Doctor's Column: Where can I get rabies vaccine after a dog bite?

Dear doctor, my son was bitten by a dog two months ago. He now has difficulty in swallowing which according to what I read on the internet, is a sign of rabies. Where can I take him for rabies injections?
Counsel Ojara, EBB

Dear Counsel Ojara, rabies is a viral disease that is transmitted from animals to humans usually through bites of rabid dogs (but can also be acquired from rabid bats) or even a lick on the skin if it is broken. The virus travels from the site of the wound to the brain leading to various symptoms. The time of the bite to the first symptoms (incubation period) depends upon the site. The nearer this is to the brain, the faster the manifestation of symptoms. Hence, it can vary from as short as four days to as long as seven years.

Rabies can be fatal when left untreated and even with the best treatment, death almost invariably results two to 10 days after the first symptoms. Probably this is why you are worried that your son could have contracted rabies.

The signs and symptoms may include a flu-like illness, difficulty in swallowing, which creates fear of water (hydrophobia), excessive salivation and anxiety.

It is also likely that your son has difficulty in swallowing because of some other condition especially a throat infection rather than rabies. You need to take him to a doctor for investigation and treatment.

What you call injections after being bitten by a dog is a vaccine which is protective if given to the bite victim within 10 days of the bite.

The vaccine however, has side effects and should be given after ascertaining that one was most likely bitten by a rabid dog but can also be given if in doubt.

Rabid dogs are usually stray, whose rabies immunisation history is unknown and usually do not survive 10 days after biting. A home dog which may still be alive after 10 days is unlikely to be rabid. However, it can cause tetanus thus anyone bitten by a dog should visit a doctor for examination and treatment.

It is important that Ugandans have their dogs vaccinated. If bitten by any dog, they should wash the wound thoroughly with clean water and soap for at least 15 minutes and apply povidone –iodine cream that kills viruses and then immediately visit the nearest doctor.

Dear doctor, I sweat profusely yet I have come across two women who do not sweat no matter the task. Apart from saving on deodorants, I feel disturbed by the condition. Is it normal?
Lenah Kokugonza

Dear Lenah, we sweat as a way of regulating temperature so that when sweat evaporates off the skin, we cool down. Therefore, when we are exposed to heat on a hot day or when we do vigorous exercise or have a fever, we sweat more.

When we sweat less, say, on a cold day, we may not notice we have sweated because the sweat quickly evaporates off the skin.

However, there are some people who sweat a lot with minimal exercise or when they are not exposed to heat or have no fever. This may affect particular areas like the face, armpits, groins or even the feet.

Usually this also happens to other parts of the body and is said to be due to overworking of nerves that are connected to the sweat glands. Sweating with minimal effort runs in families and usually begins at puberty or earlier but stops at night when one sleeps. However, although it is harmless and not associated with disease, it can cause embarrassment when it wets the hands or causes smelly feet.

When one sweats all over the body, and not just on the hands or feet, this may indicate an underlying medical condition requiring a visit to the doctor. The suspected conditions include menopause, pregnancy, thyroid problems, diabetes, alcoholism, obesity, stress and some drugs including panadol. Sometimes the sweating may accompany fever-like symptoms in infectious diseases like tuberculosis and malaria.