Urgent attention to animal bites crucial in rabies prevention

SHAH ALAM - It is best to go to the nearest hospital right away if a stray dog or even a pet dog or cat bites you.

Medical experts said stray animals, including dogs and cats, posed a risk of transmitting rabies, a typically fatal disease, making prompt medical attention crucial after a bite.

Universiti Kebangsaan Malaysia (UKM) Public Health Medicine Specialist Professor Dr Sharifa Ezat Wan Puteh said rabies is caused by a virus that can be transmitted from animals to humans.

She said seeking immediate medical care was crucial and that the first steps should include cleaning the wound with water and soap.

Dr Sharifa said this can be done by getting to the nearest clinic, where the wound can be cleaned, dressed and sutured if necessary.

“Appropriate antibiotics may be applied or taken orally as deemed fit by the doctor. A tetanus toxoid jab may also be provided if not taken before.

“The specific rabies jab can be administered if there is a wound or if the animal shows signs of rabies or has not been vaccinated before.

“This is the appropriate post-exposure prophylaxis (PEP) to be given,” she said when contacted.

She further explained that any mammal can contract rabies, with the most common wildlife reservoirs being raccoons, skunks, bats and foxes.

She added that domestic mammals were also susceptible to rabies, with cats, cattle and dogs being the most frequently reported rabid domestic animals in the United States.

“Any wound, including skin punctures or exposure to saliva or other bodily fluids from infected animals (including through sneezing) can transmit the rabies virus,” Dr Sharifa said.

She also highlighted that the transmission was commonly observed among dogs, accounting for 96 per cent of rabies cases in Southeast Asia.

However, she said other animals were also capable of transmitting the virus.

She said rabies in dogs marked by unusual behaviour such as exhibiting wild aggression, biting without provocation and eating strange things such as sticks, nails, or faeces.

Other symptoms, she said may include running for no apparent reason, changes in vocalisation such as hoarse barking or growling, or the inability to make any sound at all.

She added that dogs may experience excessive salivation or foaming at the mouth, though not necessarily hydrophobia (fear of water), as well as excessive self-licking.

Based on the CDC USA medical website, Dr Sharifa said PEP involved administering a dose of human rabies immune globulin (HRIG) and rabies vaccine on the day of exposure to rabies (such as from a dog bite), followed by additional doses of the vaccine on the third, seventh and 14th days.

“For people who have never been vaccinated against rabies before, PEP should always include administration of both HRIG and rabies vaccine.

“The combination of HRIG and vaccine is recommended for both bite and non-bite exposures, regardless of the interval between exposure and initiation of treatment,” she added.

She said individuals who have previously been vaccinated or were undergoing pre-exposure vaccination for rabies should only receive the vaccine.

She cited facts from the CDC website, stating that individuals with a higher risk of rabies exposure, such as those who worked with potentially infected animals, farmers and animal breeders were recommended to receive the vaccine as a preventive measure in case of exposure.

She recommended that these individuals receive two doses of the rabies vaccine administered on the first and seventh days.

However, she said the frequency of vaccination may vary depending on the individual's level of risk.

She also recommended undergoing one or more blood tests or getting a booster dose within three years after the initial two doses to maintain ongoing protection against rabies.

Dr Sharifa said approximately 95 per cent of individuals who received three doses of the rabies vaccine will acquire some level of protection against rabies.

She said the duration of protection can vary, but typically lasted at least one to three years adding that individuals at continued risk of rabies may require one or more booster doses of the rabies vaccine to maintain protection.

Additionally, she suggested that pet owners, especially dog owners, ensure their pets receive proper care, shelter, including vaccinations and regular health checks.

“Puppies must be around 12 to 16 weeks old to receive the first dose of the rabies vaccine.

“This is called the primary dose and the second dose of the vaccine is given within one year of the primary vaccination.

“Subsequent doses, known as booster doses, are administered every year or every three years, depending on the vaccine. It is important to keep boosters updated,” she added.

She urged residents to report stray animal sightings to the nearest local council authority. This would enable authorities to round up the strays for vaccination and rehoming.

Dr Sharifa also emphasised the importance of avoiding socialising with stray animals or providing them with food, as it could lead to increased breeding and potential aggression, particularly towards small children who may be at risk of being bitten.

Furthermore, she she said if resources were available, stray dogs could receive rabies vaccinations and be placed in homes.

However, dogs showing symptoms of rabies may require euthanasia, she added.

She said without euthanasia, rabid dogs typically live for one to seven days after infection before succumbing to the disease.

“Subsequently, they can be tested for rabies posthumously,” she said.

Meanwhile, consultant Public Health Specialist Professor Dr Hematram Yadav said it was important to seek medical care immediately from the nearest hospital if bitten by a stray dog or even a pet dog or cat.

He said stray animals, including stray dogs and cats, posed a risk of transmitting rabies, a fatal disease.

However, he said not all dog bites, whether from pets or stray animals, carried the rabies virus adding that it was up to the doctor to determine whether the dog was rabid or not.

“As for suspected stray dogs, they need to be trapped and sent for examination to the veterinary from time to time. If found positive for rabies they need to be put to sleep.

“There are no preventive measures or vaccinations available for rabies in humans. However, if bitten by a suspected animal infected with rabies the individual is given a vaccine but even then, the chances of survival are slim,” he said when contacted.

He said pet owners needed to vaccinate their cats and pet animals regularly for rabies.

Dr Yadav stressed that not all stray dogs were infected with rabies, making euthanasia an unjustified course of action.

Hence, to reduce the number of stray dogs, he suggested trapping them and sending them to animal shelters or dog shelters (such as PAWS) or having them checked for rabies at the vet.

“If a dog or any animal is found to be positive, euthanasia can be considered, but it's important to note that not all stray dogs are rabid.

“As of 2024, there have been 71 fatalities due to rabies in Sarawak, stemming from 78 reported cases in humans since July 2017.

“Out of the total cases, 38 were caused by pet dogs that roamed freely with stray animals, 20 cases were from stray dogs, five cases were from pet cats, and one case was from a stray cat,” he said.

Dr Yadav added that the health department advised the public about the risk of humans contracting rabies from infected animals.

He said that from 2017 to 2024, there were a total of 52,969 dog bite cases, 43,345 cat bite cases and 1,490 bites from other animals reported in Sarawak.

He highlighted that on average, 381 animal bite cases were reported in Sarawak weekly from Dec 31, last year to Jan 20.

He stressed that the public should seek treatment at the nearest health facility if they were bitten or scratched.

Dr Yadav said that there have also been previous cases of citizens being attacked by stray dogs, resulting in various harms.