SalivaSaliva : The patient was admitted to a Pietermaritzburg, KwaZulu Natal hospital on the 2nd May 2012 with migratory pain in his arm and shoulder, unilateral ptosis, fever, confusion, and progressively hypersalivation and hydrophobia. The patient was already unwell on the 29th April 2012. Rabies was considered as a differential diagnosis when the patient reported contact with a stray dog that died and with which he had contact two months prior to his illness. The patient provided shelter for the animal which was initially well, but reportedly developed signs and symptoms consistent with rabies within a couple of days. The animal was buried on the farm. The patient did not report any bites or serious injuries from the animal and therefore did not receive any rabies post exposure prophylaxis at the time. It is however likely that the patient was in contact with the saliva of the dog (which may be a source of infection on broken skin or mucous membranes). Once rabies was suspected in the human patient, the dog was exhumed and tested positive for rabies. On admission the patient received rabies immunoglobulin (human origin at 20IU/kg) and rabies vaccination in the Emergency Department. Once the diagnosis of rabies was likely, the patient was managed according to a modification of the Milwaukee protocol . Pending laboratory confirmation of rabies he was treated empirically with acyclovir for possible herpes infection and quinolones for rickettsial disease. Laboratory tests for rabies were carried out at the Centre for Emerging and Zoonotic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service (NICD/NHLS) in Johannesburg. Ante- mortem tests using PCR on multiple samples of saliva, skin and cerebrospinal fluid over the course of his illness were consistently negative. Rabies specific IgG was positive in serum likely reflecting the recent passive and active immunization of the patient. Initial serological tests on cerebrospinal fluid were negative, but rabies specific IgG was detected at low titers on repeat samples, without an increase in titre over 4 weeks. Extensive testing for other infectious causes of encephalitis yielded negative results (including testing for West Nile fever, Rift Valley fever, herpes, malaria, enteroviruses).
The patient died on Friday 8 June 2012. Life support was discontinued when a SPECT scanner confirmed the absence of cerebral blood flow. Rabies was confirmed by a fluorescent antibody test on a brain biopsy specimen at the NICD/NHLS. Underberg is a small rural farming community located approximately 200km west of Durban. An epizootic of rabies has been ongoing in KwaZulu Natal Province for about 30 years and animal and human cases are confirmed from the province annually. The number of human rabies cases has decreased over the past years following on extensive dog vaccination campaigns in a number of high-risk areas. A recent outbreak affecting mainly dogs in the Winterton/Bergville area of the province has been ongoing since January 2012 and has claimed the life of one child to date. The likely origin of the Underberg rabies dog and human rabies case reported above is being investigated. Human cases of rabies are confirmed in South Africa annually. In addition to the case reported here, a further five cases have been confirmed for this year to date. These were from KwaZulu Natal (n=2) and the Limpopo (n=3) Provinces. A clinical case from the Eastern Cape was reported but could not be laboratory confirmed. A total of 106 cases of human rabies have been laboratory confirmed in South Africa from 2005 to date, with the majority of the cases reported from KwaZulu Natal (n=32), Eastern Cape (n=30) and Limpopo Provinces (n=37).
Definition of Rabies Disease
Disease or rabies Rabies is a contagious animal disease that can be caused by a virus and attack warm-blooded animals and humans. In animals suffering from rabies, a virus is found in large quantities in saliva. This virus will be transmitted to other animals or to humans primarily through bite wounds. Therefore, the carnivores (dogs, cats, wolves) is the most important animals as disseminators of Rabies.''
Rabies is a disease that is very dangerous Zoonosa disease and feared because when it has attacked a human or animal will always end in death. Given the ferocity of the dangers and the health and tranquility of life, the prevention and eradication of this disease need to be carried out intensively. For Indonesia, the government set the rabies-free by 2005.''
Animals susceptible to rabies
All warm-blooded animals are susceptible to rabies. Rabies disease is naturally present in the dogs, cats, bats, and wild carnivores.
Incubation period
The incubation period is the time between the bite until the onset of disease symptoms. The incubation period of rabies disease in dogs and cats less than 2 weeks (10 days-14 days). In humans 2-3 weeks and a maximum of 1 year.
Stages of Rabies Disease
Course of the disease Rabies in dogs and cats were divided into 3 phases (phase).
A. Phase prodormal: Animals looking for a cool and aloof, but may become more aggressive and nerve, extend pupils and rigid posture (tense). This phase lasts for 1-3 days. After the phase of the phase excitations prodormal proceed directly to phase bias or paralysis.
2. Phase Excitation: Animals become malignant and attack anyone around them and eat weird stuff. Furthermore the eye becomes cloudy and is always open and trembling, then go into paralysis phase.
3. Phase paralysis: Animal suffered paralysis in all parts of the body and ends with death.
Signs of Rabies Disease In Animals And Humans
In dogs and cats, Rabies disease is divided into two forms, namely the form of silent (Dumb Rabies) and malignant forms (Furious Rabies).''
Sign â a sign of silent forms of rabies:
* There was paralysis of the entire body.
* Animals can not chew and swallow food, the lower jaw clenched and can not drool excessively.
* There is no desire to attack or bite. Animals will die within a few hours.
Sign â "a sign of a malignant form of Rabies:
* Animals become aggressive and no longer know the owner.
* Attacking people, animals, and objects moving.
* When his rigid stand, tail between his legs folded behind him.
* A puppy becomes more lively and playful, but will bite when held and will be malignant in a few hours.
Signs of Rabies in Humans:
* The fear that is in the water, and sensitive to light, air, and noise.
* Tears and saliva out excess.
* Pupils dilate.
* Talk is not frivolous, always wanted to move and seemed in pain.
* Next is characterized by convulsions and paralysis and eventually death.
Actions Against the Biting Animal
Dogs, cats and since the era of human or other animal bite should be suspected of having rabies. The animal should be taken as follows:
* If the animal is a pet or an owner, then the animal must be captured and handed over to the local Animal Husbandry Department for observation for 14 days. When the observation of the animal is rabies negative should receive rabies vaccinations before being handed back to its owner.
* If the biting animal is a wild animal (no owner) then the animal is captured alive to be undertaken and submitted to the local Animal Husbandry Department for observation and after the completion of the observation period the animal may be destroyed or maintained by people who are willing, after the first rabies vaccination was given .''
* When the elusive animals that bite and had to be killed, then the head of the animal should be taken and immediately submitted to the local Animal Husbandry Department for laboratory examination.''
Actions Against Persons The Bitten (Victim)
A. Immediately wash the bite wound with clean water and soap or detergent for 5 â € "10 minutes then rinse with running water, then dry with a clean cloth or paper towel.
2. Wounds and injuries that are given a drug (eg iodine) and then wrapped loosely with a clean bandage.
3. Patients or victims were quickly taken to the nearest health center or hospital for further treatment.
Action against dogs, cats, or monkeys Yang Maintained
A. Putting pets in cages is good and appropriate, and always pay attention to cleanliness and the surrounding cage.''
2. Keeping a pet health by providing good food, good maintenance and carry out regular rabies vaccination every year to the Department of Animal Husbandry or Veterinary Practice.
3. Install the chain on the dog's neck when the dog is not grounded or being invited to take a walk.
Taking Tips Water Dog Saliva
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