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Management of Rabid Dog bites

"last update: 13 Oct 2024"  

- Introduction

Rabies is an acute viral disease, which causes encephalomyelitis in virtually all the warm blooded animals including man. The causative agent is found in domestic and wild animals, and is transmitted to other animals and to humans through close contacts with their saliva (i.e. bites, scratches, licks on broken skin and mucous membranes).  Rabies is an important zoonotic infection in which man is dead end host and therefore it does not play any role in its spread to new hosts. Rabies occurs in all continents with the exception of Australia and Antarctica. Several countries are currently free of rabies. In Africa rabies is prevalent in almost whole of the territory with a stable pattern.  In most of the developing countries, dogs are the principal reservoirs of rabies (canine rabies) whereas sylvatic rabies involving animals such as foxes are principal wild animals’ reservoirs of this disease in Egypt. It is a viral, zoonotic, neglected tropical disease that causes tens of thousands of deaths annually, with 40% being children under 15. Worldwide the number of human rabies deaths is estimated to be between 35,000 and 50,000 annually. Regarding animal bite incidents in Egypt, a total number of cases of reported animal bites were 482,040 in 2018, compared to 431,917 in 2017 and 355,373 in 2016. It seems that this trend of increased number of reported incidents of animal bites is continuing with 574149 cases reported in 2019 indicating a 20% increase from the previous year. According to the WHO, in the late 1990s, the average number of rabies deaths was reported to be 30-40 persons per year, and in 2000, were about 35 persons per year [12]. Stray dogs bites are considered as the most common  source of the disease. Virus is excreted by the rabid animal mainly in saliva. It is present in the saliva of the dogs for 2-3 days before the appearance of clinical features. It remains in the saliva till the animal dies. Death usually occurs within one week of onset of clinical manifestations.