Dr K K Aggarwal

28th September is World Rabies Day

1. Bites, scratches, abrasions, or contact with animal saliva via mucous membranes or a break in the skin can transmit rabies.
2. Early wound cleansing is an important prophylactic measure in addition to timely administration of rabies immune globulin and vaccine
3. Dog, cat and bats can transmit rabies
4. Raccoons, skunks, foxes and coyotes can transmit rabies
5. Rabies has been reported in large rodents (woodchucks and beavers).
6. Small rodents, such as squirrels, chipmunks, rats, hamsters, gerbils, guinea pigs, mice, and lagomorphs (rabbits and hares) are almost never identified as infected with rabies virus; there has never been a case of transmission to a human from one of these animals.
7. Data from rabies pathogenesis studies in dogs, cats, and ferrets indicate that these animals uniformly begin to sicken and die within 10 days (usually 5 to 7 days) of spread of rabies virus from the CNS to the salivary glands. If the animal remains healthy for the full 10 days, then it did not have rabies virus in its saliva at the time of exposure.
8. Post exposure prophylaxis should be given immediately if an exposing animal is rabid or suspected to be rabid. If the animal is available for observation, immediate prophylaxis is indicated when the animal develops clinical signs of illness. In addition, prophylaxis should be started if the person’s significant exposure is to the head or neck, since incubation periods as short as four days have been reported in bites this close to the central nervous system. If the animal remains well for 10 days, the regimen can be discontinued at that time. If the animal is tested for rabies and is found negative, prophylaxis can be discontinued
9. Pre exposure prophylaxis should be targeted to persons in high-risk groups, including veterinarians, laboratory workers and international travelers.

Depression linked to paralysis

Patients with depression are more likely to have paralysis (stroke) than mentally healthy people and their strokes are more likely to be fatal, according to a study published in the Journal of the American Medical Association.

The researchers looked at data from 28 studies of more than 300,000 people. Over a follow-up period that ranged for two to 29 years, there were 8,478 strokes. Depression was associated with a 45 percent increased risk for stroke and a 55 percent raised risk for fatal stroke. Depression was linked to a 25 percent higher risk for ischemic stroke.

3.9% of stroke cases in the US could be attributable to depression.

Eating white fleshed fruits can reduce the risk of paralysis

A large Dutch study, published in Stroke, a journal of the American Heart Association, has found that eating apples and pears is associated with a lower risk of paralysis. The study spanned 10 years and included more than 20,000 adults ages 20 to 65. None had cardiovascular disease at the start of the study.  The risk of stroke was 52% lower for people who ate a lot of white-fleshed fruits and vegetables.  However, that no link was found between stroke incidence and green (dark leafy vegetables, cabbages and lettuces) orange/yellow (mostly citrus fruits) or red/purple fruits and vegetables.