This month World Rabies Day is again celebrated ton September 28 – and the goal to “End rabies now!” will echo around the world.
This call is being made to end rabies deaths in humans by 2030. Globally, it is estimated that up to 59 000 people die of rabies – this amounts to a rabies death every 10 minutes. The vast majority of human rabies cases are reported from poor countries in Africa and South East Asia.
These figures may seem relatively low when one considers the burden associated with HIV, TB and malaria, but rabies is an untreatable disease.
Once the brain infection appears, we do have the tools to prevent human cases that result from exposure to rabies in dogs.
Rabies is caused by a virus which infects the brain. The virus is transmitted to humans most often through exposure to infected domestic dogs.
The exposure may include bites, but it is important to note that small nicks that break the skin or even licks of the eyes, nose and mouth are regarded as exposure.
Other animals are also affected, and in South Africa reports of rabid jackal, mongoose and cattle are not uncommon, but human cases are not often linked to these animals.
Rabies is a progressive disease and once a person starts developing symptoms it usually takes no more than two weeks for them to slip into a coma and die. Rabies is truly horrific, and people and animals endure an agonising death.
Rabies can however be controlled.
This is achieved through ensuring rabies vaccination in domestic dogs in accordance with national laws.
Around the world, the elimination of rabies in domestic dogs has been achieved where people have set this goal for themselves and put programmes in place to ensure that domestic dogs are vaccinated appropriately.
In South Africa, dog rabies has been reported since the 1960s. KwaZulu-Natal has always been the most affected regarding the number of rabid dogs, with many exposed persons and up to 25 human deaths annually.
However, since the province has made it a priority to control the disease in dogs much progress has been made and the number of cases in the past five years has dropped markedly both in dogs and humans.
We have however seen reports of rabies increasing in various other locations. In 2010 an outbreak of rabies in southwest Joburg took considerable efforts over a year to bring the outbreak under control.
This marked the first report of local transmission of the rabies virus in the city.
The outbreak also highlighted the vulnerability created when people are complacent regarding dog rabies vaccination – even if rabies is not occurring in your area at the time, if one fails to vaccinate you open the door for the disease to your community.
Apart from dog rabies, a marked increase in the number of jackal rabies has been reported in North West and more recently Gauteng.
Although these animals cannot be reached by conventional measures of control, the vaccination of domestic dogs, cats and cattle is now more critical than ever to reduce the risks of human rabies.
The disease may easily spill over to domestic animals but if they are vaccinated they are protected from infection and cannot pass it on to people.
The focus of control and prevention of rabies in domestic animals and humans is clearly to ensure regular vaccination of domestic animals, the owners’ responsibility, with supplemental vaccination campaigns from state veterinary departments.
There is no effective treatment for rabies and all animals and patients will die, but there is an opportunity to provide effective prevention if a person is exposed to a suspected rabid animal through wound care and the administration of rabies vaccine and preformed rabies antibodies as soon as possible after exposure.
In South Africa, the uptake of rabies post exposure prophylaxis is considerable, and the National Rabies Action Group estimated in 2014 that at least R70 million was spent on this annually.
This economic burden will remain a reality until dog rabies is brought under control.
So how can you be part of the solution? The answer is vaccinate, vaccinate, vaccinate!
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* Dr Weyer is a medical scientist, Centre for Emerging and Zoonotic Diseases at the National Institute for Communicable Diseases
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How World Rabies Day came into being
World Rabies Day is an international campaign co-ordinated by the Global Alliance for Rabies Control, a non-profit organisation with headquarters in the US and the UK.
World Rabies Day takes place each year on September 28, the anniversary of the death of Louis Pasteur who, with the collaboration of his colleagues, developed the first efficacious rabies vaccine.
World Rabies Day aims to raise awareness about the impact of rabies on humans and animals, provide information and advice on how to prevent the disease, and how individuals and organisations can help eliminate the main global sources.
World Rabies Day is a UN observance event endorsed by international human and veterinary health organisations including the World Health Organisation, the Pan American Health Organisation, the World Organisation for Animal Health (OIE), the US Centers for Disease Control and Prevention, the World Veterinary Association, and the American Veterinary Medical Association.
The World Veterinary Association and the World Medical Association have joined forces to mark World Rabies Day by calling for human rabies contracted from unvaccinated dogs infected with rabies to be totally eradicated by 2030 in collaboration with the “End Rabies Now” campaign initiated by the Global Alliance for Rabies Control.
It is estimated that rabies kills more than 60 000 people every year, about 40% of them children under 15. The disease is more prevalent in poor communities.
Dr René Carlson, president of the World Veterinary Association, states: “Rabies is one of the deadliest diseases we know. Yet rabies is preventable if several measures are followed. Some measures include mass vaccination programmes of dogs, humane population control of dogs through spay and neuter programmes, community education about rabies and dog bite prevention, the importance of dog bite medical treatment, and availability of rabies vaccine therapy after exposure.
"We currently have the tools to prevent this devastating disease and eliminate the suffering of dogs and people who contract this fatal disease. Eradicating rabies is a public health necessity.”
She says when a person is bitten by a suspect rabid animal, that person must seek immediate medical care and be evaluated for rabies vaccine therapy. If possible the animal should be examined, quarantined at an appropriate location, or euthanised for rabies virus infection verification by a qualified laboratory. – Staff Reporter, Wikipedia