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Vietnam: Rabies deaths reported in Lao Cai province

by Malo Phomsouvanh
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The Center for Disease Control of Lao Cai province recorded information about a case of a Lao Cai woman who died of rabies and was treated at the Central Hospital for Tropical Diseases.

The patient is a 23-year-old female from the H’Mong ethnic group residing in Tham Phuc village, Coc Ly, Bac Ha.

About 18 months ago, the patient was bitten by the family dog ​​on the left index finger with bleeding, after 3 days of biting the patient, the dog died. The patient did not receive rabies vaccine or serum. After that, the patient went to work in Hanoi until January 2023. The patient showed signs of illness and went to a private hospital and was transferred to the Central Hospital for Tropical Diseases with the following symptoms: Fatigue, irritability, shortness of breath, convulsions and excessive sputum secretion. On January 17, 2023, the patient was assigned to take saliva and cerebrospinal fluid samples for testing, the results were positive for rabies virus.

On the afternoon of February 18, 2023, another case was recorded, a male student born in 2007, studying at Lao Cai College was bitten by 2 stray dogs while exercising, then was attacked by local people. He was discovered and brought to the provincial general hospital where the patient was in panic, with multiple injuries all over the body, about 10 large wounds causing deep soft tears and many wounds caused by dog ​​teeth.

What is rabies and how do you get it?

Rabies is an acute viral infection that is transmitted to humans or other mammals usually through the saliva from a bite of an infected animal. It is also rarely contracted through breaks in the skin or contact with mucous membranes.

What types of animals are considered high risk for having the virus?

According to the Control of Communicable Diseases Manual, all mammals are susceptible to rabies. Raccoons, skunks, foxes, bats, dogs, coyotes and cats are the likely suspects. Other animals like otters and ferrets are also high risk. Mammals like rabbits, squirrels, rodents and opossums are rarely infected.

How do infected animals appear?

They can appear very aggressive, attacking for no reason. Some may act very tame. They may looks like they are foaming at the mouth or drooling because they cannot swallow their saliva. Sometimes the animal may stagger (this can also be seen in distemper). Not long after this point they will die. Most animals can transmit rabies days before showing symptoms.

What type of symptoms will it cause in humans?

Initially, like in many diseases, the symptoms are non-specific; fever, headache and malaise. This may last several days. At the site of the bite there may be some pain and discomfort. Symptoms then progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.

What if your exposed (bite, scratch) to an animal?

First, clean the wound well with soap and water for 5-10 minutes. This will help reduce the chance of getting other bacterial infections and some studies show it can reduce the likelihood of getting rabies. Next, get good description of the animal for Animal Control so it can be picked up for quarantine or rabies testing.

Go see your family physician or the emergency room. Though technically not a medical emergency, it is important to seek medical attention quickly so proper, timely treatment is given. If you have to shoot or otherwise kill the animal, take care not to damage the head. The brain will be required for rabies testing.

Your doctor will evaluate the type of exposure (bite, scratch), and the type of animal that you had contact with. If post-exposure treatment is required it will likely be a combination of Rabies Immune Globulin (RIG) and Rabies vaccine. The RIG is given in one dose. RIG is basically pre-formed antibody that will provide immediate protection until you respond to the vaccine. The vaccine will help your body produce antibody to the virus, but this takes some time.

According to the CDC, the RIG should, if possible, be given around the wound itself. Any remaining RIG should be given intramuscularly away from the bite. Rabies vaccine is not like the old days, 20 shots in the stomach; instead it is four shots in the shoulder area.

Source : Outbreak News Today

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