The fight to end rabies by 2030
While I was preparing for my first volunteering trip with animals, I went to get my vaccines status checked a few months ago. Beyond the usual tetanos booster, I have been recommended to get the rabies vaccine since I was going to volunteer with dogs in various parts of the world.
Albeit rabies is no longer an issue in Europe or North America, it is still an awful reality in developing countries in some parts of Africa & Asia.
That prompted me to learn a bit more about that deadly disease. Rabies is an example of zoonosis (definition here) and appears on the list of Neglected Tropical Diseases (NTDs) that the World Health Organization (WHO) aims to eradicate. Today, it continues to kill an estimated 59,000 people a year, many of whom are children living in Asia and Africa, where 95% of deaths occur [reference]
Let's review some key facts about rabies together!
What is rabies and how is it transmitted?
Rabies is a disease caused by a Lyssavirus (named after Lyssa, the Greek goddess of rage and madness). Rabies can affect any warm-blood mammal. This means that animals such as dogs, cats or even cattle can get rabies, and obviously humans too.
Rabies affects the central nervous system and is transmitted by saliva from an infected animal to another. Human beings can get rabies if an infected animal bites, licks or scratches them. In fact, someone can get the disease if the saliva from an infected animal gets into their body through any opening. If you get the saliva in your eyes, for example, it can give you rabies.
The #1 reason for rabies transmission is dog bites [reference]. That's why it is so important to tackle this challenge by minimizing risk of dog bites and also vaccinate as many dogs as possible.
What are the clinical symptoms of rabies in animals and in humans?
One of the first signs of rabies in animals is a change in behavior. A calm animal may become aggressive, or a very active animal may seem depressed. Rabid animals may show some or many of the following signs:
they might appear confused, restless or AGGRESSIVE strange behaviour, such as trying to bite the air, turning in circles, or appearing unusually tame around strangers
they might try to attack or bite anything that comes near, including things that are not alive
their voice might change (for example, you may notice a change in the pitch and tone of your dog's bark or howl)
they drool excessively
they sometimes eat strange things, such as rocks, dirt or wood
they lose their appetite
they are fully or partly paralyzed
and many other behaviour changes
In humans, several symptoms resemble in fact the ones seen in animals. The infographic below summarizes these.
What to do in case of bite by a suspected rabid animal?
If you plan to travel or live in a country where rabies is endemic, best is to get vaccinated beforehand (pre-exposure vaccination).
If you are bitten by a suspected rabid animal you should wash the wound with soap and running water (from a tap or poured from a jug) for at least 15 minutes and then go to a clinic for further treatment. The clinic will administer post-exposure prophylaxis (PEP).
The vaccines used for pre-exposure and post-exposure vaccination are the same, but the immunization schedule differs. Rabies immunoglobulin is used only for post-exposure prophylaxis. The rabies vaccines are now available in major urban centers of most countries of the developing world. Rabies immunoglobulin, on the other hand, is in short supply worldwide and may not be available, even in major urban centers, in many dog rabies-infected countries [reference]
Rabies vaccination is only effective during the incubation period. After clinical symptoms appear the patients usually dies within a few days. There is no test to diagnose rabies before the symptoms appear.
Rabies is 100% preventable
Effective tools and methods exist to stop the spread of canine rabies to humans. The most practical and cost-effective way to end canine rabies is mass dog vaccination, which saves the lives of both dogs and humans [reference]. Sustained vaccination of at least 70% of dogs in a rabies-endemic area creates herd immunity and eliminates canine transmitted rabies. The infographic below [link to PDF] from endrabiesnow.org depicts the current spending on rabies vaccination and shows that dog vaccination is the most cost-effective method to end rabies.
Did you know that rabies is 100% preventable if dogs are vaccinated?
So what's next?
The fight is on! Rabies is 99.9% fatal if you don't get access to proper care, yet it is 100% preventable. Rabies prevention and control requires different sectors to work together. These include people working in animal health, human health, animal welfare, government, education, and industry, together with the local community. The challenge of preventing and controlling the disease cannot be addressed by one sector alone. Everyone needs to work together = that's the One Health approach (more to come about One Health in a separate post).
Several organizations are taking this challenge seriously and aim to end rabies by 2030. The Global Alliance for Rabies Control is one of them. They provide educational material and resources, enable capacity building etc. You can get involved too. There are several ways to contribute such as Stay informed, Spread the word, Get certified or even Raise funds for rabies! You can check out this page to find more information.
Other organizations that you can follow and are active in that space include:
Mission rabies: they run dog vaccination program & educational outreach in Malawi, Uganda, Tanzania, Sri Lanka and India.
End rabies now: raising awareness, fundraising and providing educational resources (such as the infographic I shared above)
Thanks for reading!