A male teenager who had contracted rabies in the Federal District could not resist the disease and died on Saturday (30). He had been admitted to a private hospital since June 20.
“All necessary measures of epidemiological investigation, control and prophylaxis have been taken among family members, close contacts and health professionals,” the Federal District Health Department informed.
Caused by a virus, rabies is a zoonosis that can affect several mammals, but the main species involved in the disease cycle are dogs, cats, bats, foxes, wild dogs and marmosets. It is transmitted to humans through the saliva of infected animals, mainly by biting, scratching or licking.
The disease is almost always fatal and is characterized by progressive encephalitis, resulting in inflammation of the brain.
Brazil, however, has been effective in control and occurrences have been sporadic. According to the historical series available on the Ministry of Health website, 45 cases have been recorded across the country since 2010. There have been only two recoveries. In the Federal District, no cases have been recorded in the past 12 years.
Annual anti-rabies vaccination of dogs and cats throughout the national territory is the main strategy for combating the disease. It is included in the National Rabies Prophylaxis Program (PNPR) created in 1973. The results have been decisive in reducing cases of the disease. In 1999, the country registered 1,200 dogs with a positive diagnosis. In 2020, there were only 11. The goal is to keep at least 80% of the canine population vaccinated. Over the past two years, however, coverage has declined as some states and municipalities have suspended animal vaccination campaigns due to the covid-19 pandemic.
Another important measure is the blocking of outbreaks: whenever there is a suspected case, all dogs and cats within a radius of at least 5 kilometers must be vaccinated within 72 hours. There are also pre-exposure prophylaxis measures which essentially consist of vaccinating the most exposed groups. Among them are veterinarians, veterinary students, people who carry out research or work involving the capture or handling of mammals, speleologists, ecotourism guides and other professionals who carry out activities in areas with risk.
The general population should be warned never to directly touch bats or other wildlife, especially when they are lying on the ground or in unusual situations. It is also impractical to approach stray dogs and cats, as well as not to move or touch them when they are feeding, sleeping or with their young or even sleeping.
According to the Federal District Health Department, since the confirmation of the teenager’s infection, various measures have been taken to prevent new cases, including blocking the outbreak and anticipating the animal vaccination campaign. The record reports that more than 120,000 dogs and cats have been vaccinated.
DF’s health department has not disclosed how the teenager was affected by the illness. In an investigation by the Ministry of Health, of the 44 other cases recorded in the country since 2010, nine were infected by a dog, 22 by bats, four by non-human primates, two by foxes and four by felines. In three cases, it was not possible to identify the aggressor animal.
In the last 12 years, the highest number of cases was recorded in 2018. There was, at the time, an epidemic in the municipality of Melgaço (PA), affecting 10 people, all with bats involved in transmission. With one more case in Ubatuba (SP), there were 11 in all.
Throughout the historical series started in 2010, it was not until 2014 that no cases were recorded. In addition to the adolescent victim from the Federal District, four other people have already died from complications of the disease in 2022: all of them were indigenous adolescents and children from the municipality of Bertópolis (MG).
In the event of an accident with animals, it is recommended to immediately wash the wound with running water and soap and seek help as soon as possible for guidance. The physician may indicate the need for post-exposure prophylaxis, by applying vaccine or serum.
If these measures are not adopted in time, the disease sets in. The incubation period is on average 45 days. From this period, the first symptoms appear, such as general malaise, fever, headache, nausea, sore throat, irritability, restlessness and a feeling of anxiety. Subsequently, the infection progresses with more acute manifestations which may involve increased anxiety and hyperexcitability, delusions, muscle spasms and seizures.
The confirmation of the disease is made by a laboratory examination. There is a treatment protocol for rabies, based on the induction of a deep coma, the use of antivirals and other specific drugs. However, the survival rate is low.