Rabies is a serious disease that kills thousands of people around the world every year, with the main culprit being dog bites. Because of the considerable number of dogs in Cambodia (one dog for every three humans), people in Cambodia are particularly susceptible to dog bites and rabies. We speak to Dr. Trish Johansen of Siem Reap Veterinary Care to learn more about the situation of rabies in Cambodia and how we can protect ourselves from this destructive virus.
Dr. Johansen, could you explain what rabies is in layman’s terms, and why it can be so dangerous to humans?
Rabies is a fatal virus that affects the nerves and the brain of anyone who’s infected. In fact, any warm-blooded animal could catch and spread rabies. It’s often spread through the bites of infected animals or contact with saliva and nervous tissue through a wound, eyes, or nasal aerosols.
Rabies is a scary condition for people because once the virus travels along the nerves and reaches the brain resulting in the appearance of symptoms, the disease is almost always fatal, often within a number of days. Rabies cannot be detected with a blood test, because the virus doesn’t travel through the blood stream.
What are the symptoms of rabies?
In humans, the symptoms of rabies are the following:
- pain, tingling or itching at the site of the bite wound (in 80% of cases)
- fever, malaise, headache lasting for two to four days
- hydrophobia (fear of water)
- intolerance to noise, bright light or air
- fear of impending death
- anger, irritability and depression
- at a later stage, the mere sight of water may provoke spasms in the neck and throat
The duration of illness is usually two to three days, but it might stretch to five to six days or more if the patient receives intensive care support.
What is the rabies situation in Cambodia? What are the animals that most commonly carry rabies in Cambodia?
It’s reported that an average of 800 people die in Cambodia from rabies per year, but the actual number could be much higher due to the lack of a reporting system.
Rabies in Cambodia is mainly carried by dogs. It’s estimated that Cambodia has five million dogs, most of which are not vaccinated. Although most of these dogs have owners, people in Cambodia still suffer from approximately 600,000 severe dog bites each year, with 60% of them occurring to children under 17.
What are the preventive measures recommended to tourists before travelling to Cambodia? Should they get a rabies injection?
The best preventive measure is definitely getting a pre-exposure vaccination. A pre-exposure vaccination involves getting four 0.1 ml injections at day 0, 7, 21, and 28.
A pre-exposure vaccination is particularly important for children, who are the most vulnerable to dog bites.
What should a person do after being bitten by an animal?
Here is the immediate course of action to take after a person is bitten by an animal:
- Wounds should be washed and flushed immediately with soap and water for 10–15 minutes. If soap is not available, flush with water alone. This is the most effective first-aid treatment against rabies.
- Wounds should be cleaned thoroughly with 70% alcohol/ethanol or povidone-iodine, if available.
- As soon as possible, take the person to a healthcare facility for further treatment.
- Keep the biting dog/cat under 10 days of observation. If the animal remains healthy during the observation period, then post-exposure prophylaxis (PEP) can be converted into pre-exposure regimen (i.e. the vaccine taken will be to prevent rabies if bitten in the future).
Take care to not do the following:
- Apply irritants to the wound such as chili powder, plant juices, acids or alkalis.
- Cover the wound with dressings or bandages.
Our goal is to eradicate rabies in Cambodia one village at a time. By educating ourselves and understanding how rabies is spread, we can initiate meaningful, sustainable changes in the communities and make headway towards saving lives.