Rabies virus: Early post-exposure prophylaxis saves lives

Rabies is a life-threatening disease in humans and warm-blooded animals, including dogs and cats.

The disease is acquired through an infectious bite, scratch or exposure of mucous membranes to the rabies virus. Saving the lives of humans and animals depends on early diagnosis, timely administration of PEP to humans and increasing dog vaccination coverage to 70% and more.

PEP a life-saving treatment bouquet for humans, is an expensive intervention consisting first of, proper essential wound management then an assessment to determine the need for administering a dose of human rabies immunoglobulin (RIG) and human rabies vaccines (HRV) on the day of exposure and then vaccine continued for victims for subsequent days (day 3,7 and 14) by qualified health personnel. PEP is required for both bite and non-bite exposure to the virus, irrespective of the duration between treatment initiation.

Few rabies virus-exposed victims have been shown to access or initiate PEP within 24 hours of exposure. While some victims may be non-compliant in completing the entire PEP regimen, which is detrimental, some health facilities may not have the PEP or its full complement, especially in rural areas where dog-to-human interactions are more.

Poor health-seeking behaviour and poor rabies case management have been the cause of some rabies deaths. Proper rabble case management is important for human survival when bitten and should be strictly adhered to irrespective of wound size. We outline here practical and basic steps to undertake in bite or wound management before receiving PEP together with other precautions.
Step-by-Step Basic Wound Management.

1. Wash or irrigate the wound area with soap under running water for 3 minutes immediately after exposure and leave the wound uncovered
2. Identify the dog that bit you: Note whether it is a stray dog or owned,
3. Report to the nearest hospital or public health clinic for healthcare
4. Ask to receive PEP
5. A continuous combination of RIG and human rabies vaccine will be given to you if you have never been vaccinated.
6. Report to the nearest government Vet Clinic with the dog owner. The dog’s pet passport for vaccination records will be checked.
7. The dog may be quarantined at the facility, or the owner will be made to monitor the dog for up to 2 weeks at home, depending on the assessment made in the facility
8. Ensure completion of all PEP injections.
9. Precautions and responses;
10. Report non-cooperating dog owners to the nearest Police station
11. If it is a stray dog, take all PEP treatments to stay safe
12. Children should be taught not to play with or touch dogs without their owners’ consent and presence
13. When kids and dogs meet, always ensure adult supervision
    
    including you in the fight against rabies. Our team from the Council for Scientific and Industrial Research – Animal Research Institute believes that the predicament of death due to rabies can be eliminated by basic wound management, which is simple to self-initiate. Further, onward treatment with PFP in a health facility and compliance to receiving the full PEP regimen is essential for human survival from rabies exposures.
    
    Authors:
    Dr. Hilda Chene Asa (email: hildaoheneasa@gmail.com) Veterinary Surgeon (Principal Technologist)
    
    Dr. Jonas Bedford Danquah (email: jonydan4@yahoo.com) Public Health/Biomedical Scientist (Research Scientist)
    
    Dr. Jennifer Atua Afrifa Yamoah (email: jofor763@gmail.com) Biochemist/Biomedical Scientist (Research Scientist)
    
    This article is published in commemoration of World Rabies Day which falls on September 28