The rabies outbreak situation is once again “concerning” as the Animal Disease Control, Prevention, and Treatment Office, Department of Livestock Development, has declared 22 provinces in Thailand as temporary epidemic zones after continuous increases in animals falling ill and dying from rabies. There have also been human fatalities in 3 provinces: Songkhla, Trang, and Surin. The at-risk group is children who may not be cautious enough… Let’s hear advice from Dr. Thitior Nakboonnam, a pediatric infectious disease specialist at the Pediatric Health Center, Phyathai 3 Hospital, on how to care for children.
Not only dogs are the cause of rabies
Rabies is caused by the rabies virus and can infect all mammals including dogs, cats, gibbons, monkeys, squirrels, bats, rats, even cattle, buffaloes, and goats. This disease is 100% fatal once symptoms appear. The virus can be transmitted from infected animals or those with rabies to humans through bites, scratches, wounds, mucous membranes of the eyes, nose, mouth, via saliva of the infected animal.
These symptoms… indicate a risk of rabies infection
Not everyone infected shows symptoms immediately. Dr. Thitior explains that some people develop symptoms 3 weeks to 6 months after exposure, and some up to 1 year. Early symptoms include loss of appetite, sore throat, fever, fatigue, severe itching at the wound site, behavioral changes, restlessness, fear of light and wind, dislike of loud noises, delirium, difficulty swallowing, lower abdominal pain, leg muscle spasms, chest tightness, difficulty breathing, convulsions, paralysis, and eventually death.
5 “Don’ts” to prevent rabies infection
Dr. Thitior says we can reduce the risk of dog bites with the 5 “Don’ts”: “Don’t tease, don’t step on, don’t separate, don’t pick up, don’t interfere.” Avoid approaching animals showing signs of rabies. If you have pets at home, vaccinate them against rabies annually, spay/neuter and use contraceptives to control their population. Parents should not allow children under 6 years old to care for pets as they cannot do so safely. If bitten by a dog, immediately wash the wound, apply medication, quarantine the dog for observation for at least 10 days, see a doctor, and complete the full vaccination course.
Who should get the rabies vaccine?
Those at risk or working in high-risk environments such as animal caretakers or handlers, children who like to play with dogs, personnel working directly with animals, tourists traveling to countries with rabies outbreaks, and children living in outbreak areas should receive pre-exposure rabies vaccination before any bite occurs, on days 0, 7, and 21 (or 28). After completing 3 doses, the initial vaccination series is considered complete.
- For these groups, if bitten by an animal suspected or confirmed to have rabies after 6 months of vaccination, a booster of 2 doses on days 0 and 3 is recommended.
- For those at high risk of rabies infection, after completing the 3-dose pre-exposure vaccination, antibody levels should be checked every 6 months or every 1–2 years. If levels fall below the safe threshold, a booster vaccine should be administered.
The body will develop immunity to destroy the virus within 10-14 days after completing the vaccination.
Precautions for rabies vaccination
- Pregnant women have no contraindications for receiving the vaccine and immunoglobulin as it is an inactivated vaccine.
- For HIV-infected individuals, those with immunodeficiency, or those receiving immunosuppressive drugs, the vaccine should be given intramuscularly along with immunoglobulin in all cases.
No need to worry if these side effects occur
- There are no reports of severe vaccine allergies. Possible reactions include pain, redness, heat, itching at the injection site, or general reactions such as fever, headache, fatigue, which usually resolve on their own or with symptomatic treatment.
- Frequent booster vaccinations may cause serum sickness or hives but are usually not severe.
