Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei
Hayeshua Hospital
The most lethal infectious disease is an ancient one and is
mentioned in the gemora. It kills more than 99
percent of the people infected with it; indeed, there are
probably only three documented survivals in the history of
man. All had received immediate treatment. Worldwide, 35,000
people still die from this disease. This disease is
rabies.
Rabies in Hebrew is called Kalevet, and this is from
the Hebrew word for "dog." The reason is that dogs and
related animals are still the most common carriers for
rabies. Related animals include jackals, foxes, hyenas and
coyotes, all of which can be found in Israel. In other
countries, carriers include raccoons and skunks. While farm
animals and rodents such as squirrels, mice and rabbits can
carry this disease, this is rare. In Israel, wild cats can
carry the disease as well. Recently a more common animal to
transmit the disease is bats, and often the bite is
unnoticed, so if there is a bat in the house or anyone has
been exposed to a bat he should report to his local Ministry
of Health office. The disease is most commonly transmitted
by the bite of the animal that will appear sick or is
behaving erratically. The disease kills the animal that
transmits it.
People who have been bitten and do not receive the vaccine
will initially look like they have a cold, but then a little
later have agitation, irritability and delirium.
Hydrophobia, another name for this disease, is the jerking
and foaming at the mouth that people with advanced disease
present with. Once the disease has progressed this far,
nothing can be done. However, when a bite or exposure (like
a scratch) has been reported to local health authorities,
all countries have protocols to determine who should get the
vaccine, which will be life saving if given early enough --
which means within a few days of the bite.
Please do not let your children play or feed wild animals.
Your local council should shoot all wild dogs that frequent
dwellings of humans as, even if they are not carrying
rabies, they can attack children and deaths have been
reported. Dogs hunt in packs and are attracted by fear and
those who are trying to flee, which would be a small child's
reaction to seeing a dog.
If you own a pet, you must be responsible in making sure
rabies shots are given, as if it is ever outside it can
receive the disease itself. Cat bites in Israel, which are
frequent, should be reported. All animal bites should be
cleaned immediately with a scrub of soap and water. Write me
in care of the Yated.
A message from Glaxo, sponsor of this column. Zinnat
will not help you for this disease, but if you have received
antibiotics in the last month, you should know that Zinnat
is the drug of choice for an ear infection or sinusitis for
those recently exposed to antibiotics.
