Rabies, in some areas known as "mad dog disease" because the transmission of the disease is most frequently associated with bites by infected dogs is also commonly known as Hydrophobia which relates to the major symptom. Numerous attempts are going on throughout the world to lessen the spread of this horrific disease. Any warm blooded animal can carry the virus. Almost all are themselves killed by the disease and so following a bite, if the animal survives a period of 10 days it may be taken that it was not rabid at the time of the bite. - WHO Recommendations: 2002.

The disease is caused by an RNA virus of the rhabdovirus group which has a long incubation period.

The incubation period ranges from 3 days to 3 years, most commonly between 1 and 3 months. The incubation period is directly related to the extent of the inoculation (bite) and the proximity of the brain. Thus bites on the face and neck are particularly significant and will, in general, be associated with a short incubation period.

In many patients no symptoms occur until the final days of the disease are reached. The site of the initial inoculation will usually have fully healed and be well forgotten. When the patient begins to experience the first effects of the disease, frequently they will experience fever and headaches. They may then relate numbness at the site of the original bite. With the ankle as the most common site. Following this, patients may complain of anxiety, photophobia and muscular pains after which patients fall into one of two categories:

Furious Rabies: (most common variety - 80%). Paralytic Rabies: Less common variety in humans.

This disease is endemic in most areas of the world but is very common in the tropics where control of animals is limited. A few island countries are free of the disease.

All ages are at equal risk with the major source of infection through the bite of an infected animal. Any warm blooded animal may be capable of transmitting the disease through their infected saliva. A few cases of airborne transmission have been reported. Congenital transmission is known to occur in some animals but human cases have not been shown. Again ingestion of infected meat has been known to cause the disease in animals but not man. Human to human spread is possible in theory but has not been reported to date.

In a rabies-endemic area, the circumstances of an animal bite, other contact with the animal, and the animal's behaviour and appearance may suggest that it is rabid. In such situations, medical advice should be obtained immediately.

At the time of Exposure: The bite should be well washed with water to remove as much saliva as possible from the area. If soap is used at this stage it must be washed off before an antiseptic is applied to the area. The area should then be covered and the patient should have post exposure vaccination as soon as possible.

Post-exposure treatment to prevent the establishment of rabies infection involves first-aid treatment of the wound followed by administration of rabies vaccine and anti-rabies immunoglobulin in the case of severe exposure.

The administration of vaccine, and immunoglobulin if required, must be carried out, or directly supervised, by a physician, as post-exposure treatment depends on the type of contact with the confirmed or suspect rabid animal.

In late stages of the disease only supportive humanitarian measures are available; Valium Analgesia Intravenous fluids Atropine.

Vaccination is the most important aspect of dealing with rabies from a human point of view.

Pre Exposure Vaccination: Rabies (HDCV) may be used to confer antibody protection to individuals before they are infected. The vaccine is expensive and given on two occasions one month apart. It should be boosted within 6/12 to 1 year.