By NewsDesk  @bactiman63

According to a report in the Bhutanese news source, Kuensel, a three-year-old girl from Lamjumsa village of Norbugang (Chengmari) gewog in Samtse died of rabies infection on November 11.

The child died two months after a stray dog had bitten her.


It is reported that although the parents were aware of the rabies risk, they did not take the child to the hospital after the exposure.

Rabies is an acute viral infection that is transmitted to humans or other mammals usually through the saliva from a bite of an infected animal. It is also rarely contracted through breaks in the skin or contact with mucous membranes.

According to the Control of Communicable Diseases Manual, all mammals are susceptible to rabies. Raccoons, skunks, foxes, bats, dogs, coyotes and cats are the likely suspects.

Initially, like in many diseases, rabies symptoms in humans are non-specific; fever, headache and malaise. This may last several days. At the site of the bite there may be some pain and discomfort. Symptoms then progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.

What should do if you are exposed?

First, clean the wound well with soap and water for 5-10 minutes. This will help reduce the chance of getting other bacterial infections and some studies show it can reduce the likelihood of getting rabies. Next, get good description of the animal for Animal Control so it can be picked up for quarantine or rabies testing.

Go see your family physician or the emergency room. Though technically not a medical emergency, it is important to seek medical attention quickly so proper, timely treatment is given. If you have to shoot or otherwise kill the animal, take care not to damage the head. The brain will be required for rabies testing.

Your doctor will evaluate the type of exposure (bite, scratch), and the type of animal that you had contact with. If post-exposure treatment is required it will likely be a combination of human Rabies Immune Globulin (HRIG) and Rabies vaccine. The HRIG is given in one dose. RIG is basically pre-formed antibody that will provide immediate protection until you respond to the vaccine. The vaccine will help your body produce antibody to the virus, but this takes some time.

According to the CDC, the HRIG should, if possible, be given around the wound itself. Any remaining HRIG should be given intramuscularly away from the bite. Rabies vaccine is not like the old days, 20 shots in the stomach; instead it is four shots in the shoulder area.