b. Clinical Features. Rabies is transmitted by the bite of an infected animal.
The infective period when the virus is present in the animal's saliva is from three to five
days before symptoms appear until death. Rabies symptoms in animals appear in three
stages: the prodromal stage (fever and dilated pupils) lasting two to three days, the
excitation stage (lasting three to seven days, and the paralytic stage lasting one to four
days. The excitation stage during which the animal becomes vicious or lethargic and
froths at the mouth is the most dangerous stage. During this stage, animals will bite
without provocation and wild animals may appear to be tame. When a human contracts
the disease, the first symptoms are headache, fever, restlessness, and a sense of
apprehension. The disease progresses to uncontrollable excitement. Spasms of the
throat make attempts to swallow so painful that the patient has a fear of water
(hydrophobia). Death usually occurs in two to six days caused by respiratory paralysis.
c. Control. Rabies control is through prevention. All dogs and cats should be
vaccinated for rabies. Dogs and cats known to have been bitten by a rabid animal
should be destroyed or detained for observation in a kennel. Wild animals appearing to
be tame should be avoided and destroyed. If a person is bitten by any animal, the
animal should be apprehended alive and detained under the observation of a
veterinarian. If it is not possible to capture the animal alive, the head should be taken
intact, packed in ice, and delivered to the nearest veterinarian for examination. The bite
wound should be immediately and thoroughly cleaned with soap and water. Following
first aid, the patient should be referred to a physician for treatment. Rabies
immunizations should be administered if it cannot be positively established that the
animal did not have rabies.
1-38. SERUM HEPATITIS
Serum hepatitis (hepatitis B) is a viral disease similar to infectious hepatitis
(hepatitis A) in its symptoms (paragraph 1-22d). Hepatitis B is more serious than
hepatitis A and has a fatality rate of 6to 12 percent. Hepatitis B can be transmitted
through whole blood, plasma, serum, and other blood products from an infected person.
Contaminated hypodermic needles, syringes, and other intravenous equipment are also
important vehicles of transmission. Patients undergoing transfusions or otherwise
exposed to blood or blood products are always at risk. Incidence is high among
narcotics users. Cases have also been traced to tattoo parlors. This disease has
particular significance to persons involved in sterilizing and handling intravenous and/or
hypodermic supplies and equipment.
Dermatophytosis, or ringworm, is a general term applied to infections of the skin,
hair, and nails caused by various fungi. The dermatophytoses, while generally not
serious, make up a considerable number of the medical cases treated in military health
care facilities--particularly in tropical and subtropical climates.