Lyssinum (= Hydrophobinum) Anhang
[Swan and Berridge]
Lyssinum is the nosode made from rabid dog; the raw material for the mother tincture is collected from the saliva of a rabid dog. It contains the rabies virus, Lyssa, meaning rage or madness. The rabies virus lives as a parasite, depending on its host for life. It attacks the central nervous system suddenly and rapidly, causing great rage, biting, and violence.
Feeling of torture by someone you are dependent on
This remedy resonates with a state where the person feels horribly ridiculed or tormented. Often, there is a history of serious family abuse. Such mistreatment arouses phobic type of behaviour, so we see a lot of fears in this remedy. Accordingly, there is a conflict between their dependence and their need to revolt against this constant torment.
The main feeling is of having suffered wrong, being tormented, especially by one whom he has served, been faithful to and is dependent on, thus creating an intense feeling
of anger and rage, in which the person can bite, strike, and even violently mutilate.
Violent anger/ rage leading to craziness
One can imagine that in such a fearful person, there could be a lot of rage, which is a strange mixture of emotions. On the one hand, fearful and the other hand, violent rage;
so in a sense, rage is a defensive mechanism to cope with the threats from outside. They become very angry but the anger is followed by quick repentance or remorse.
Because the rage comes on suddenly and almost impulsively, they are left with an incredible sense of guilt or repentance afterwards. In a way, this guilt is a protection, as they are usually dependent on the person who is abusing them and therefore to continue to lash out would not be in their best interest
Deeply phobic; profound intense fear leading to craziness
We can observe very intense fear in Lyssinum cases. Lyssinum’s fear is ‘fear of insanity’: “Am I going mad?” The intensity of fear is so high that everything goes out of control. Everything is so intense and profound that it can lead to craziness. They have all sorts of fears but prominent fears are: fear from water, from glittering objects/ mirrors/reflected lights/sun light, fear of dogs, of madness, of all animals, of choking.
Sudden, violent and acute effect or action
Lyss. is highly impulsive and during case taking, it is difficult to find out the correct or accurate focus of the case. What we can observe is sudden, violent and acute effect
or action. They are hectic and rash in talking, which makes it difficult to follow them and we cannot sort out anything except intense sensitivity (morbidly sensitive).
<: heat of sun/glistening objects/running water (water in any form)/copper in any form;
Physical general – CNS irritability; wild look, staring, rolling movement of eyeballs; ropy, viscid, frothy saliva, constant spitting; acute sense of smell and hearing;
sneezing from dust or bright light (DD.: Lac-m)
History of rabies vaccines or animal bite
Easily choking, difficulty swallowing
Convulsions, worse from light, from liquids, from trying to swallow, from running water
Choking at the sound or sight of water
[Jeffrey Mduduzi Hadebe]
Experiences of People affected by Rabies in Ethekwini District
Rabies in humans is acquired through a bite from an infected animal; there are no documented cases where rabies was transmitted from one human to
another (Bishop et al. 2010: 33). The rabies virus is introduced via saliva of the infected animal and the virus stays for some time in the bite site and
travels slowly until it reaches the nerve cells where it travels faster till it reaches the brain (Bishop et al. 2010: 33).
At this point encephalitis will ensue and most of the rabies disease symptoms will show, but by this time there is nothing anyone can do because the
disease is fatal (Bishop et al. 2010: 42).
Several factors may influence the incubation period; including the amount of virus introduced into the wound, the site itself (whether it possesses
a large number of nerve cells), and the distance of the wound site from the brain or nerve cells.
The only known control measure is pre- and postprophylaxis (Hendekli, 2005: 1048).
Deshmukh et al. (2011: 178) argue that post-exposure prophylaxis sometimes fails due to deviation from the WHO guidelines. The WHO rabies
guidelines state that human death caused by rabies can be reduced drastically and pre- and post-exposure prophylaxis is the mainstay
(WHO1994, cited in by Bishop et al. 2010:34).
Besides all this information, there are some individuals around the world who have survived the rabies disease. One of the documented rabies survivors,
a teenager from Wisconsin U.S:A., Jeanna Giese, was put into an induced coma by her doctor in 2004 to put her brain at rest for it to recuperate, an approach
known as the Milwaukee Protocol. However, a study conducted around the world between 2005 and 2014 on rabies survivors noted that the same protocol
failed in a ll 12 patients who were treated using it (Zeiler and Jackson, 2016: 46).
The survival of some of the individuals can be attributed to other factors such as the amount of virus introduced to the individual, the immune status of the
individual, or that the individual was already vaccinated with anti-rabies vaccine (Zeiler and Jackson 2016: 44).
Hendekli (2005: 1052) documented five rabies survivors and the similarity among them was the fact that they did not receive the immunoglobulin at any stage.
They were treated with an incomplete course of anti-rabies vaccine. Weyer et al. (2016: 68) found13 human cases who survived rabies around the world,
four of whom were exposed to rabid bat bites.
There is a view that the bat strain of the virus is different from other rabies strains in a sense that bat strain is lethal to a lesser degree.
Jeanna Giese (the patient that was treated with the Milwaukee Protocol), was bitten by a bat.
The other rabies survivors were bitten by rabid dogs.
Among them there were two patients who survived without any post-exposure prophylactic treatment. The other patients were mismanaged in a sense that
immunoglobulin was not administered and the full course of the post-exposure prophylactic treatment was not completed (Zeiler and Jackson 2016: 46).
RECOMMENDED TREATMENT OF RABIES IN HUMANS
The WHO advocates pre- and post-exposure prophylaxis, which is recommended in particular for individuals whose careers involve working with animals.
Pre-exposure consists of administering a total of 3 doses of anti-rabies vaccine in the deltoid muscle on day 0, day 7 and day 21 or 28 (Bishop et al. 2010: 33).
For post-exposure prophylaxis, first the bite site or wound is categorised to one, two or three, and the treatment is given according to wound category
(Bishop et al 2010: 36).
The wound is cleaned preferably with soap and running water, this is done in order to reduce the number of viruses that may enter the body.
Neither suturing nor dressing is permissible because the rabies virus is anaerobic so covering the wound would make matters worse (Bishop et al. 2010: 37).
A dose of anti-tetanus toxoid in administered as a precaution. Passive immunisation is acquired by administration of Human rabies immunoglobulin (HRIG),
which is administered around the wound site within seven days of the bite. HRIG may not be able to neutralise the virus once it reaches the nerve cells, which
is believed to take up to seven days after the bite (Bishop et al. 2010: 37).
Active immunisation is acquired as a result of administration of the anti-rabies vaccine.
The anti-rabies vaccine is administered in the deltoid muscle on day 0, day 3, day 7 and day 21 after the bite (Hendekli 2005: 1051). . Initially, day 28 was
included in the treatment protocol, but after studies were conducted in the USA it was discovered that by day 14 after receiving the immunoglobulin and
anti-rabies vaccine, the body is able to produce rabies neutralising antibodies. The virus would have reached the brain before day 28 anyway in the absence of
treatment (Rupprecht et al. 2010: 3).
DIAGNOSING RABIES IN HUMANS
There are two ways to diagnose rabies in humans: ante-mortem and post-mortem (Bishop et al. 2010: 42).
History taking is very important in diagnosing rabies. The patient must have a history of contact with a rabid animal. Contact may involve feeding, nursing or
playing, which may result in contact with infected saliva from the infected animal.
An aggressive encounter may involve being scratched or bitten by a rabid animal (Bishop et al. 2010: 42).
Cardinal signs and symptoms of rabies in humans incl. pain, paraesthesia or itchiness at the bite site, which at this stage is a scar, because it would have healed
(Bishop et al. 2010: 42).
As the disease progresses, in the first four to five days there will be early onset of general body malaise, fever, headache, and gastrointestinal symptoms, which
are nonspecific. Following these initial signs and symptoms is a period where neurological signs and behavioural symptoms manifest, such as irritability, agitation
and restlessness, depression, anxiety and insomnia (Bishop et al. 2010: 42).
As the disease progresses, more neurological signs manifest: incoherent speech episodic terror, hallucinations, manic behaviour or nonspecific generalised convulsions.
Terminally there is progressive loss of neurological function. The patient experience inability to swallow, fear of drinking water because the swallowing reflex is
malfunctioning and hyper-salivation. As the patient deteriorates neurologically, there will be frequent muscular spasms and convulsions. The patient becomes
disorientated with increased hallucinations and confusion, followed by coma.
Demise (das Ableben/der Tod) may follow as soon as specimen for testing including the following:
Saliva is collected daily for three conservative days using a sputum container with about 1 ml being collected (Department of Health 2016: 7).
Lumber puncture is performed and 0.5 ml of cerebrospinal fluid is collected (Department of Health 2016: 7).
Nuchal biopsy is conducted by harvesting tissue which contains hair follicles at the nape of the neck.
The sample should be 5 mm or 6mm in diameter and 5mm thick (Department of Health 2016: 7).
If rabies was suspected and not diagnosed while the patient was still alive, a post-mortem is conducted to confirm the diagnosis.
The whole or half the patient’s brain is collected for testing by a forensic pathologist.
The specimen collection and storage procedures should be adhered to.
Specimens should be labelled, stored in a sealable container and not in formalin and kept at 4° C.
The specimen should be sent to the National Institute for Communicable Diseases (NICD), (Department of Health 2016: 8).
PREVENTION OF RABIES
Several scholars agree on mass vaccination of pets and pre- and post-exposure prophylaxis (Pye, 2014: 56-57/Rupprecht et al., 2010: 5/Smith 2015b: 3/
Meltzer and Rupprecht 1998: or contact with stray animals even if they are pets.
Treat wild, free-roaming or captive animals with caution.
Avoid bats, especially from caves.
Be cautious of dogs that may chase mobile modes of transport (bicycles).
Information, educational and campaign material should be made available at strategic points to benefit travellers (children).
GLOBAL PERSPECTIVES ON RABIES
Marinozzi et al. (2016: 374) assert that rabies was first discussed during the 18th century and there were a number of theories that emerged as causal factors.
After a period of trial and error, in the late 18th century, rabies was associated with bites from poisonous dogs. This was the first linkage of rabies to animals.
The 19th century saw initial attempts at treating rabies.
Although rabies is a global scourge, it was listed as one of the neglected tropical diseases in the WHO Report (WHO 2013a: 4). Some countries are rabies free
for example, Islands and some peninsulas while, India, China and some parts of Africa remain the leaders in the rabies incidence (Smith 2015a: 1). The contributing
factor to the disease being out of control in areas such as India is the usage of out dated vaccines but this has improved in the last 10 years.
Another strategy that has helped is control of the dog population by the introduction of animal birth control programmes (WHO 2013a: 32).
Many countries have strategies to reduce the incidence of rabies and eradicate it with South East Asia aiming to eradicate the disease by 2020 (WHO 2013a: 31).
Rabies is responsible for 55 000 annual deaths globally (Matibag et al. 2009).
Hendekli (2005: 1047) argues that if one includes unreported cases, the actual number is likely to be more than 60 000 deaths.
The estimation is that about 327 000 individuals would die of rabies annually if rabies treatment was not available in areas like Asia and Africa (WHO 2010: 310).
The actual incidence of rabies worldwide may not be accurate due to the fact that rabies is sometimes misdiagnosed and the victims die before the disease is suspected
and in the absence of post-mortems the disease may never be confirmed (Carrara et al. 2013: 4/Marinozzi et al. 2016: 378).
According to Mudiyanselage et al. (2016: 1), due to its long incubation period rabies can be misdiagnosed, and health service providers may suspect other tropical
diseases like malaria until the history of dog bite surfaces, which in some instances is after the demise of the patient. Kakkar et al. (2012: 6) reported problems such as
ineffective intersectoral coordination, focus on rabies control in urban areas and not other areas, ineffective dog population management, and weak diagnostic capacity.
These problems contributed to India being one of the leading countries for human fatalities from rabies. Matibag et al. (2009: 58-59) state that information on rabies is
available on media platforms like radio, print media and television.
Some information comes from sources like teachers in schools, and health outreach campaigns.
They found that information on rabies did not alter the participants in their study’s health practices related to rabies although the information was deemed useful.
Globally, Rabies Day is commemorated annually on the 28th September.
This date was chosen to honour Louis Pasteur who was the founder of the anti-rabies vaccine and many other vaccines (WHO, 2017). He died on this day.
Rabies was earmarked for elimination in 2015, however the goal was not achieved, hence the 2017 slogan is ‘Zero by 30’ (WHO 2017).
Participants gave accounts of how rabies affected their lives; for some of the participants their normal routines changed.
Expression of inner feelings Participants expressed their experiences emanating from the effects of the rabies disease in their lives.
The participants were either directly affected (directly bitten by a rabid dog) or indirectly affected (being close to the individual who was bitten by a rabid dog).
From the experiences shared by the participants, it was determined that there were elements of desperation and pain. One participant referring to the rabies survivor
she was caring for stated: “It is very painful because as it is he is bedridden and cannot do anything for himself.
He cannot go to school, he is missing out, and his peers are progressing he cannot do anything....
He is like a disabled individual....
The situation put me in a difficult position. Normally I would find jobs and earn a living, and now if I were to get a job, I cannot take it because I need to take care
of him. If I have to go somewhere I have to ask for assistance from somebody to be his guardian.” (P1)
“I felt the pain, because I had to live with the knowledge that he cannot do anything for himself. His milestones would have progressed but because of rabies he is
not able to progress and that affects me....
The family was adversely affected psychologically, because since the child was diagnosed with rabies there was no improvement in his condition, he was never cured
of rabies.” (P2)
One participant verbalised memories of the scenes from when her mother who died of rabies acted in a very peculiar manner. She stated that her mother behaved
almost like a dog. At the time none of the family understood or knew what was wrong with her. Her mother was diagnosed post-mortem.
She stated: “...she howled like a dog, she would bite on people and she ripped her clothes apart, she would act like a playful dog to the visitors who came, and in her
mind she was welcoming them, not realising that she was acting like a dog.... We realised after she passed on that she had rabies.” (P3)
Not all participants were worried about their lives, and some participants raised concerns about the welfare of the animals. One participant stated that he felt bad for
the dog, after it was put down and diagnosed with rabies. He stated that it was his animal and he loved it as noted in the excerpt below:
“I had worst fears for the dog, but I could not just abandon my dog like that.”(P4)
One participant stated that although it came as a shock that he almost lost a finger from a bite from a donkey, it was not its fault. He stated: “...he did not bite me
intentionally, it happened because of me trying to help him because he appeared ill”. (P9).
Some participants verbalised fear of dogs. The researcher gathered that these participants would not keep dogs and they would change direction when a dog was
approaching or sometimes had an urge to harm dogs.
Participants stated: “I hate dogs and cats, if I see a dog it is as if I am seeing rabies.... When the dog approach, I am always tempted to throw a stone at it.” (P10)
“We developed fear of dogs and cats, I am scared to go to my neighbour because she is keeping dogs, and here at home we would never keep any dog or cat.
Before the incident I did not have anything against the dogs and cats and that all changed after the incident.” (P8)
“We are now very scared of dogs and cats, because whatever actions they display become suspicious to us and this is because the community do not take care to
vaccinate their dogs and cats.” (P6)
Periods of uncertainty and anxious moments
Participants demonstrated the rabies disease brought about confusion in and inability to comprehend the situation of not understanding the illnesses their family
members suffered from prior diagnosis.
Participants, after a period of waiting for a confirmation of diagnosis, stated:
“... the child was admitted for about 10 days, injections and drips were administered however the child passed on during that period, from then on I feared rabies
because my first encounter with it resulted in a death.” (P8).
This participant was only made aware of the diagnosis after the child died.
One participant reported that initially her mother was diagnosed with joint pains and rabies was diagnosed after her death as noted below:
“The doctor we consulted initially before we knew the diagnosis, stated that she was suffering from joint pains....
The worst part is that we were not aware of what she was suffering from, rabies was only diagnosed after she passed on, and looking back, then we realised why
she acted the way she did, it was because of rabies”. (P3)
Some of the participants went through a period of seeking answers, their family members were ill, and it looked serious and there was even a display of strange
symptoms by their ill family member.
Participants verbalised: “It was scary because we did not know whether the child would be diagnosed with rabies.
However, we were assured at the health facility that if medical help was sought sooner there would be lesser damage.” (P6)
It is during these anxious moments that the participants would have flooding of mixed emotions, fearing for their loved ones and hating the perpetrator animal
at the same time.
“...I even wish that the dog would die the same day because it attacked and mauled many children in its path of destruction, about four that we knew of and
I wished that to stop.” (P6)
“...if the damage was not done by my neighbour’s dogs, I swear something in a form of retaliation would have happened to their family by now.” (P1)
The study noted that the peculiarity of the signs and symptoms of rabies brought anxiety to the participants.
This is supported by the comments from the participants who made the following statements:
“After two or three months, we realised that the disease was affecting him inside, but before that no one noticed anything because the wound healed and
he was his normal self. He complained of pain on the arm that was bitten, it could be possible that as a man he had ego and concealed the pain.” (P10)
“The dog bite happened in April and the wound healed without her going to the clinic, then at the end of May she started complaining of sore arm the same
one that was bitten and three days later she got ill and passed on.” (P3)
“...my child was bitten on the foot and arm, it was around March 2013, we sent the child to hospital and we were told that she was supposed to get two
injections however one was out of stock and only one was administered, we were then sent home to continue with the scheduled injections at our local clinic.
The rest of the scheduled vaccines were received at the local clinic.
Towards the end of March, the child started complaining about pains on the sites that were bitten, the arm and the leg. ” (P8)
Coping with rabies
Participants gave accounts of the aftermath of rabies.
They indicated that there were challenges in their lives that can be attributed to rabies:
“I even failed at my second term grade at school (term ending in June).
Memories would come back like a picture film, and the realisation that all that happened was because of a rabid dog, affected me adversely. ” (P3)
“It was very painful because we lost a breadwinner; he did everything for the family. After he passed on many negative occurrences happened, even the
family was divided. It is never the same without him.” (P10)
Awareness about rabies and rabies control measures
The study revealed that the participants’ experiences made them aware of the rabies disease.
“We think we could have lost the child if we approached traditional healer.” (P2)
“...this was the first episode we have ever heard of person passing on because of rabies, we learnt that the dog could be rabid and rabies could kill.
So everybody was wondering as looking back at the time the dog attacked my mother to the time she got ill, and realising that rabies has strong toxins.”
“I think the focus should be on animals, since rabies is acquired through, they should be managed in such a manner that they do not acquire rabies, or if
they do acquire the disease, it does not cause problems. In my opinion the rabies control measures are not enough because these dogs are vaccinated...
but rabies still affect them. ” (P4)
“...before the ordeal we were aware of the rabies disease but it was something we had never seen before and we were not aware of rabies control
programmes, however now knowing that there are such programmes I would say they are not enough because the dogs reproduce constantly and the
relevant department should at least vaccinate monthly.” (P8)
“The impact is that my family knows that if there is another rabid dog on the property, I am the one that can go and catch it because I am immune now.
I am protected whereas they are not. We do have a safe guard and they are all aware now far more knowledge and knowledge is powerful....
All our pets have always been inoculated. All our domestic pets, dogs and cats. The donkey was not inoculated because he was difficult to control or get
hold of it. He lived on a hill side over there, but we do get our horses now all inoculated....
I am far more aware of the consequences, so I am knowledgeable. I know what to do, when to do it and what not to do, I am far more educated.” (P9)
“We had no idea of what rabies was about. We were only informed of rabies after we were alerted that the dog we came into contact with was diagnosed
with rabies.” (P5)
“We think the rabies control measures that are in place are enough, it is up to the community members to take advantage of such initiatives.” (P6)
“Rabies control programme does exist however I don’t think people are hundred percent aware of such.” (P3)
It was evident that the community members were affected by rabies in different ways. Those who kept the animals as pets or livestock should take
responsibility for them. Individuals who were bitten by animals should take responsibility for their own lives. The health facilities should take responsibility
for health care provision of health including educating the community and make sure that the medication is available at all times.
In the next chapter, the results of the study will be discussed.
DISCUSSION OF THE RESULTS IN REFERENCE TO Health Believe Model (= HBM)
HBM ELEMENT THEME
Perceived seriousness Family background and support. Some participants viewed dog bites as a minor concern and the family
members were unaware of the gravity of the situation until it was too late.
· Socio economic status.
· Social beliefs.
Perceived susceptibility Predisposing factors and risky behaviours. Participants were aware of the threat unvaccinated animals posed and
some of them tried to persuade ignorant owners to vaccinate.
· Social misconceptions.
· Unsafe gestures and practices.
Perceived benefits Knowledge about rabies and expectations Participants became aware of the benefits of animal vaccination;
from officials. hence, there were some expectations from the Health Department.
· Role played by the officials.
· Availability of health support resources.
Perceived barriers Hindrances to seek help. Some participants had financial challenges to seek help and they
ended up being infected by rabies.
· Lack of income.
· Attitudes towards animal bites.
· Unavailability of resources.
Modifying factors Effect of rabies to the individuals. Participants who experienced caring for patients with rabies are the best
teachers for people who do not understand rabies.
· Expression of inner feelings.
· Periods of uncertainty and
Cue for action Sub-theme: Some participants started using the rabies experience to their family’s advantage.
· Coping with rabies situation. They were ready to assist with knowledge using their own experiences.
Self-efficacy Sub-theme: Some participants started educating others on the dangers that rabies
could pose and the preventative methods.
· Awareness about rabies and
rabies control measures.
Predisposing factors and risky behaviours
It was evident in the study that some community members had a low perception of susceptibility to rabies. They were committing risky acts. These acts included
a deliberate move not to vaccinate animals like dogs.
These findings agree with Lembo et al. (2010:6). Their study concluded there was unwillingness/inability by the community members to bring dogs for vaccination.
The dog owners stated they could not catch their dogs. This study revealed that the reason for not vaccinating was the belief that dogs become less sharp in hunting
if they are vaccinated. One of the participants observed this action and he got involved in trying to correct it.
Another kind of risky behaviour by the community members was the tendency to pick up stray animals. In most cases, the intention is to help the animal.
Stray animals are a big risk for rabies because they are ownerless, which means they are likely not be vaccinated (P 9).
The findings of this study also concur with Pye (2014: 56) who made the following recommendations for overseas travellers in her study:
Avoid contact with free-roaming animals (dogs and cats).
Avoid contact with wild, free-roaming or captive animals.
Be aware that sick dogs may chase bicycles and motorcycles.
Adedeji et al. (2010: 1302) concur with Pye (2014: 56) stating that individuals should avoid engaging with animals they are not familiar with no matter how friendly
they may seem.
Some of the reasons the animals end up being stray is the uncaring nature of their owners who abandon them. These abandoned animals end up fending for themselves.
Nel (2009: 63) asserts that HIV and AIDS have fuelled rabies expansion. In some parts of KZN, the HIV rate is 60% to 80%.
When a dog owner dies, the family often abandons the dog.
During this period, their animal instinct kicks in and they form packs. Bishop et al. (2010: 2) concurs with (Nel 2009: 63), stating that one of the reasons for emergence
of rabies in 1976 because of immigrants from neighbouring countries who migrated due to socio-political reasons and came with unvaccinated animals or abandoned
them to fend for themselves.
The emergence of HIV/AIDS has also resulted in ownerless animals after the owners have died. The abandoned animals form feral packs to survive.
Abubakar and Bakari (2012: 110) asserts that stray dogs were the major contributor to dog bites in the communities, with most dog owners being irresponsible and did
not putting their animals on a leash, which meant they were wandering around.
Other evidence of low perception of susceptibility evident from the study are statements that some community members drink water from the same water that the dog
has been drinking from. The risk is that infected dog’s saliva harbours rabies.
Drinking water which has traces of dog’s saliva could introduce rabies to humans because the rabies virus can be absorbed through the mucosa and enter the blood stream.
Modupeoluwa et al. (2014: 617) stated that rabies could be transmitted by means of rabies virus introduction through the mucous membrane.
The reason for this behaviour, as stated by one of the participants, was to treat shortness of breath, for example asthma attacks.
Another participant said that that dog bite wounds were not taken to health facilities; instead, the dog’s hair was burned and the ash would be rubbed on the wound to bring
Ekanem et al. (2013: 1171) confirms the presence of misconceptions in the communities by stating that the dealers in the dog trade relating to dog meat consumption were
cognisant of rabies. The dealers believed that there was an organ within the dog's abdomen which serves as a prophylaxis against rabies when consumed, but they kept this
knowledge secret. These practices although they are not widespread in eThekwini, remain a danger to society and should be addressed.
Tarkang and Zotor (2015:5) define perceived susceptibility, as individuals’ beliefs about the risks of being exposed to a health condition. The higher the risk, the more
the individual feels vulnerable. Eventually the individual feels inclined to take preventative action against a health condition. An example of this change is an individual
who engages in sexual activity and uses a condom to curb vulnerability to HIV.
The study yielded information about the participants’perceived susceptibility.
The chapter discussed the themes that emerged from the study in relation to the theoretical framework underpinning it, and a response to the research question,
“What are the experiences of the people affected by rabies in eThekwini district?”
It was evident that participants in this study agreed on some issues and differed on some other issues.
This is natural because people’s perceptions on any given matter will not always be the same. The discussion on the findings of this study leads to the conclusion of the study including limitations and recommendations,
The irresponsibility of owners starts with not conforming to eThekwini bylaws regarding animal keeping, the mostly violated one being fencing of the yard and
keeping animals like dogs on a leash when they are outside the yard.
The rabies control programme is not sufficient because plans are in place to control rabies among the human owned animal population, but pets are exposed to wild and stray
animals whose rabies is not under control. The animal vaccination cycle is three years under normal circumstances and annually during outbreaks.
The researcher is of the view that this should be reviewed.
The main circumstance surrounding the demise of some of the participants’ family members was lack of knowledge about rabies, which led to decisions not to visit health facilities.
Three participants from different families had similar challenges of unavailability of sufficient anti-rabies treatment at health facilities. Consequences were fatal for two
of the family members and there were serious health problems for the other.