Sunday, October 14, 2012

Singapore - Rabies is a risk to man, and not just man's best friend

SINGAPORE: Rabies, which is often associated with animals, is a viral disease that kills over 55,000 people each year, according to the World Health Organization.

Most of the deaths occur in Africa and Asia, with India, China, Indonesia and Thailand being one of the high-risk areas listed by the UK-based Health Protection Agency.

And travel, apart from poverty is reported as one of the biggest risks in contracting rabies, with more travellers choosing to avoid tourist spots, for the rough and tumble of outback adventures and eco-tourism.

"We receive calls to our Assistance Centre related to animal bites nearly every day" said Dr Jonathan O'Keeffe, Medical Director at International SOS, a global medical-assistance company.

Although dogs are often associated with rabies, the virus can be picked up from bats, with contact from saliva onto broken skin being the usual mode of infection.

"In countries with endemic rabies, all animal bites and scratches and even a lick to broken skin must be taken seriously. If medical attention is not sought immediately and the patient contracts Rabies, the disease is fatal."

No tests are available for early diagnose of a rabies infection, which means prevention is the only option.

"It is important to get rabies vaccination before travelling, especially to places where rabies is endemic, like Bali or rural parts of Nepal or Thailand," advises Dr David Teo, Medical Director for Singapore and Malaysia at International SOS, who has come across visitors to Bangkok and Bali who've been bitten by animals.

In one case, Dr Teo recalled "a business traveller was having a meal out in Bangkok when his toe was bitten by a rat under the dining table".

"He was treated for possible rabies expose in a medical centre in Bangkok where his wound was thoroughly cleaned and rabies immunoglobulin and vaccination treatment was administered straight away".

Immediate treatment is crucial with the WHO recommending a minimum of 15 minutes with soap and water, iodine or other substances that would kill the rabies virus.

"The case fatality rate in humans for rabies is very high" said Dr Teo adding, "There are very few documented human survivors after infection with rabies".

What makes the rabies risk in humans even scarier is the fact that symptoms do not appear immediately and may be dismissed as just a fever or a bad skin infection.

"One to three months after contracting rabies, non-specific symptoms such as fever, tingling or numbness near the bite might develop.

"Eventually it causes delirium, convulsions, coma and death," said Dr Teo.

While rabies is more commonly transmitted from an infected animal, getting the deadly disease after being bitten from an infected human is also "theoretically possible" said Dr Teo who also points out that "no laboratory documented cases have been reported thus far".

According to the WHO, it is also not possible for a person to contract rabies by eating meat from an infected animal

The best protection against rabies is a preventive vaccination which takes approximately a month to complete.

Dr Teo also advises travellers to be wary of wild or stray animals, especially those which may appear sick or behaving abnormally.

While not all animal bites will infect one with rabies, but as Dr points out an animal's saliva could contain "other diseases aside from rabies."

Even after contacting rabies, a person's life could still be saved with early treatment that Dr Teo said could run from a few hundred dollars to even thousands of dollars if the rabies vaccination has to be flown in.

- CNA/lp

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