Dr. Huynh Tran An Khuong, Medical Manager of the VNVC Vaccination Center System, issued this warning as many hospitals report cases of children being attacked, bitten, and scratched by pet dogs and cats. Recently, the Hospital for Tropical Diseases in TP HCM admitted two boys, aged 29 months and 12 years, who were attacked by dogs while playing. The 29-month-old was bitten on the neck, arm, and right thigh while petting a dog, sustaining a 3x5cm wound on his neck, dangerously close to the carotid artery. The Can Tho Children's Hospital also reported a 24-month-old boy from Hau Giang who suffered severe head injuries, including exposed skull and serious facial abrasions, after being bitten by a pet dog.

According to Dr. Khuong, the rabies virus reservoir in nature typically includes mammals like dogs, cats, bats, and foxes. The virus, present in the animal's saliva, enters the human body through bites, scratches, or by licking open wounds.

A 5-year-old girl, bitten on the face and head by a dog weighing over 20kg, receives treatment at the National Hospital for Tropical Diseases. Photo: National Hospital for Tropical Diseases

A 5-year-old girl, bitten on the face and head by a dog weighing over 20kg, receives treatment at the National Hospital for Tropical Diseases. Photo: National Hospital for Tropical Diseases

Children often hug, pet, play with, and tease dogs and cats, which can irritate the animals. Misinterpreting these actions as aggression, the animals may retaliate. Children under 5 are small, while dogs can be large, their heads level with a child's head, face, or neck. This makes it difficult for children to defend themselves, leaving them vulnerable to bites and scratches on the head, face, neck, fingers, and toes. Young children also don't understand how to interact appropriately with pets, sometimes invading their space, stepping on them, or pulling their fur, ears, or tails, which can provoke an attack.

Older children, who often play outdoors, are also at risk of being bitten or scratched when near animals. The risk of rabies increases during summer. Hot weather can make dogs and cats more agitated and aggressive, while the practice of letting unvaccinated pets roam freely remains widespread. Even vaccinated dogs and cats can still carry and transmit the rabies virus.

Upon entering the human body, the rabies virus multiplies at the entry point and travels into the muscle nerves. It then moves through the peripheral nerves to the spinal cord and brain at an estimated speed of 12-24mm per day. Once it reaches the brain, the virus causes encephalomyelitis, destroying nerve cells in the spinal cord and spreading to internal organs. This makes treatment efforts futile, leading to death.

The rabies incubation period depends on the severity and location of the bite (especially its proximity to nerve-rich areas and the brain), and the amount of virus transmitted. More severe bites closer to the central nervous system result in shorter incubation periods.

Therefore, Dr. Khuong advises families to closely supervise children playing with animals. Children should be taught not to provoke animals or approach them while they are eating or have recently given birth. Pets should be muzzled, fully vaccinated, and kept in areas separate from children's play spaces.

Children and adults receive pre-exposure rabies vaccinations at VNVC. Photo: Moc Thao

Children and adults receive pre-exposure rabies vaccinations at VNVC. Photo: Moc Thao

If a child is bitten or scratched by a dog or cat, families should treat the wound properly: wash it under running water for 15 minutes and then disinfect it with 45-70% alcohol or iodine to minimize the rabies virus at the bite site. The child should then receive a rabies vaccination as soon as possible. Families should not use herbal remedies, self-treat, or consult traditional healers for rabies.

The rabies vaccine activates the immune system, creating antibodies that recognize and destroy the virus, protecting the body from infection. Vietnam currently has two types of rabies vaccines: Verorab (France) and Abhayrab (India), administered intramuscularly or intradermally. Individuals bitten or scratched by an animal (who haven't been previously vaccinated) receive five doses on days 0, 3, 7, 14, and 28 intramuscularly; or eight doses on days 0, 3, 7, and 28 intradermally.

Those who have not been bitten or scratched but are at high risk of rabies exposure, such as those who regularly handle animals, can receive pre-exposure prophylaxis with three doses on days 0, 7, and 21 or 28. If a child has completed the pre-exposure vaccination schedule, they only need two additional doses and no serum, even if the wound is severe.

Tuan An