1. Introduction:
Rabies is a zoonotic disease (transmitted to humans from animals) with 100% fatality rate
causing thousands of deaths annually all across the globe. Mammals commonly domestic
pets such as dogs, cats and even livestock can be infected. Dog bites and scratches
cause 99% of human rabies cases. However, human deaths following exposure to foxes,
raccoons, skunks, jackals, mongooses and other wild carnivore host species are rare and
bites from rodents are not known to transmit rabies according to World Health
Organisation (WHO).
Rabies is present on all continents except Antartica but more than 95% of human deaths
occur in Asia and Africa. Malaysia has been encountering obstacles in rabies control
efforts particularly in Sarawak. According to Department of Veterinary Services Sarawak
(DVS), Sarawak is a hotspot for rabies cases in which total of 63 301 dog bite cases, 57
210 cat bites or scratches and 1832 bites by other animals were reported between 2017
until May 2025. There were 114 positive rabies cases from Kuching, Serian, Sri Aman,
Samarahan, Kapit, Mukah and Bintulu found during animals testing last year. Cumulative
number of human rabies cases in Sarawak since 2017 remains at 83 with 76 fatalities. In
2024, 7 deaths were recorded among human rabies cases in Sarawak meanwhile no
death has been reported this year so far.
In March 2025, 11 new rabies cases were detected by Sarawak Veterinary Diagnostic
Laboratory involving multiple bite incidents by stray and free-roaming pet dogs across
Kuching, Padawan and Bau districts. An article published stated that the affected
locations include Kampung Sejijak, Batu Kawa, Kampung Surih Stapok, MJC Factory
Batu Kawa, Jalan Stephen Yong, Jalan Penrissen Padawan, Jalan Sebum Buso, Pekan
Paku Bau, Jalan Bau Lama, Kampung Nyabut Trombol, Taman Hillside Matang and
Taman Desa Sejijak (Bernama, 2025).
The first human rabies case for this year reported affecting a 13 years old teenager from
Kampung Segedup, Kuching. Based on a statement by Sarawak State Health
Department, the boy began showing symptoms on 21st May 2025 such as fever, loss of
appetite, vomiting, hallucination, delirium, difficulty in walking and trouble in drinking
water with recent history of bitten by stray cat (Toyat, Jude. 2025).
As mentioned by DVS, following those detected rabies cases, it is mandatory for pet
owners within a one-kilometre radius of infected areas to vaccinate their pets
immediately.
Failure to comply with anti-rabies vaccination requirements is an offence under Veterinary
Public Health Ordinance (VPHO) 1999 whereby an individual is punishable by a fine up to
RM 2500.
Pet dumping is also an offence under Section 73 of VPHO 1999 carrying a fine up to RM
2000.
Failure of pet owners to obtain their dog licence may get charged with a fine up to RM
5000 under Section 3 of the Dog Licensing and Control By-laws 2018.
2. Mode of spread:
Dogs are mainly responsible for virus transmission in 99% of human rabies cases. People
usually infected by saliva of infected animals via bites, scratches or direct contact with
mucosa such as eyes, mouth and open wounds. Human-to-human transmission through
bites or saliva is theoretically possible but never been confirmed. Transmission through
inhalation of virus-containing aerosols, consumption of raw meat or milk of infected
animals or through organ transplantation is extremely rare. In United States of America,
Canada, Australia and parts of western Europe, bat-mediated rabies has become an
emerging public health threat.
3. Signs and symptoms:
Incubation period for rabies is typically 1 to 3 months but it may vary from less than one
week to more than one year depending on location of virus entry and viral load. Clinical
rabies can be managed but very rarely cured and not without severe neurological deficits.
Once the virus infects the central nervous system and clinical symptoms appear, rabies is
fatal in 100% of cases.
In humans, initial symptoms may manifest as fever, headache, fatigue, pain and unusual
or unexplained tingling, pricking or burning sensation at the wound site. Later symptoms
appear as the virus moves to the central nervous system causing progressive and fatal
inflammation of the brain and spinal cord leading to confusion, hallucinations,
hydrophobia (fear of water) and paralysis. There are 2 forms of disease can follow. People
with furious rabies will show hyperactivity, excitable behaviour, hallucinations, lack of
coordination, hydrophobia (fear of water) and acrophobia (fear of drafts or of fresh air).
Death occurs after a few days due to cardio-respiratory arrest. On the other hand,
paralytic rabies accounts for about 30% of total number of human rabies and usually less
dramatic with longer course. Muscles progressively become paralysed from wound site,
coma slowly develops and eventually lead to death. Often being misdiagnosed
contributing to under-reporting of disease.
Infected animals commonly having unusual aggression or friendliness, drooling, difficulty
swallowing, staggering or paralysis resulting in unsteady walking or gait.
4. Prevention:
• Pet owners to ensure their dogs and cats receive yearly anti-rabies vaccination and to
not left their pet roam unsupervised.
• Avoid animal bites.
• Avoid approaching, feeding, petting or handling stray dogs and cats with unknown
vaccination status or wild animals.
• Educate children to stay away from unknown or stray animals.
• Report any bites or suspicious animal behaviour to Department of Veterinary Services or
local authorities without making physical contact with the animals.
• Pre-exposure prophylaxis (PrEP) for high risk occupations such as laboratory workers,
animal disease control staff and wildlife rangers.
5. What should be done if a person is bitten, scratched or exposed to the saliva of a
potentially rabid animal:
• Immediately wash the affected area with soap and running water for at least 15 minutes.
• Seek medical attention immediately at nearest healthcare facility.
• Get prompt post-exposure prophylaxis (PEP) to stop the virus from reaching the central
nervous system. PEP consists of thorough wound washing, administration of a course
of anti-rabies vaccine and rabies immunoglobulins (RIG) if indicated.
• Recognise signs that bite wounds get infected such as redness, pain, swelling and pus
discharge.
6. Conclusion:
“Rabies is deadly but preventable.”
References:
1. World Health Organisation
2. U.S. Centers For Disease Control and Prevention
3. https://www.bernama.com/en/news.php/crime_courts/world/news.php?
id=2407505
4. https://dvs.sarawak.gov.my/web/subpage/news_view/141
5. https://dvs.sarawak.gov.my/web/subpage/news_view/147
6. https://www.theborneopost.com/2025/05/25/first-human-rabies-case-reported