Dr Sharmeen Mushtaq Nizami
Rabies, a terrifying and deadly disease, has claimed many lives, including that of 21-year-old Srushti Shinde from Kolhapur, who succumbed to the virus despite completing the anti-rabies vaccination course. Her tragic case highlights the urgency to understand why rabies remains one of the deadliest viruses known to humanity.
How Rabies Kills
Rabies is caused by the rabies virus, which spreads through the saliva of infected animals, primarily dogs, bats, raccoons, and foxes. The virus travels along nerve fibers to the brain, leading to inflammation and ultimately resulting in characteristic symptoms. Once symptoms appear, rabies is nearly always fatal, progressing rapidly from flu-like symptoms to neurological symptoms like agitation, hallucinations, and paralysis.
The rapid progression of rabies is due to the virus’s ability to evade the immune system, allowing it to spread quickly and cause severe damage. The virus also has a long incubation period, ranging from days to months, making it difficult to diagnose and treat.
Rare Cases of Survival
While rabies is overwhelmingly fatal, there have been rare cases of survival, sparking curiosity among medical professionals and researchers. These cases often involve early and aggressive treatment, including the rabies vaccine and rabies immune globulin (RIG) soon after exposure. In some instances, induced coma and experimental treatments have been used to give the body more time to mount an immune response.
One such case is that of Jeanna Giese, an American teenager who contracted rabies from a bat bite in 2004. She was treated with an experimental protocol known as the Milwaukee protocol, which involved putting her in a medically induced coma and administering antiviral drugs. Miraculously, she survived and made a full recovery.
The Importance of Vaccination
Vaccination remains the most effective means of preventing rabies. Post-exposure prophylaxis (PEP), which includes a series of rabies vaccine doses administered promptly after exposure, can effectively prevent the virus from causing disease if administered before symptoms appear.
Pre-exposure prophylaxis (PreP) is also recommended for individuals at high risk of exposure, such as veterinarians, animal control officers, and laboratory workers. The vaccine is highly effective, with a success rate of over 95% in preventing rabies.
Global Burden of Rabies
Rabies is a global health concern, particularly in regions where access to healthcare and rabies vaccination is limited. According to the World Health Organization (WHO), rabies causes tens of thousands of deaths worldwide each year, primarily in Asia and Africa. Most of these deaths occur in children under 15, highlighting the disproportionate impact of rabies on vulnerable populations.
In India, for example, rabies is a significant public health problem, with an estimated 20,000 to 30,000 human deaths annually. The country accounts for over 36% of global rabies deaths, with most cases occurring in rural areas where access to healthcare and vaccination is limited.
Hope for Better Prevention and Treatment
While rabies remains a formidable challenge, advancements in medical research offer hope for better prevention and treatment options. Ongoing studies into the immune response to rabies, development of novel antiviral therapies, and innovations in vaccine delivery hold promise for reducing the global burden of rabies and saving lives.
One such innovation is the development of a new rabies vaccine that can be administered orally, making it easier to reach remote and hard-to-reach populations. Another area of research is the development of antiviral drugs that can treat rabies, reducing the need for PEP and improving treatment outcomes.
Conclusion
Srushti Shinde’s tragic case serves as a poignant reminder of the deadly nature of rabies. Rabies remains a formidable global health threat, causing tens of thousands of deaths each year, particularly in regions with limited access to healthcare and vaccination services. While rabies is overwhelmingly fatal once symptoms appear, there have been rare cases of survival, often involving early and aggressive medical intervention.
By raising awareness, investing in research, and implementing effective prevention strategies, we can strive towards a world where no one lives in fear of rabies. It is crucial to prioritize efforts to eliminate rabies as a public health threat, ensuring that no one else suffers the same fate as Srushti Shinde.
The fight against rabies requires a multi-faceted approach, involving governments, healthcare professionals, researchers, and the general public. By working together, we can reduce the global burden of rabies and save countless lives. Remember, rabies is a preventable disease, and together, we can make a difference.
In memory of Srushti Shinde and countless others who have lost their lives to this devastating disease, let us renew our commitment to eliminating rabies as a public health threat. We owe it to them, and to future generations, to ensure that no one else suffers the same fate.
