The Analysis of Rabies Within the Concepts of Population Health and Epidemiology

Introduction

Rabies is an ancient and most prevalent zoonotic neurological infection that is caused by the Rabies virus (RABV) and other Lyssavirus species of the family Rhabdovirida. Such infectious disease results in progressive and fatal encephalomyelitis. According to Domachowske (2019), the rabies virus is responsible for the mortality rate of 55 000 people annually (p. 277). Furthermore, death outcomes usually emerge in developing countries that lack control over the virus dissemination among livestock. The rabies transmission begins from a bite of an infected animal, notably dogs, raccoons, skunks, bats, or foxes. The virus also can be transmitted from inhaling contaminated aerosols and in the laboratory in case of accidental occupational exposure or from the infected donor.

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The common disease vector for rabies mainly affects developing countries such as Africa and Latin America. The incubation period varies from one to three months, but can also last for several years. This implies the “amount of virus in the inoculum, the density of motor endplates at the wound site, and the proximity of virus entry to the central nervous system” (Barecha et al., 2017, p. 58). The initial clinical symptoms of rabies include “low-grade fevers, malaise, and anorexia” (Domachowske, 2019, p.277). It is later followed by the progressive deterioration of mental status, autonomic instability, dysphagia, hydrophobia, or the paralysis phase.

Determinants of Health

The determinants of health can be classified into various factors that influence oneself in health status. The predominant factor within the rabies virus is particularly the specific animal species that transmit the disease through the bite. The dogs are considered as the most important reservoirs for the virus in the developing countries of Asia and Africa. Therefore, dogs are the primary source of rabies infection to humans and other domestic animals.

In terms of public health, this zoonotic infection in humans remains a significant health-related concern that has a worldwide occurrence. As described by Barecha (2017), about 98% of the human rabies incidents emerge in developing countries that involve a great number of dogs, strays explicitly. As such, the virus occurs since dog rabies is endemic and is transmitted directly from dog to dog. With that said, rabies is perceived as the ongoing threat, which is easily spread to humans through dog bites. The statistics showcase that children also share extremely high rates of the disease.

Epidemiological Triad

Rabies is a life-threatening concern that has a global occurrence and is transmitted mostly by carnivores to humans and domesticated animals. The risk factors related to the disease include “age and gender indicators, educational level, occupation, the income level of the family, as well as the knowledge about rabies of the respondents” (Penjor et al., 2019, p. 7).

Moreover, the type, circumstances, and category of exposure; ownership of the animal responsible for exposure; vaccination ad rabies status of biting animals; location; and distance to the nearest hospital are the key factors to consider. Within the broad host range of rabies, the virus infects all warm-blooded animals, including humans. One should carefully behave around the following animal families that maintain rabies cycles, such as Canidae, Mustelidae, Viverridae, Procyonidae, and Chiroptera (agent factors). The environmental factors include the developing countries, namely in Africa and Latin America.

Role of the Nurse Practitioner

Within the analysis of the infectious disease, it is essential to note that a large scale of human deaths is attributed to rabies virus annually. Unfortunately, death outcomes are inevitable once the symptoms of rabies emerge. It remains a neglected health concern that affects most impoverished and deprived nations, which inhabit in rabies endemic areas. Hence, they have limited or no access to the proper healthcare system and delivery, as well as safe rabies vaccine products, which promotes the dissemination of this disease. As stated by Simons et al. (2019), practice nurses serve the fundamental role in “raising the profile of rabies as a travel‑related hazard” (p. 589). As such, it is essential to examine the role of a nurse practitioner, specifically for those who travel to dangerous regions.

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The core task of the nurse is to raise awareness of the risk associated with rabies infection within a travel destination and target travel itinerary, and provide the instructions on pre-travel vaccination and post‑exposure treatment. Thus, it is of the utmost importance for a nurse practitioner to provide travel health services, which can be a complex issue to address. The health care professionals as well must ensure that they are delivering care within their level of competence.

A nurse should necessarily offer a coherent consultation about avoiding contact with specific animals, as well as the management of bites, scratches, and mucous membrane impact from animals. In addition, a nurse must provide the “guidance on pre-travel rabies vaccination and post-travel treatment in the event of a rabies-prone exposure” (Simons et al., 2019, p. 590). With that said, rabies keeps affecting the population of the rabies-endemic regions and those who might be infected by these people after international traveling. A nurse plays a crucial role in delivering care and raising awareness of the infectious disease to warn and protect the patients.

References

Barecha, C., Girzaw, F., Kandi, V., & Pal, M. (2017). Epidemiology and public health significance of rabies. Perspectives in Medical Research, 5(1), 55-67. Web.

Domachowske, J. (2019). Introduction to clinical infectious diseases: A problem-based approach. Cham, Switzerland: Springer International Publishing.

Penjor, K., Tenzin, T., & Jamtsho, R. (2019). Determinants of health seeking behavior of animal bite victims in rabies endemic South Bhutan: A community-based contact-tracing survey. BMC Public Health, 19(1), 1-24. Web.

Simons, H., Fletcher, R., & Russell, K. (2019). Rabies: An update for nurses in general practice. Practice Nursing, 30(12), 589-594. Web.

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