality rate. Louis encephalitis virus. Powassan virus.[18] The human diploid cell rabies vaccine was started in 1967. but this is not as sensitive. including coxsackieviruses.[17] Similar nerve tissuederived vaccines are still used in some countries. Their original vaccine was harvested from infected rabbits. St. and La Crosse virus.[19] Currently pre-exposure immunization has been used in both human and non-human populations. including eastern and western equine encephalitis viruses. in particular infection with viruses such as herpesviruses. and ticks) may help direct the diagnostic workup. rodents. and (less commonly) enteroviruses. the California encephalitis virus serogroup. geographic location. consideration should be given to the local epidemiology of encephalitis caused by arboviruses belonging to several taxonomic groups. echoviruses. West Nile virus). a newly recognized paramyxovirus. but are found in only about 80% of cases.g.[12] The differential diagnosis in a case of suspected human rabies may initially include any cause of encephalitis.[1] If possible. 40%) caused by Nipah virus. season.. as they are much cheaper than modern cell culture vaccines.[16] [edit] Prevention Main article: Rabies vaccine All human cases of rabies were fatal until a vaccine was developed in 1885 by Louis Pasteur and Émile Roux. the animal from which the bite was received should also be examined for rabies.[12] A recombinant vaccine called V-RG has been successfully used in Belgium. whereas in many jurisdictions domesticated animals are required to be vaccinated. as is illustrated by the recent outbreak of encephalitis due to West Nile virus in the eastern United States.[edit] Diagnosis The reference method for diagnosing rabies is by performing PCR or viral culture on brain samples taken after death. a new and less expensive purified chicken embryo cell vaccine and purified vero cell rabies vaccine are now available. The most important viruses to rule out are herpes simplex virus type 1.

nose or mouth should be flushed well with water. ranging as high as several thousand dollars. only the post-exposure vaccinations on day 0 and 2. Patients who have previously received pre-exposure vaccination do not receive the immunoglobulin. which promotes information on. in general within ten days of infection. September 28 is World Rabies Day. and reproduce more stray animals. which may go unnoticed by the victim and hence untreated.[1] Thoroughly washing the wound as soon as possible with soap and water for approximately five minutes is very effective in reducing the number of viral particles. to 1–2 per year. As much as possible of this dose should be infiltrated around the bites. aqueous iodine solution. a virucidal antiseptic such as povidone-iodine. with additional doses on days three. mostly caused by bat bites."[23] In the United States.[22] [edit] Management [edit] Post-exposure prophylaxis Treatment after exposure. cats. and ferrets against rabies Keeping pets under supervision Not handling wild animals or strays Contacting an animal control officer. "If available. the Centers for Disease Control and Prevention (CDC) recommend patients receive one dose of human rabies immunoglobulin (HRIG) and four doses of rabies vaccine over a fourteen-day period. and contacting your healthcare provider to see whether you need rabies post-exposure prophylaxis. Pets that are sterile are less likely to leave home. Exposed mucous membranes such as eyes. is highly successful in preventing the disease if administered promptly. iodine tincture.[25] The first dose of rabies vaccine is given as soon as possible after exposure. . become strays.In the USA. known as post-exposure prophylaxis (PEP). Washing the wound with soap and water between 10 and 15 minutes. with the remainder being given by deep intramuscular injection at a site distant from the vaccination site.[24] The immunoglobulin dose should not exceed 20 units per kilogram body weight. Getting pets spayed or neutered. or alcohol (ethanol) should be applied after washing. the number of recorded deaths from rabies has dropped from one hundred or more annually in the early 20th century. of Health and Senior Services Communicable Disease Surveillance 2007 Annual Report states that the following can help reduce the risk of exposure to rabies[21]:       Vaccinating dogs. especially if the animal is acting strangely. seven and fourteen after the first. since the widespread vaccination of domestic dogs and cats and the development of effective human vaccines and immunoglobulin treatments. if you do get bitten by an animal.[4] The Missouri Dept. if you see a wild animal or a stray. HRIG is very expensive and constitutes the vast majority of the cost of postexposure treatment. and prevention and elimination of the disease.

[29] Opening the BBB during rabies infection has been suggested as a possible novel approach to treating the disease. the blood-brain barrier (BBB) does not allow anti-viral immune cells to enter the brain. the lateral thigh is used as for routine childhood vaccinations. especially in sleep areas. is regarded as an indication for post-exposure prophylaxis. the dramatic circumstances surrounding our patient's history. Begun with little or no delay.[25] If there has been a delay between exposure and attempts at treatment. This is illustrated by the September 2000 case of a nine-yearold boy from Quebec who died from rabies three weeks after being in the presence of a sick bat. PEP is 100% effective against rabies.[26] However. Awakening to find a bat in the room. The recommendation for the precautionary use of post-exposure prophylaxis in occult bat encounters where there is no recognized contact has been questioned in the medical literature. where a bite or exposure may occur while the victim is asleep and unaware or awake and unaware that a bite occurred. The old nerve-tissue-based vaccinations that require multiple painful injections into the abdomen with a large needle are cheap.[8] In the case in which there has been a significant delay in administering PEP. the primary site of rabies virus replication. The notion that a bite or an overt break in the skin needs to be seen or felt for rabies to be transmitted by a bat is a myth in many cases. not gluteal area. based on a cost-benefit analysis.[27] It is highly recommended that PEP be administered as soon as possible.[citation needed] . if the bite or exposure was on an arm or leg.[12] Intramuscular vaccination should be given into the deltoid. even though there was no apparent report of a bite. recent studies have further confirmed the wisdom of maintaining the current protocol of precautionary administering of PEP in cases where a child or mentally compromised individual has been left alone with a bat.[citation needed] [edit] Blood-brain barrier During lethal rabies infection of mice. even though no attempts have yet been made to determine whether or not this treatment could be successful. the possibility exists that amputation of the affected limb might thwart rabies. In infants.[28] This aspect contributes to the pathogenicity of the virus and artificially increasing BBB permeability promotes viral clearance. as well as increasingly frequent reports of human rabies contracted in North America. which has been associated with vaccination failure due to injection into fat rather than muscle. This treatment should be combined with an intensive PEP regimen. such that the possibility exists that the virus has already penetrated the nervous system. as shown in the following conclusion made by the doctors involved in the case: Despite recent criticism (45). but are being phased out and replaced by affordable WHO ID (intradermal) vaccination regimens. or finding a bat in the room of a previously unattended child or mentally disabled or intoxicated person.Modern cell-based vaccines are similar to flu shots in terms of pain and side-effects. support the current Canadian guidelines that state that RPEP [PEP] is appropriate in cases where a significant contact with a bat cannot be excluded (45). as it may still be effective. the treatment should be administered regardless of that delay.

After thirty-one days of isolation and seventy-six days of hospitalization.[32] The anesthetic drug ketamine has shown the potential for rabies virus inhibition in rats.[30] She survived with almost no permanent sequelae and as of 2009 was starting her third year of university studies. became the third reported person in the United States to have recovered from rabies without receiving post-exposure prophylaxis. A further 10 patients have been treated under the revised protocol and there have been a further 2 survivors. which has since undergone revision (the second version omits the use of ribavirin).[34] On June 12. American teenager Jeanna Giese survived an infection of rabies unvaccinated. California. ribavirin. Giese was released from the hospital. On April 10. Precious Reynolds.[36] There are only six known cases of a person surviving symptomatic rabies.[edit] Induced coma See also: Milwaukee protocol In 2004. 2008 in Cali. Rabies kills around 55. mostly in Asia and Africa.[31] Giese's treatment regimen became known as the "Milwaukee protocol". Her doctors administered treatment based on the hypothesis that detrimental effects of rabies were caused by temporary dysfunctions in the brain and could be avoided by inducing a temporary partial halt in brain function that would protect the brain from damage while giving the immune system time to defeat the virus.[39] [edit] Epidemiology . an eight-year-old girl from Humboldt County. There were 2 survivors out of 25 patients treated under the first protocol. Colombia.[33] and is used as part of the Milwaukee protocol. She was placed into an induced coma upon onset of symptoms and given ketamine.[35] [edit] Prognosis In unvaccinated humans.[8][37][38] Survival data using the Milwaukee protocol are available from the rabies registry. an eleven-year-old boy was reported to survive rabies and the induced coma without noticeable brain damage. 2011. and amantadine. and only one known case of survival in which the patient received no rabies-specific treatment either before or after illness onset.000 people a year. rabies is usually fatal after neurological symptoms have developed. midazolam. but prompt post-exposure vaccination may prevent the virus from progressing.

varied.Rabies-free countries (in green) as of 2010 [edit] Transmission Main article: Rabies transmission Any warm-blooded animal (including humans) may become infected with the rabies virus and develop symptoms (although birds have only been known to be experimentally infected[40]). the virus enters the peripheral nervous system. and vaccination may still confer cell-mediated immunity to prevent symptomatic rabies. This is called the prodromal phase. raccoons.[43][44] monkeys. except in Australia and New Zealand. cattle. A few cases have been recorded through transplant surgery. bears and other wild carnivores. Small rodents such as squirrels.[53][54] [edit] Prevalence Main article: Prevalence of rabies The rabies virus survives in widespread.[48][49] The route of infection is usually. dogs remain the principal host. wolves. and mice and lagomorphs like rabbits and hares are almost never found to be infected with rabies and are not known to transmit rabies to humans. Rabies may also spread through exposure to infected domestic farm animals. When the virus reaches the brain. Mandatory vaccination of animals is less effective in rural areas.[51] After a typical human infection by bite. rats. weasels. In many cases the infected animal is exceptionally aggressive. In Asia. dogs. coyotes. it rapidly causes encephalitis. guinea pigs. like those in western Europe and Oceania. skunks. foxes. Infected bats. and exhibits otherwiseuncharacteristic behavior. chipmunks. Indeed the virus has even been adapted to grow in cells of poikilothermic ("cold-blooded") vertebrates.[55] In some countries.[50] Transmission between humans is extremely rare.[52] During this phase. hamsters. mongoose (normally yellow mongoose)[45] or cats present the greatest risk to humans. rabies is considered to be prevalent among bat populations only.[46] The Virginia opossum is resistant but not immune to rabies. parts of the Americas. producing transverse myelitis. Once the patient becomes symptomatic. It then travels along the nerves toward the central nervous system. the virus cannot be easily detected within the host. by a bite. and large parts of Africa. rural fauna reservoirs. Especially in developing . It is present in the animal populations of almost every country in the world.[47] The virus is usually present in the nerves and saliva of a symptomatic rabid animal. Rabies may also inflame the spinal cord.[41][42] Most animals can be infected by the virus and can transmit the disease to humans. but not always. groundhogs. treatment is almost never effective and mortality is over 99%. gerbils. and is the beginning of the symptoms. may attack without provocation.

which . and 24.[64] The first written record of rabies is in the Mesopotamian Codex of Eshnunna (ca. primarily because of stray dogs. Surveying other states in the midwest (including Illinois. Ohio.[58] As of 2007. According to the Journal of the American Veterinary Medical Association (JAVMA). in these countries too the virus is primarily transmitted through canines (feral dogs and other wild canine species). this root is used in the name of the genus of rabies lyssavirus. 50 were bats.[56] There are an estimated 55.[36] One of the sources of recent flourishing of rabies in East Asia is the pet boom. a practice that has successfully reduced rabies in rural areas of Canada. Oral vaccines can be safely distributed in baits. and one domestic cat. Therefore. Vietnam had the second-highest rate. "to do violence". and the USA. and costbenefit analysis suggests that baits may be a cost effective method of control. 1930 BC). dating from the 1970s. comprising 134 of the 237 documented non-human cases in 1996.[59] Rabies was once rare in the United States outside the Southern states[citation needed]. 15 were skunks. North and South Dakota. This contradicts the CDC finding that in the midwest most rabies cases are found in skunks. "madness". but as of 2006 raccoons in the mid-Atlantic and northeastern United States have been suffering from a rabies epidemic.000 in Africa. between 1996 and 2009. which was moving westward into Ohio. Kansas. pets may not be privately kept and their destruction may be unacceptable. and an increase in the prevalence of bats with rabies. 352 cases were bats. Of the 66 cases. Canada. skunks are the primary carriers of rabies. Vaccination campaigns may be expensive.[63] [edit] Impact This section requires expansion with: currently the following web page [1]. The Greeks derived the word "lyssa". Iowa.[60] In the midwestern United States. China introduced the "one-dog policy" in the city of Beijing in November 2006 to control the problem. out of 671 confirmed rabies cases. and the remaining cases were other animals.000 human deaths annually from rabies worldwide.[62] This. rabies has been known since c. from "lud" or "violent". with about 31.C.[61] [edit] History [edit] Etymology The term is derived from the Latin rabies.[57] India has been reported as having the highest rate of human rabies in the world. Wisconsin. Because of its potentially violent nature. France. Michigan. Nebraska. there has been a relative decrease in the US midwest in the prevalence of skunks with rabies.000 in Asia.countries.2000 B. 223 were skunks. followed by Thailand. the JAVMA found that. in turn. the state of Missouri had a total of 66 documented cases of rabies. Minnesota. and Indiana). may be related to the Sanskrit rabhas. In Montréal. baits are successfully used on raccoons in the Mont-Royal Park area.

[63] however. Incoordination is seen owing to rear limb paralysis and drooling and difficulty swallowing is caused by paralysis of facial and throat muscles. by an application of magical thinking.[65] Rabies was considered a scourge for its prevalence in the 19th century. Three stages of rabies are recognized in dogs and other animals.dictates that the owner of a dog showing symptoms of rabies should take preventive measure against bites. Death is usually caused by respiratory arrest. The second stage is the excitative stage. The first stage is a one. where Saint Hubert was venerated.[67] Rabies   "Rabies" is also available in Portable Document Format Versión en español What is rabies? Rabies is a deadly disease caused by a virus that attacks the central nervous system (brain and spinal cord). Fear of rabies related to methods of transmissions was almost irrational. In France and Belgium. the owner was heavily fined. this gave Louis Pasteur ample opportunity to test post-exposure treatments from 1885.to three-day period characterized by behavioral changes and is known as the prodromal stage. It is this stage that is often known as furious rabies for the tendency of the affected animal to be hyperreactive to external stimuli and bite at anything near. If another person was bitten by a rabid dog and later died. The third stage is the paralytic stage and is caused by damage to motor neurons. dogs were branded with the key in hopes of protecting them from rabies. Infected mammals can transmit rabies virus to humans and other mammals. Rabies . the "St Hubert's Key" was heated and applied to cauterize the wound. which lasts three to four days. Main article: Rabies in animals Rabies is infectious to mammals.[66] [edit] In other animals This section requires expansion with: information from the main article.

It may become excited or irritable and attack anything in its path. cats are most frequently diagnosed with rabies in New York State. Infected animals usually die within one week after showing signs of rabies. What animals can get rabies? Rabies is most often seen among wild animals such as raccoons. skunks and foxes. convulsions. but only in rare circumstances. What are the signs of rabies in animals? The first sign of rabies is usually a change in an animal's behavior. chipmunks.htm. birds. These include rabbits and small rodents such as squirrels. fish and insects do not get or carry rabies. Report all animal bites to your county health department.ny. choking. A wild animal may appear affectionate and friendly. Some animals almost never get rabies. Fortunately. only a few human cases are reported each year in the United States. Among domestic animals. amphibians (like frogs).health. It is possible for these animals to get rabies. What should I do if I am exposed to rabies? Wash all wounds thoroughly with soap and water and seek medical attention immediately. if possible. Staggering. How do people become exposed to rabies? People usually get exposed to the rabies virus when an infected animal bites them. Exposure may also occur if saliva from a rabid animal enters an open cut or mucous membrane (eyes. guinea pigs. mice. Many animals will make very unusual sounds. rats. such as if they are attacked but not killed by a rabid animal.is almost always fatal once symptoms appear. but any mammal can be infected with rabies. even if they seem minor. The phone number for your county health department can be found in the government listing of your telephone directory or the New York State Department of Health (NYSDOH) website at: http://www. gerbils and hamsters. Reptiles (such as lizards and snakes). In the case of a bat. It may become unusually aggressive or tame.gov/diseases/communicable/zoonoses/rabies/contact. frothing at the mouth and paralysis are sometimes seen. bats. you may . nose or mouth). Try to keep track of the animal that exposed you and report this information to your county health department so the animal can be captured safely. The animal may lose its fear of people and natural enemies. Pets and livestock can get rabies if they are not vaccinated to protect them against infection.

with the remaining injections given on days 3. the animal did not transmit rabies at the time of the bite. ferrets and livestock that have bitten or otherwise caused a potential human exposure to rabies will be confined under the direction of the county health department and observed for ten days following the exposure.gov/diseases/communicable/zoonoses/rabies/ . plus 4 doses of rabies vaccine given over two weeks. . If the animal remains healthy during this period. treatment may be necessary for the people exposed. Even though your pet has been vaccinated. stray dogs or cats.ny. as determined by their doctor. view a short video (1 minute 22 seconds) at www. If your pet has been injured by a rabid animal. If there is a wound. the full dose of HRIG should go into the wound. What is the treatment for people exposed to rabies? Treatment after rabies exposure consists of a dose of human rabies immune globulin (HRIG) administered as soon as possible after exposure. if possible. rabies can be prevented. A person who has already been vaccinated for rabies and is exposed to rabies must receive two booster vaccine doses three days apart immediately after exposure. Other types of animals that cause a potential human exposure must be tested for rabies under the direction of the county health department. the disease almost always results in death. The first vaccine dose is given at the same time. If treatment is initiated promptly following a rabies exposure. What can people do to protect themselves against rabies?  Don't feed. People who have weakened immune systems may require a fifth dose of vaccine. Contact your county health department to determine what additional follow-up may be needed. If an animal cannot be observed or tested for rabies. Your county health department will assist you and your physician to determine whether treatment is necessary. touch or adopt wild animals. contact your veterinarian to get medical care. If a rabies exposure is not treated and a person develops clinical signs of rabies. To learn how to capture a bat safely.health. a booster dose of rabies vaccine may be needed within five days of the incident.be able to safely capture it yourself and take it to your county health department where it will be transferred to the state for rabies testing. What happens if a rabies exposure goes untreated? Exposure to a rabid animal does not always result in rabies. cats. Healthy dogs. 7 and 14 following the initial injection. They do not need an injection of HRIG. How do I protect my pets from rabies? The best way to keep pets safe from rabies is to vaccinate them and keep their shots up-to-date.

The rabies virus infects the central nervous system. Rabies is almost always fatal once symptoms appear.       Be sure your pet dogs. in your telephone directory under pest control. If possible. Keep family pets indoors at night.ny. If nuisance wild animals are living in parts of your home. Don't leave them outside unattended or let them roam free. let it wander away. Pets too young to be vaccinated should be kept indoors and allowed outside only under direct observation.health. consult with a nuisance wildlife control expert about having them removed. If a wild animal is on your property. Cap your chimney with screens. skunks. Detailed rabies information is also available at the following websites:   NYSDOH: Rabies Centers for Disease Control and Prevention (CDC): Rabies Last Reviewed: October 2010 Last Updated: October 2010 Revised: September 2011 What is rabies? Rabies is a preventable viral disease of mammals (including humans) most often transmitted through the bite of a rabid animal. porch or garage. Report all animal bites or contact with wild animals to your county health department. Animal rabies is reported annually in New York City and State. who work on a fee-for-service basis. Keep your property free of stored bird seed or other foods that may attract wild animals. and foxes. Board up any openings to your attic. You may contact a nuisance wildlife control expert who will remove the animal for a fee. bats. The phone number for your county health department can be found in the government listing of your telephone directory or the NYSDOH website at: www. New York City .htm. Bring children and pets indoors and alert neighbors who are outside. Don't attract wild animals to your home or yard. skunks and raccoons. You can find wildlife control experts. Where can I get more information about rabies? The county health department is your best source of additional rabies information. The vast majority of rabies cases in the United States each year occur in wild animals like raccoons. Tightly cap or put away garbage cans. cats and ferrets as well as horses and valuable livestock animals are up-to-date on their rabies vaccinations. basement. Feed pets indoors. primarily in bats.gov/diseases/communicable/zoonoses/rabies/contact. do not let any animal escape that has possibly exposed someone to rabies. Vaccination protects pets if they are exposed to rabid animals. Teach children not to touch any animal they do not know and to tell an adult immediately if they are bitten by any animal.

if administered promptly and as recommended. can prevent infection after a person has been bitten or otherwise exposed to an animal with rabies. The one time dose of RIG and five vaccines administered over the course of one month is referred to as post exposure prophylaxis (PEP). especially among animals in the Bronx. Table 1: Number of Rabid Animals in New York City and New York State 2003-2008 2003 2004 2005 2006 2007 2008 New York City New York State 6 14 28 44 44 19 429 546 565 612 515 496 Table 2: Number of Rabid Animals in New York City by Borough. The human rabies vaccine is given in a series of five vaccinations along with one initial dose of rabies immune globulin (RIG). Human rabies vaccine. There have been no human cases of rabies in New York City for more than 50 years.first saw rabies in animals starting in 1992. 2004-2009 Borough Bronx Brooklyn Manhattan Queens 2004 2005 2006 2007 2008 2009 13 0 0 0 26 1 0 1 6 0 1 2 14 0 0 1 13 1 0 1 15 0 12 1 . New York State has reported 14 human cases since 1925. and continues to every year. rabies rarely infects humans because of companion animal vaccination programs and the availability of human rabies vaccine. In the United States.

1992-2009 1992-2007 Bronx Queens Man SI Bklyn Total Raccoon Skunk Opossum Bat Dog Cat Groundhog Coyote Total 163 40 0 8 0 2 0 1 214 9 0 0 4 0 0 0 0 13 20 121 0 0 7 0 1 0 0 2 2 5 0 7 1 0 0 0 0 5 0 1 0 0 6 313 42 2 29 0 11 1 1 399 28 138      Animals Testing Positive for Rabies in New York City in 2009 Animals Testing Positive for Rabies in New York City in 2008 Animals Testing Positive for Rabies in New York City in 2007 Animals Testing Positive for Rabies in New York City in 2006 Animals Testing Positive for Rabies in New York City in 2005 back to top Who gets rabies? All mammals. fox and coyotes. skunk. but it most often seen among wild animals such as raccoons. including humans.Staten Island 1 0 35 29 4 1 Table 3: Number of Rabid Animals in New York City by Species and Borough. can get rabies. back to top . bats.

and the person exposed should receive PEP. mice. raccoons may infect other animals such as cats. guinea pigs. Two of those occurred in New York State. Rabbits and small rodents (such as chipmunks. On occasion. an infant. skunks. It is also possible. back to top . In New York City. which have occasionally been reported to have rabies. bats are the most common source of infection for people across the United States. In all cases involving rodents. Bites by these animals are usually not considered a risk of rabies unless the animal appeared sick or was behaving in an unusual manner. when raccoon rabies is widespread in an area. While raccoons. but quite rare. mouth. Of the 38 cases. and none occurred in New York City. while only 7 cats. the bat is assumed to be rabid. rabies and advice on how to capture a bat. results will determine whether the person exposed needs PEP. rats. A history of having had contact with a bat could only be documented in approximately half of the cases. hamsters. 32 were due to bats. foxes and coyotes. for people to get rabies from a scratch or from direct contact with a rabid animals saliva or nerve tissue if it gets directly into their eyes. back to top How do people get rabies? People usually get rabies from the bite of a rabid animal. Bat bites may not be obvious as their teeth are small and very sharp. skunks. dogs or other mammals. bats. 2 opossums and 1 coyote were reported. a person that is sleeping or intoxicated). A suspect encounter would include any scenario in which a bat is found in an enclosed setting with a person who may not be fully aware of its presence (i. and squirrels) are rarely found to be infected with rabies and have not been known to transmit rabies to people. or an open wound. suggesting that even limited contact with bats may be associated with transmission of the rabies virus.Which animals get rabies? Animal species most often diagnosed with rabies in the United States are wild and include raccoons. Every known or suspect encounter with a bat is considered a possible rabies exposure and is treated as such. From 1990 to 2003 there have been 38 human rabies cases acquired within the US. For more information on bats. raccoons are the principal reservoir of rabies and primarily transmit the virus to other raccoons. The vast majority of those were raccoons. see the link to the NYS DOH website listed below. the health department should be consulted before a decision is made to initiate postexposure prophylaxis (PEP). If the bat can be captured safely and tested. gerbils. foxes and coyotes are considered high-risk sources of virus. Anyone who thinks they may have been exposed to a bat or a rabid animal should contact their physician or their local health department for advice. If the bat is not available for testing. In the eastern US.e. as of January 2007. 263 animals have tested positive for rabies since 1992 when the virus was first introduced. nose. The one exception has been woodchucks or groundhogs.

varying degrees of paralysis frequently beginning at the head and neck causing jaws to hang open. and or impaired locomotion. Rabies has been transmitted through organ transplantation. One of the most recognizable signs is excessive drooling or foaming at the mouth. plants. delirium and death. vacant stare. Within days the patient may develop slight or partial paralysis. There have been eight well-documented cases of rabies transmission through corneal transplantation.. muscle tremors (especially in cats). four persons became infected and died from rabies after receiving solid organ donations from one infected donor. but this is extremely rare. hypersalivation. back to top What are the symptoms of rabies in animals? Animals with rabies most often exhibit behavior changes such as a friendly dog that becomes withdrawn or belligerent. Other signs may include a change in voice so that it is hoarse. A nonbite exposure could include a scratch. with a throaty bark or snarl. open wounds. Occasionally non-bite exposures are treated with PEP. agitation. More recently. soil. back to top What are the symptoms of rabies in humans? Early symptoms. Inhalation of aerosolized rabies virus is also a potential non-bite route of exposure. headache. stones. malaise. guano or skunk spray) of a rabid animal. confusion. but other than laboratory workers who work with the rabies virus. such as petting a rabid animal or having contact with the blood. difficulty swallowing. hallucinations.g. They may eat or chew things such as wood. dilated pupils. fever. back to top . does not constitute an exposure and is not an indication for PEP. abrasion.Can I get rabies in any way other than an animal bite? It is extremely rare for a person to get rabies from an exposure other than an animal bite. most people are unlikely to encounter an aerosol of rabies virus. convulsions. anxiety. include irritability. Other contact. urine or feces (e. or mucous membranes of the nose or eye that gets contaminated with saliva or other potentially infectious material (such as brain or other nerve tissue) from a rabid animal. hydrophobia (fear of water). or an animal that demonstrates unusual aggression. which may last for several days. or other foreign objects. excitation. an aloof animal that becomes suddenly affectionate. and sometimes discomfort or tingling at the site of the bite or exposure.

ferrets and some other animals the period during which they can shed the virus has been documented. should be discussed with a medical provider. coyote. back to top When and for how long is an animal able to spread rabies? An animal can only transmit rabies through a bite when the virus has infected the animal's brain. Once the brain is infected. This protocol may not apply to all animal species. back to top What constitutes a possible rabies exposure? A person is considered to have had a possible rabies exposure if: 1. they were bitten by a skunk. they were bitten by a dog. Animal bites from animals other than ferrets. the animal begins shedding the virus in its saliva. so any injury from an animal.How soon after infection do symptoms appear? Typically. raccoon or bat that either has tested positive for rabies or the animal is not available for rabies testing 2. fox.e. It is at this time or soon after that the animal begins to shows signs of illness. although time periods of up to several years have been reported. It is sometimes difficult to determine whether a possible rabies exposure occurred. For dogs. cat or ferret for 10 days to determine whether it could have been shedding rabies at the time of the bite. cat or ferret that is unavailable for testing or a 10 day observation period 3. the animal was not shedding rabies virus and the exposed person does not need PEP. rabies virus is present in saliva only a few days prior to the onset of their illness and up until their death. or a bat is found in an enclosed setting with a person that may not be fully aware of it's presence (i. symptoms of rabies may start to appear within 1 to 3 months of exposure. an infant. they had contact with a bat. If the animal does NOT develop rabies illness during the 10 days observation period. back to top . cats or dogs should be discussed with the DOHMH. cats. or exposure to a bat within the household. back to top How are animals tested? Animal rabies testing is done at the New York City Public Health Laboratory. a person that is sleeping or intoxicated). This allows us to observe a biting dog. In these animals.. Prior arrangements must be made through the DOHMH before samples will be accepted.

Untreated cases of rabies will likely result in death. animal bite or bat exposure)? If a physician determines that rabies exposure may have occurred. back to top How can rabies be prevented? Avoiding contact with bats and staying away from all wild and stray animals. Rabies preventive vaccine is no longer given in the abdomen. If the animal is available for observation. followed by the injection of PEP which includes rabies immune globulin (dosage depending on weight) and four doses of rabies vaccine injected into the arm muscle on days 0. and 14 after exposure. most cases of rabies will be prevented. 3. they will recommend PEP. Immediately wash the wound with soap and water and consider seeking care from your health care provider. Any animal-related injury. should be discussed with a physician to determine if rabies preventive treatment is necessary. 7. back to top What happens if I am exposed to rabies but I don't get PEP? Exposure to a rabid animal does not have to result in rabies. Preventive treatment requires prompt washing of the bite site with soap and copious amounts of water. the animal can be watched for a period for 10 days at home by the owner. have tested positive. and any household exposure or other direct contact with a bat.. address and phone number. Report the bite to the DOHMH by calling 311. name. If after 10 days the animal is still alive and healthy. click here.What is the preventive treatment for a potential rabies exposure (e. the bite victim does not need to get rabies shots. For the most recent rabies data. back to top What is the 10 day observation period? After a healthy dog or cat has bitten someone. It is also important to have domestic animals (dogs. although several cats. No rabid dogs have been reported in NYC since 1954. especially those acting abnormally may minimize exposure to rabies. This will help the DOHMH follow up with the pet owner regarding the 10 day at home observation. primarily strays. Immunosuppressed persons should receive a 5th dose of vaccine on day 28 followed by a blood test 14 to 28 days after the last vaccine to ensure an acceptable rabies antibody response. If preventive treatment is obtained promptly following a rabies exposure. you do not need to start rabies shots. cats and ferrets) vaccinated against rabies.g. back to top What should I do if I've been bitten by a healthy dog or cat? Try to get the owner’s contact information including. The health department will attempt to communicate with the pet .

. In developing countries of Africa and Southeast Asia. Animals most likely to transmit rabies in the United States include bats. If the animal will be tested. but is regularly observed and easy to identy. If during this time the animal develops signs of rabies. or any animal that appears rabid? Raccoons. of Health) • Rabies Information for Children (CDC) Rabies Definition By Mayo Clinic staff Rabies is a deadly virus spread to people from the saliva of infected animals. in most instances. you do not need to start the rabies vaccine. foxes. testing will be performed. coyotes. unless the animal tests positive for rabies. skunk. Call 311 to see if arrangements can be made to capture the animal and test it for rabies. stray dogs are the most likely to spread rabies to people.owner during this time. raccoons and skunks. bat. skunks and bats are known to transmit rabies. The rabies virus is usually transmitted through a bite. If you are bitten by one of these animals. back to top Related Information     • Rabies: Protecting Yourself and Your Pet • The Veterinary Public Health Service Website • Bat Inspection and Management (New York State Dept. Rabies testing requires that the animal be humanely euthanized. consider observing the animal for 10 days where it lives. back to top What if I was bitten by a raccoon. immediately wash the wound with soap and water and see your health care provider. back to top What if the dog or cat was a stray animal? If the animal is a healthy stray. Otherwise. call 311 to see if arrangements can be made to capture the animal so it can be observed at a shelter.

a bat that flies into your room while you're sleeping may bite you without waking you. For that reason. Based on your injuries and the situation in which the bite occurred. For instance. assume that person has been bitten. such as the mouth or eyes. This could occur if an infected animal were to lick an open cut on your skin. assume you've been bitten. Also. Even if you aren't sure whether you've been bitten. In rare cases. Causes By Mayo Clinic staff Rabies infection is caused by the rabies virus. rabies can be spread when infected saliva gets into an open wound or the mucous membranes. The virus is spread through the saliva of infected animals. you and your doctor can decide whether you should receive treatment to prevent rabies. Signs and symptoms may include:            Fever Headache Agitation Anxiety Confusion Difficulty swallowing Excessive salivation Fear of water (hydrophobia) because of the difficulty in swallowing Hallucinations Insomnia Partial paralysis When to see a doctor Seek immediate medical care if you're bitten by any animal. Infected animals can spread the virus by biting another animal or a person.Once a person begins showing signs and symptoms of rabies. If you awake to find a bat in your room. . if you find a bat near a person who can't report a bite. anyone who may have a risk of contracting rabies should receive rabies vaccines for protection. such as a small child or a person with a disability. seek medical attention. often just days before death. the disease is nearly always fatal. Symptoms By Mayo Clinic staff Rabies doesn't cause any signs or symptoms until late in the disease.

In rare cases. The animals most likely to transmit the rabies virus to people include: Pets and farm animals        Cats Cows Dogs Ferrets Goats Horses Rabbits Wild animals         Bats Beavers Coyotes Foxes Monkeys Raccoons Skunks Woodchucks There has never been a documented case of human-to-human rabies transmission. the virus has been transmitted to tissue and organ transplant recipients from an infected organ. Risk factors By Mayo Clinic staff Factors that can increase your risk of rabies include:     Traveling or living in developing countries where rabies is more common. including countries in Africa and Southeast Asia Activities that are likely to put you in contact with wild animals that may have rabies. which may help the rabies virus travel to your brain more quickly   Tests and diagnosis By Mayo Clinic staff .Animals that can transmit the rabies virus Any mammal can transmit the rabies virus. such as exploring caves where bats live or camping without taking precautions to keep wild animals away from your campsite Working in a laboratory with the rabies virus Wounds to the head or neck.

A series of rabies vaccines to help your body learn to identify and fight the rabies virus. You receive five injections over 14 days. Other pets and farm animals are considered on a case-by-case basis. Part of this injection is given near the area where the animal bit you if possible. then it doesn't have rabies and you won't need rabies shots. That way. Rabies shots include:   A fast-acting shot (rabies immune globulin) to prevent the virus from infecting you. there's no way to know whether the animal has transmitted the rabies virus to you. Treatment for people bitten by animals with rabies If you've been bitten by an animal that is known to have rabies. such as a bat that came into your home. But this will depend on several factors. Tests on the animal's . it's possible to determine whether the animal that bit you has rabies before beginning the series of rabies shots. For this reason. For instance:   Pets and farm animals. Cats. For that reason. Blood and tissue tests are used to diagnose rabies in people who have signs and symptoms of the infection. Treatments and drugs By Mayo Clinic staff There is no specific treatment for rabies infection. If the animal that bit you can't be found. Rabies vaccines are given as injections in your arm.  At the time a rabid animal bites you. can be killed and tested for rabies. treatment to prevent the rabies virus from infecting your body is recommended if the doctor thinks there's a chance you have been exposed to the virus. such as the type of animal and the situation in which the bite occurred. If the animal that bit you remains healthy during the observation period. the disease is usually fatal. you won't need the shots. Procedures for determining whether an animal has rabies vary by situation. you'll receive a series of shots to prevent the rabies virus from infecting you. Wild animals that can be found and captured. Though a small number of people have survived rabies. if it's determined the animal is healthy. dogs and ferrets that bite can be observed for 10 days to see if they show signs and symptoms of rabies. anyone thought to have been exposed to rabies receives a series of shots to prevent the infection from taking hold. it may be safest to assume that the animal has rabies. Wild animals that can be caught. Determining whether the animal that bit you has rabies In some cases. Talk to your doctor and local public health officials to determine whether you should receive rabies shots. as soon as possible after the bite.

FROM: http://rabiespoi. Call your local animal control officials or other local law enforcement to report stray dogs and cats. brain may reveal the rabies virus. dogs and ferrets can be vaccinated against rabies. you won't need the shots. Keep bats out of your home. such as guinea pigs. It's not normal for a wild animal to be friendly with people. If the animal doesn't have rabies.php?option=com_content&view=article&id=59&Itemid=64 Declaring RabiesFree Zones . Keep rabbits and other small pets. Cats. This will help keep your pets from coming in contact with wild animals. Animals that can't be found. work with a local expert to find ways to keep bats out. Seal any cracks and gaps where bats can enter your home. Don't approach wild animals. If you know you have bats in your home. Protect small pets from predators. If the animal that bit you can't be found. In other cases. so stay away from any animal that seems unafraid. In certain cases. If you're traveling to a country where rabies is common and you'll be there for a long period of time. discuss the situation with your doctor and the local health department. Ask your veterinarian how often your pets should be vaccinated. Prevention By Mayo Clinic staff You can reduce your risk of coming in contact with rabid animals. Report stray animals to local authorities. Consider the rabies vaccine if you're traveling. it may be safest to assume that the animal had rabies and proceed with the rabies shots. it may be unlikely that the animal that bit you had rabies and it may be determined that rabies shots aren't necessary. These small pets can't be vaccinated against rabies. Wild animals with rabies may seem unafraid of people. Keep your pets confined. inside or in protected cages so that they are safe from wild animals.org/index. Keep your pets inside and supervise them when outside. Here's how:        Vaccinate your pets. ask your doctor whether you should receive the rabies vaccine.

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Rabies Fast Facts .

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the highest in the region) .000 population Region IV-A had the highest incidence of rabies (in 2007).3.4. Tarlac ranked second at the regional level with an incidence of 30 and a rate of 3. (rate of 2 per 100.Reported Rabies Cases in the Philippines for 2007 were 833 (with a rate of 1 per 100.2. Reported Rabies Cases in Angeles City for 2007 was 26 (with a rate of 8.000 population) Bulacan had the highest number of reported rabies cases for 2007 with a total of 126 but the rate was lower at 6. Region X had the 2nd highest incidence of rabies Region III ranked 3rd in national rabies morbidity in 2007 with 190 cases.

We had gained notoriety among international communities as a nation with high endemicity (or prevalence) of rabies. otherwise known as the Rabies Act of 2007 which seeks to eradicate rabies in the Philippines by 2020. In 2007. the Philippines ranked fifth in the rabies list of the World Health Organization in terms of prevalence in a specific area. In 2006. DOH recognizes that rabies remains a public health problem in the country despite the enactment of Republic Act 9482.ph RABIES: THE PHILIPPINE SITUATION Rabies is a dangerous disease of animals transmissible to humans through bites. In 2001. In the Philippines. At least 50% of victims are children aged 5 to 14 years.Reference: Field Health Service Information System Annual 2007 National Epidemiology Center. In recent years. the most common sources of infection are dogs and cats. He died in a London hospital. It is transmitted to other animals through contact with virus-laden saliva from a rabid animal. two Japanese nationals were infected after being bitten by dogs in the Philippines. there were 833 reported rabies cases in the country with a rate of 1.0 per 100. Manila www. scratches or licks on open wounds. Department of Health.000 population. a long-time resident of the UK contracted rabies after being bitten by a dog in the Philippines. . The last indigenous case of rabies infection in the UK occurred in 1902 while that of Japan was in 1954.gov. The Department of Health (DOH) estimates that 300 to 600 Filipinos die of rabies each year.doh. Both countries have declared themselves rabies-free a long time ago.

Many. still believe that garlic and a few drops of vinegar can cure rabies. on Monday. Rabies is a highly misunderstood disease among Filipinos. Only a few know that an inch-long scratch or a playful lick on an open wound can cost a person his/her life. Poypoy has not died in vain. PRESCRIBING PENALTIES FOR VIOLATION THEREOF AND APPROPRIATING FUNDS THEREFOR Be it enacted by the Senate and House of Representatives of the Philippines in Congress assembled: SECTION 1. . the nineteenth day of February. two thousand seven. 4654 Republic of the Philippines Congress of the Philippines Metro Manila Thirteenth Congress Third Special Session Begun and held in Metro Manila. – This Act shall be known as the “Anti-Rabies Act of 2007”. especially those in rural areas.people believed to have the power to eliminate the virus from the body with the use of a stone (called batong buhay) or by sucking with the use of a carabao horn or an animal bone are widely accepted as a wiser and more economical alternative to post-exposure treatment or vaccination. 2541 H.9482 AN ACT PROVIDING FOR THE CONTROL AND ELIMINATION OF HUMAN AND ANIMAL RABIES. REPUBLIC ACT NO.Rabies is highly and easily preventable in this day and age but once the signs and symptoms appear. 25 March 2009 16:33 Anti-Rabies Act of 2007 Date 2007-06-22 (RA 9482) S. Tandoks or faith healers . rabies is almost always fatal and irreversible. Title. His shocking and dramatic exit from this world has opened our eyes to the realities surrounding this disease. No. No. Last Updated on Wednesday.

or the genital organs. 3. health workers. (f) Impound refers to seize and hold in the custody of the law. (j) Rabies refers to a highly fatal disease caused by a lyssa virus. and other neurological manifestations. streets. (c) Direct Supervision refers to range supervision where physical presence of the veterinarian within the barangay is necessary. (k) Rabies transmission refers to the transmission or passage of the Rabies virus through a bite by an infected animal.SEC. police officers or government veterinarians. – For the purpose of this Act. the mouth. (b) Concerned Officials refers to barangay officials. – It is the declared policy of the State to protect and promote the right to health of the people. harboring or having charge. malls. (e) Euthanasia refers to the process of painless death to Dogs and other animals. cuts or grips with its teeth so that the skin of a person has been wounded. a system for the control. Towards this end. and eventual eradication of human and animal Rabies shall be provided and the need for responsible pet ownership established. the following terms shall mean: (a) Bitten refers to an act by which a Dog seizes. prevention of the spread. or through contamination with virus-laden saliva on breaks in the skin and of mucous membranes such as the eyes. (h) Pound refers to a public enclosure for stray animals. hydrophobia and aerophobia. (g) Owner refers to any person keeping. etc. 2. Declaration of Policy. SEC. (d) Dog refers to a common quadruped domestic animal belonging to the order carnivora (male or female). markets. the lips. (i) Public Place refers to any place open to the public like parks. scientifically known as canis familiaris. Definition of Terms. transmitted mainly through the bite of an infected animal and is characterized by muscle paralysis. . pierced or scratched. care or control of a Dog including his/her representative.

(q) Veterinary or Human Barbiturates refer to drugs that depress the function of the central nervous system.T. which include local wound care. (p) Stray Dog refers to any Dog leaving its Owner’s place or premise and no longer under the effective control of the Owner. (2) establishment of a central database system for registered and vaccinated Dogs. The program shall be a multi-agency effort in controlling and eliminating Rabies in the country. with or without antiRabies immunizing agent. – It is hereby mandated that there shall be a National Rabies Prevention and Control Program to be implemented by a multiagency/ multi-sectoral committee chaired by the Bureau of Animal Industry of the Department of Agriculture. with modern day rabies vaccines or Rabies immunoglobulin.E. .) refers to Rabies vaccination administered before an exposure to Rabies to those who are at high risk of getting Rabies. (m) Rabies Vaccination of Dogs refers to the inoculation of a Dog with a Rabies vaccine by a licensed government or private veterinarian or trained individual under the direct supervision of a licensed veterinarian. National Rabies Prevention and Control Program. (o) Pre-exposure Prophylaxis (P.(l) Rabies Vaccination/Immunoprophylaxis of Humans refers to the inoculation of humans. 4. Among its component activities include: (1) mass vaccination of Dogs. The services of the said trained individual shall be limited only to Rabies Vaccination Injection in Dogs and only during government mass vaccination campaigns. SEC. Stray and unvaccinated Dogs. Rabies vaccine. (n) Post-exposure Treatment (P. field control and disposition of unregistered.P. by a trained doctor or nurse under the supervision of a qualified medical practitioner.) refers to an anti-Rabies treatment administered after an exposure to Rabies.E. ( (3) impounding.

as well as Local Government Units (LGUs) with the assistance of the Department of Environment and Natural Resources (DENR). Non-Governmental Organizations (NGOs) and People’s Organizations (POs). for accurate record purposes. (3) Undertake free anti-Rabies Vaccination of Dogs giving priority to high . – All Pet Owners shall be required to: (a) Have their Dog regularly vaccinated against Rabies and maintain a registration card which shall contain all vaccinations conducted on their Dog. Department of Health (DOH). (2) Ensure the availability and adequate supply of animal anti-Rabies vaccine at all times. (e) Within twenty-four (24) hours.(4) conduct of information and education campaign on the prevention and control of Rabies. – The following government agencies. (5) provision on pre-exposure treatment to high risk personnel and Post Exposure Treatment to animal bite victims. SEC. Responsibilities of Pet Owners.) of schoolchildren aged five to fourteen in areas where there is high incidence of rabies as well as the (7) encouragement of the practice of responsible pet ownership. Responsibilities of Government Agencies. (d) Be a responsible Owner by providing their Dog with proper grooming.P. shall be tasked to: A. Department of Agriculture (1) Improve and upgrade existing animal Rabies laboratory diagnostic capabilities to ensure better services to the people. adequate food and clean shelter. (b) Submit their Dogs for mandatory registration. The program shall be implemented by the Department of Agriculture (DA). (c) Maintain control over their Dog and not allow it to roam the streets or any Public Place without a leash. Department of the Interior and Local Government (DILG) and Department of Education (DepEd).E. SEC. report immediately any Dog biting incident to the Concerned Officials for investigation or for any appropriate action and place such Dog under observation by a government or private veterinarian. 6. 5. (6) provision of free routine immunization or Pre-Exposure Prophylaxis (P. (f) Assist the Dog bite victim immediately and shoulder the medical expenses incurred and other incidental expenses relative to the victim’s injuries. which shall jointly implement the National Rabies Prevention and Control Program.

(5) Develop and maintain a human Rabies surveillance system. (8) Conduct research on Rabies and its control in coordination with other agencies. but not limited to. DILG. (5) Establish and maintain Rabies free zone in coordination with the LGUs. B. (9) Formulate minimum standards and monitor the effective implementation of this Act. DepEd. Department of Health (1) Ensure the availability and adequate supply of DOH pre-qualified human Anti-Rabies vaccine in animal bite treatment centers at all times and shall coordinate with other implementing agencies and concerned NGOs for this purpose. veterinarians. DepEd. (6) Encourage collaborative activities with the DA. NGOs. DENR. (4) Maintain and improve animal Rabies surveillance system. (7) Immediately approve the registration of Veterinary and Human Barbiturate drugs and veterinary euthanasia drugs in coordination with the PDEA. DENR. (3) Provide Pre-Exposure Treatment to high-risk personnel. laboratory staff. such as. DILG. vaccinators and other persons working with Rabies virus for free. POs and other concerned sectors. (6) Immediately facilitate for the approval of the sale and use of Veterinary and Human Barbiturate drugs and veterinary euthanasia drugs by the DOH and the Philippine Drug Enforcement Agency (PDEA). POs and other concerned sectors. (7) Strengthen the training of field personnel and the Information Education and Communication (lEC) activities on Rabies prevention and control and responsible pet ownership. (10) Encourage collaborative activities with the DOH.risk depressed areas. NGOs. Department of Education (1) Strengthen Rabies education program through school health . animal handlers. C. (4) Coordinate with the DA in the development of appropriate health education strategy to inform the public on Rabies prevention and control and responsible pet ownership. (2) Provide Post-Exposure Treatment at the minimum expense to individuals bitten by animals suspected of being rabid which will consist of the initial vaccine and immunoglobulin dose.

(2) Assist in the Dog mass immunization campaigns in the community. opt to share the expense of having a veterinary office. 7. (4) Integrate proper information and education on responsible pet ownership in the relevant subjects in the Elementary and High School levels. on their own. shall. SEC. particularly on the financing of supplies and human and Dog vaccines needed for immunization. NGOs. (3) Ensure that Dogs are leashed or confined within the premises of the Owner’s house or Owner’s fenced surroundings. POs and other concerned sectors. – LGUs. (3) Encourage collaborative activities with the DA.teaching/curriculum. That the other municipalities shall. shall: (1) Ensure that all Dogs are properly immunized. (12) For purposes of ensuring the administrative feasibility of implementing the provisions of this Act and subject to . 8485 or “The Animal Welfare Act of 1998”. city and firstclass municipality: Provided. (2) Strictly enforce Dog Impounding activities and field control to eliminate Stray Dogs. DILG. registered and issued a corresponding Dog tag for every i mmunized and registered Dog. (5) Ensure the enforcement of Section 6 of Republic Act No.” (7) Prohibit the trade of Dogs for meat. establish a Dog Pound or opt to share the expense of establishing and maintaining a Dog Pound with other adjoining municipalities and/or with private animal shelters and control facilities. (11) Require pet shops to post information regarding Rabies and responsible pet ownership. (4) Allocate funds to augment the implementation of the National Rabies Prevention and Control Program. in accordance with Section 9 herein: Provided. (10) Appoint a veterinarian and establish a veterinary office in every province. Responsibilities of the LGUs. DOH. in their respective localities. (8) With respect to cities and first class municipalities. (6) Enact additional local ordinances that will support the National Rabies Prevention and Control Program that should include the regulation of treatment locally known as “tandok. establish and maintain a Dog Pound where Impounded Dogs shall be kept. DENR. on their own.That the other municipalities. (9) Prohibit the use of electrocution as a euthanasia procedure.

(5) and (6) hereof. – The agencies tasked to implement the anti-Rabies program shall seek the assistance and participation of NGOs in any of the following activities: (1) Community mobilization. SEC. (4). (4) Promotion of the anti-Rabies campaign during pet or any animal shows. (3) A fee shall be paid by Owners of Impounded Dogs to the LGU concerned. Stray or unvaccinated Dogs shall be impounded and kept in the LGU’s designated Dog Pound. with the assistance of an animal welfare NGO. (6) Any other activities geared towards the prevention and complete eradication of Rabies. as well as the achievement of the objectives envisioned in this Act. when feasible. it is hereby mandated: . Any and all fines collected pursuant to this Act shall be used for the enhancement of the National Rabies Prevention and Control Program within the locality concerned. The DILG shall ensure compliance of these responsibilities by the LGUs. there is the need to control the Dog population and minimize the number of unwanted Stray Dogs. otherwise known as the “Animal Welfare Act of 1998”. (2) Health education/information dissemination on Rabies and responsible pet ownership. As such.paragraph 8 of this Section. – In furtherance of the policy of this Act to eradicate Rabies. Field Control and Disposition of Unregistered. 8485. subject to the pertinent provisions of Republic Act No. Dog Population Control. (3). SEC. (3) Mass anti-Rabies campaign. taking into consideration the following guidelines: (1) Unregistered. Assistance of NGOs and the Academe. Impounding. SEC. (2) Impounded Dogs not claimed after three days from the Dog Pound shall be placed for adoption to qualified persons. Stray or unvaccinated Dogs shall be put in Dog Pounds and disposed of. Stray and Unvaccinated Dogs. 9. 8. – Unregistered. 10. or otherwise disposed of in any manner authorized. the LGU shall collect the fines imposed under Section 11 subparagraphs (1). (5) Surveillance/reporting of Rabies cases in animals and humans. pursuant to Section 7 hereof.

00) for each incident. (9) If the violation is committed by an alien. Penalties.00).00) per Dog and subjected to imprisonment for one to four years. (6) An impounded Dog shall be released to its Owner upon payment of a fine of not less than Five hundred pesos (P500. DILG. (8) Any person found guilty of using electrocution as a method of euthanasia shall be fined not less than Five thousand pesos (P5.00) per act and subject to imprisonment for one to four years.000. DOH.000. at the expense of the Pet’s Owner.00). (2) That the LGUs shall provide an incentive system whereby Owners of Dogs which have been spayed or neutered will be given a subsidized or discounted pet registration fee.000.000. – (1) Pet Owners who fail or refuse to have their Dog registered and immunized against Rabies shall be punished by a fine of Two thousand pesos (P2. (7) Any person found guilty of trading Dog for meat shall be fined not less than Five thousand pesos (P5. including the option of spaying or neutering their Dogs. (2) Pet Owners who refuse to have their Dog vaccinated against Rabies shall be liable to pay for the vaccination of both the Dog and the individuals Bitten by their Dog. 11. (5) Pet Owners who refuse to put leash on their Dogs when they are brought outside the house shall be meted a fine of Five hundred pesos (P500. (3) That Dogs which have been impounded three times shall only be released after having been spayed or neutered.00). .000. (3) Pet Owners who refuse to have their Dog put under observation after said Dog has Bitten an individual shall be meted a fine of Ten thousand pesos (P10. he or she shall be immediately deported after service of sentence without any further proceedings. LGUs. (4) Pet Owners who refuse to have their Dog put under observation and do not shoulder the medical expenses of the person Bitten by their Dog shall be meted a fine of Twenty-five thousand pesos (P25.000.(1) That the DA.00).00) but not more than One thousand pesos (P1. with the assistance of NGOs and POs shall undertake an educational and promotional campaign on responsible Pet Ownership. SEC. DepEd.

SEC. such sums as may be necessary for its continued implementation shall be included in the annual General Appropriations Act. NGOs and POs shall issue the necessary rules and regulations within sixty (60) days from the effectivity of this Act. 12. – The DA. YABES House of Representatives . Separability Clause.000. JOSE DE VENECIA JR. Speaker of the House Senate of Representatives This Act which is a consolidation of Senate Bill No. ROBERTO P.00) necessary to implement the provisions of this Act shall be initially charged against the appropriations of the DOH. – The amount of One hundred million pesos (P100. 14. 15. DENR. Appropriations. For the LGUs. SEC. – In case any provision of this Act is declared unconstitutional. Effectivity. the other provisions shall remain in full force and effect. DILG and DepEd under the General Appropriations Act. 4654 was finally passed by the Senate and the House of Representatives on February 9. 13. DILG. DA. Implementing Rules and Regulations. in coordination with the DOH. – This Act shall take effect fifteen (15) days after its publication in the Official Gazette or in at least two newspapers of general circulation. 2007 respectively. 2541 and House Bill No. whichever comes earlier. the requirements shall be taken from their Internal Revenue Allotment and other local funds. Thereafter. DepEd.000. NAZARENO Secretary General OSCAR Secretary of the Senate MANNY President of the VILLAR G. SEC. Approved. 2007 and February 20. SEC.

and anxiety and agitation. symptoms become more distinctive such as hallucinations. fear of water (hydrophobia). Of these. delirium. coma. muscle spasms in the face and neck. Region V (29). especially dogs. heart and respiratory failure. With the Christmas vacation coming. Human rabies is a deadly disease and over 99 percent of people who develop the symptoms of the disease die. The symptoms of human rabies are trivial such as fever. Region III (36). Matibag 20 Views: 630 The health department of the Philippines reported 264 human rabies cases between January and 23 October this year. paralysis. the following areas had the highest reported cases of rabies: Region IV-A (49). seizures. . fear of air (aerophobia). For this year. health officials are alarmed of the possible surge in the number of cases. through bites or licking of open wounds. cough or sore throat. abdominal pain. 16 of whom succumbed. burning of itching sensation at the site of the bite. and Metro Manila (20). pain.Approved: GLORIA MACAPAGAL-ARROYO President of the Philippines Rising rabies deaths alarms health dept Manila : Philippines | Nov 18. Health officials say that it is during school vacation time that cases of rabies are on the rise because children play with the unvaccinated animals. 206 died due to the virus that is transmitted by the infected saliva of animals. 2010 at 9:34 PM PST By Gino C. Later.

In 2008.478 Bangladesh-22. rats. Matibag is based in Manila.843 Sri Lanka-2. Bats. Capture the animal and observe for 10 to 15 days for behavioral changes.042 Myanmar-1.377 Indonesia-1. fishes. Philippines. Report Credibility FROM: DOH . and reptiles cannot transmit the disease. elephants. Japan.208 Some of the countries that have successfully eradicated rabies are Australia. and monkeys.183 Pakistan-2. Do not kill the offending animal.995 Philippines-5. Once bitten. Birds. Ask a veterinarian or any authorities for further action toward the animal. too.The disease is also preventable through adequate vaccination of warm-blooded animal pets like dogs. National Capital Region. cats. the 10 countries with highest human deaths due to rabies are: India-244. and the United Kingdom. rabbits. chickens. and is a Stringer for Allvoices.900 China-13. Immediately go to the doctor for medical advice.683 Thailand-1. Gino C. New Zealand. it is strongly advised that the bite wound be thoroughly washed with soap and running water for 15 minutes. and horses may harbor the rabies virus.658 Vietnam-5.

It remains a serious public health problem in the country which causes the death of between 200 . There is yet no way of immediately segregating those who had acquired rabies infection from those who had been bitten by nonrabid sources. 2005-2001. Manila. . Meanwhile. Prescribing Penalties for Violation Thereof and Appropriating Funds Therefore) on May 27. A threepronged approach – dog immunization. and the Philippines ranked No. animal control and other public health measures are undertaken because of the high case fatality rate for rabies. Dogs remain the principal animal source of rabies. Further. The battlecry is “SUMUNOD SA BATAS RABIES”. It is hard to make a definite early diagnosis of rabies. 2007.500 Filipinos annually. and the Philippines ranked number six among the countries with the highest reported incidence of rabies in the world. Thus. 9482 (An Act Providing for the Control and Elimination of Human and Animal Rabies. the Department of Health. local government units and partner agencies will advocate for the full implementation of the law nationwide. all efforts should be made to contain rabies at its source. Philippines.March is Rabies Awareness Month and September 28 is World Rabies Day! March is Rabies Awareness Month and September 28 is World Rabies Day! Rabies is 100% fatal viral disease affecting the nervous system of humans and animals. Department of Agriculture – Bureau of Animal Industry. the said agencies are also gearing up their efforts towards the goal of declaring the Philippines as Rabies-Free by the 2020. 6 among the countries with the highest incidence of rabies in the world. and the disease almost always leads to death even when vaccination and medical management are given as soon as the symptoms have set in. the cost of postexposure vaccination against rabies can be prohibitive. This next three years. Although a great majority of animal bites are non-infected with the rabies virus. Rabies Although rabies is not among the leading causes of disease and death in the country it has become a public health problem of significance for two reasons: it is one of the most acutely fatal infections which causes the death of between 200-500 Filipinos annually. responsible pet ownership and dog-bite victim immunization – is still recommended for all government units to control rabies in their areas of responsibility. Source: National Objectives for Health. The rabies prevention and control program received its needed boost when President Gloria Macapagal-Arroyo signed into law the Republic Act No. with universal immunization of dogs and responsible pet ownership as major preventive measures. Department of Health. Philippines.

it should not be killed immediately and should instead be kept on a leash or caged for observation for 14 days. Does a person bitten by a rabid person need to be given anti-Rabies immunization? Yes.Rabies. Do we need to kill the dog immediately? No. NCDPC Does a person bitten by a rabid person need to be given antiRabies immunization? Yes. dies within 14 days. » 1285 reads Is rubbing the bite wounds with garlic and vinegar useful in the prevention of Rabies? . The observation period for dogs or cats is usually 14 days starting from the day the animal has bitten a person. which is rabid at the time of the bite usually. it means that it is not rabid and has not transmitted the virus to the person. Studies have shown that a dog or cat. A rabid person can transmit the Rabies virus to another person and need to be given antiRabies immunization » 972 reads Does a person bitten by a rabid person need to be given antiRabies immunization? 10. If the dog is apparently healthy. » 1662 reads Do we need to kill the dog immediately? 8. A rabid person can transmit the Rabies virus to another person and need to be given antiRabies immunization » 1627 reads What is the difference between the observation period and the incubation period? The observation period is the period of time that the dog or cat is observed for signs of Rabies. If it remains to be alive within that period.

contamination of mucous membranes. the risk of Rabies infection will be greatly reduced. NCDPC What is Rabies post-exposure treatment? . irritation. » 1257 reads Is Rabies preventable? Yes. This is believed to suck out the Rabies virus. Once signs of brain involvement are manifested. The effect of the immunoglobulin is only short term. further introducing dirt into the wound). which should be administered within the first seven days of active immunization. Rabies. the Rabies victim dies within 1-3 days. By administering vaccine and immunoglobin at the right time to an animal bite victim. lips and mouth) in order to provide immediate protection against Rabies. Garlic and vinegar need not be applied on the bite wound for they will cause more injury (swelling. multiple/single deep bites. Records have shown that patients who received “tandok” treatment died either of Rabies or Tetanus. One important measure that will be of big help in reducing the risk of getting Rabies is by immediately washing the bite wound with soap and water. » 1526 reads Is Rabies curable? No. » 1725 reads What is active and passive immunization? Active immunization or vaccination aims to induce the body to develop antibodies against Rabies whose effect lasts for 1 to 3 years. » 1254 reads Is “tandok” effective in the prevention of Rabies? No. “Tandok” is folk medicine done by placing a deer horn over the wound. Rabies can be prevented.No. By washing the wound immediately with soap and clean water. licks of the eyes. which only means that “tandok” is not effective. Passive immunization is the process of giving an antibody to persons with Category III exposure (head and neck bites.

Post-exposure treatment is given to persons who are exposed to rabid animals. Carefully observe the animal for 14 days for physical symptoms described . A dog becomes depressed. and symptoms include the absence of appetite and difficulty in breathing. a person should seek treatment immediately after bitten by a rabid animal. The dumb type of rabies is the total opposite of the furious type. The Department of Health (DOH) and other public health organizations hold annual seminars to educate the people about rabies. Of course. There are two types of rabies: the furious type and the dumb type. active immunization (vaccination) and passive immunization (administration of rabies immunoglobin). Dogs with the furious type of rabies become wild and uncontrollable. It can also enter the body through a person’s eyes and mouth. even though they normally have a friendly disposition. Consult a veterinarian for the management of the biting dog. The most obvious sign would be the hanging of the tongue and continuous drooling. Consult a physician or go to your nearest Animal Bite Center for immunization. with approximately 600 citizens dying of it every year. The victim may also be given antibiotics and anti-tetanus immunization. Rabies is a rampant health problem in the country. It consists of local wound treatment. Dogs are the main sources of rabies in the country. lethargic and tends to hide in quiet. confine him in a cage or at least leash him in an isolated area. b. if indicated. It roams around aimlessly and will snap at or bite anyone who crosses its path. The lack of discipline towards animal care and the fact that animals are allowed to roam around freely in the streets are the main culprits behind the high incidence of rabies in the Philippines. what should be properly done? a. A dog becomes restless and has difficulty eating and drinking. To determine whether a biting dog is rabid or not. Let us examine the various rabies symptoms. Antiseptics may be applied. the most obvious and popular symptoms of rabid dog is the continuous foaming of the mouth. isolated places. » 1298 reads If bitten by a stray animal. Immediately wash the bite wound with soap and clean water. A dog with this type of rabies will die suddenly without any indication beforehand. which is why households are always encouraged to have their dogs vaccinated and restricted within their properties. c. Since rabies is a fatal disease which can kill those who get infected with it. Rabies is usually transmitted from a dog’s saliva and enters the body through breaks in the skin.

To prevent the incidence of rabies in your area. vomiting and headache. . make sure to get medical attention immediately. An infected person will experience dysfunction in the nervous system such as hallucination and paralysis. the signs of infection include: fever. nausea. it is most likely rabid. If bitten by a rabid dog. make sure to have your dogs vaccinated every year and keep them within the confines of your home or property.above. In humans. If the dog dies within two weeks. bring the dog to a veterinarian for proper observation. Better yet.

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