Dr. Muhammad Mahtab Hossain Mazed

World Rabies Day 24 Saturday (September 28). Since 2007, World Rabies Day has been observed in 12 Asian countries including Bangladesh. This day is being celebrated with the aim of increasing public awareness and prevention and eradication.

About 60,000 people die every year due to rabies. About two thousand of them died in Bangladesh. Every year, about three lakh people are at risk of rabies after being bitten by dogs and cats. You will be surprised to know that the death rate of rabies patients in Bangladesh is the second highest in the world after India. But according to experts, this number is much more. Because in Bangladesh no comprehensive system of data collection and storage of rabies has been developed even today the mortality rate in cases of rabies is almost 100%. That is, once the symptoms appear, it is almost impossible to save the patient. So it is important to know some important things about rabies.

> What is rabies?
Rabies, also known as hydrophobia, is an acute viral infection that is almost always fatal. It comes under the category of infectious diseases and is transmitted by farm or wild animals; Usually carnivores such as dogs, cats, foxes, raccoons. It is found mostly in Africa and parts of Southeast Asia. Islands such as Australia, New Zealand, Iceland, Taiwan, Japan and Cyprus do not have rabies. It is classified under zoonotic diseases (zoonotic means related to animals).

> Causes of rabies
Rabies in humans is caused by the bite of a rabid animal. The virus spreads through animal saliva. Farm animals such as dogs, cows, horses, goats, rabbits and wild animals such as jackals, bats, coyotes, foxes and hyenas can spread rabies.

Handling rabies virus in the laboratory, exploring caves that may harbor bats, or camping in areas where wild animals are present are common situations in which a rabid animal bite occurs.

Human-to-human transmission has not been documented. If a rabid animal licks an open wound on a person, the virus can be transmitted. Head and neck injuries are more dangerous because the infection can quickly reach the brain.

> Signs and symptoms of rabies

Signs and symptoms of rabies do not appear until late in the course of the disease, during which time the virus spreads to the brain, causing encephalitis and death. Rabies has an incubation period, meaning that it lies dormant in a person's body for a few days before symptoms and signs appear. Primary symptoms 1. hoarse voice
2. irritable mood
3. Tendency to bite or attack others unnecessarily
4. Aversion to food
5. unusual speech
6. Wandering aimlessly
7. Fear of water despite thirst
8. Aggravation of fear when light comes in contact with air
9. Likes to be alone, hidden from people's eyes, in the dark.
10. Convulsions and salivation etc.

> Diagnosis of rabies
If you are bitten by a stray dog or wild animal, it is wise that the animal has rabies and the person should be vaccinated immediately to save his life. If the animal is a pet and it can be verified from the owner or veterinarian that the animal is not rabid, only in this case the person has not been vaccinated.

Securing or capturing the animal after biting a person is extremely helpful because the animal can be turned over to a local agency to determine if it has rabies.

Your doctor will ask you to describe the animal's behavior (was it friendly or angry) because wild animals are unlikely to be friendly to humans. He or she will also confirm how you got the bite and what happened to the animal – did it run away or was it caught? If the animal is caught, it can be tested for signs of rabies and if found healthy, the victim can be spared vaccination shots.
> If someone in the family is afraid of water

Caregiver should be careful during his treatment. In particular, the leftover food from the affected patient's plate should not be eaten. Items used by the patient should be washed carefully. But one thing must be remembered, if the hand is cut, the attendant should be more careful in treating the patient. Because germs can spread in the body through the cut part.

> Rabies investigation
Rabies antigen can be detected using a small tissue sample of the skin using a method called immunofluorescence. The virus can be isolated from the saliva of an infected patient.

> What to do if affected

1. If bitten by any wild animal including dogs, cats, foxes, beggars, monkeys, wash the wound with running water for at least 15/20 minutes with alkaline soap (the alkali dissolves the cells of the rabies virus). It kills 70-80 percent of germs.

2. Apply any iodine/antiseptic cream within the 'zero hour' of the bite or scratch, i.e. as soon as possible to be risk-free.

3. If the bite is deep or bleeding, antirabies vaccine with rabies immunoglobulin (RIG) should be given to the wound as soon as possible. In case of excessive bleeding, measures should be taken to stop it.

4. The fear of the affected person should be removed. The animal affected by rabies should be killed and buried in the ground.

5. Symptoms of rabies usually appear between 9 and 90 days after the bite. So treat before symptoms appear.

> which cannot be done

1.No saline, ice, sugar, salt etc. alkaline substances can be used on the wound.

2. Batiprada, Panparada, Chiniprada, Michariprada, Jharfunk etc. cannot save anyone from water rabies.

3. The wound should never be cut, suctioned or bandaged with anything else. It can cause infection instead.

4. Ice, electric shock should not be applied to the wound. Hands and feet cannot be tied.

Finally, rabies is a serious brain disease that cannot be neglected. Pregnant, lactating mothers, new-born children, elderly people can also take the vaccine. Even if there is any doubt or question, it would be wise to get vaccinated considering the severity of the disease. So we must remember one thing, we should not bandage or stitch the wound. Since there is no treatment for this disease, it is not right to waste precious time by reading amulets, amulets, pani-thala-kala etc. Today many countries of the world have been freed from the scourge of the disease by adopting modern preventive treatment against rabies.

The writer is a, physician, columnist and researcher Founder and Chairman, Jatiya Rogi Kallyan Society