Altınbaş University Lecturer, Head of First Aid Department of SHMYO Özlem Karagöl explained what should be done at the first moment in cases of rabies where the risk of death is very high.
Özlem Karagöl suggested washing the wound with soap and water for at least 15 minutes and using a detergent, iodine compound or a virus-killing substance on the wound. He stated that this method, which is also recommended by the World Health Organization (WHO), should be applied, and that if soap is not available, the wound should be washed with plenty of water.
Saying that 99% of rabies cases are caused by the bite of an infected dog, Özlem Karagöl noted that according to the 2021 data of the World Health Organization, the biggest victims of stray dog attacks are children. Özlem Karagöl said, “As a source animal, dogs are responsible for 92%, cats for 2%, other pets 3%, bats 2% and other wild animals less than 1%. We can say that 93% of the animals with rabies in our country are domestic animals and dogs take the first place with 59%,” he said. He stated that these cases are geographically more common in Aegean, Marmara, Eastern Anatolia and Southeastern Anatolia regions, and as of 2014, they started to be seen in the Central Anatolia Region as well.
Stating that Turkey is still considered an endemic region in terms of rabies, Özlem Karagöl noted that approximately 300 thousand people are treated for rabies annually in our country. He pointed out that Turkey is in the same high-risk category as African and Asian countries in terms of rabies risk. According to the data of the World Health Organization, Turkey has been in the high risk category expressed in red since 2008.
Özlem Karagöl said that the incubation period in most of the rabies cases varied between 31-90 days, 30 days in 30% of the cases, 54-31 days in 90%, more than 15 days in 90% and longer than one year in 1% of cases. .
He pointed out that the first symptoms of rabies were malaise, fever, headache, and were very similar to the flu. Pointing out that these symptoms can last for days and the clinical features of this period are difficult to distinguish from a systemic viral infection, Özlem Karagöl said, “There may be discomfort, burning, tingling and itching in the bite area. Within days, symptoms of brain dysfunction, anxiety, and agitation develop. As the disease progresses, the person may experience delirium, abnormal behavior, hallucinations, and insomnia. The acute illness period typically ends after 2-10 days. When clinical signs of rabies appear, the disease is almost always fatal, and its treatment is supportive therapy.
Özlem Karagöl also stated that death due to rabies usually occurs within two weeks of the first symptoms appearing. She mentioned that cardiopulmonary disorders are the most common medical complications. “Sinus tachycardia is very common and the heart rate is higher than expected given the high fever. Various cardiac complications such as arrhythmia, heart failure, hypotension and cardiac shock may occur. Neurological findings such as personality changes and cognitive impairment can be detected with careful observation. Anxiety, depression, and restless mood are common. Insomnia and nightmares are often described. In bites close to the eyes and nose, hallucinations related to vision and sense of smell may occur.
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