Rabies is a disease known the world over. While largely associated with animals, pets as well as wildlife, did you realize that it poses an ongoing and significant danger to people, as well? In fact, rabies causes tens of thousands of human deaths ever year.
Rabies
Rabies is a virus that is spread by the saliva of an infected (rabid) animal, usually a stray dog but also infected pets and wild animals such as bats or foxes. It is also fatal.
Rabies primarily affects the central nervous system, leading to severe brain disease and death if medical care is not received before symptoms start.
– CDC
Like so many things, rabies begins with flu-like symptoms – fever, headache, nausea and vomiting. Further symptoms, however, include anxiety and hyperactivity as well as agitation and confusion. Difficulty swallowing frequently results in fear of drinking liquids. Infected persons also tend to demonstrate fear of air being blown on their face. Excessive salivation, hallucinations, and insomnia as well as partial paralysis are all symptoms of rabies. Once recognizable symptoms are apparent, it nearly always results in death.
While rabies is certainly deadly, it doesn’t have to kill. The key is to receive timely and thorough care, as prevention is the focus of treatment, even post-bite. Once the disease has reached the brain and central nervous system, nothing can be done. This means that people must receive medical attention immediately if bitten, or even if exposure is only suspected. Treatment includes not only wound care, but also a dose of human rabies immune globulin (HRIG) as well as a series of rabies vaccines. This treatment procedure is known as prompt post exposure prophylaxis or simply PEP. When administered promptly and correctly, PEP is almost 100% effective. In fact, while some 60,000 people in America are treated for rabies every year, there are fewer than 10 reported deaths caused by rabies.
Want to Know More?
Check out this Mayo Clinic article!
A World Health Concern
While areas such as the Americas and Europe have largely overcome the disease, rabies continues to be a serious health concern in more than 150 countries worldwide. In fact, rabies causes some 59,000 deaths every year. 40% of them are children. The most affected areas are Asia and Africa. India alone account for more than 35% of the world’s reported dog-mediated rabies deaths.[1] Another factor endemic to these regions is widespread poverty., including multidimensional poverty which includes access to services such as education, food, sanitation, and healthcare.
Rabies is one of a collection of medical condition included in Neglected Tropical Diseases (NTDs). Associated with stigma and social exclusion, these diseases disproportionately concern neglected populations around the world and are largely overlooked when it comes to health agendas.[2] While effective treatment is available, for many developing countries those treatments are only available in large city hospitals. Many poor and rural communities have limited, if any, access to healthcare in general, and cannot afford expensive vaccines or PEP care.
Rabies in Africa
Most cases of rabies in Africa are due to animal bite, mostly dog, but also cat, jackal, monkey, and others. There are approximately 25,000 rabies deaths every year in Africa.[3] That being said, many of cases go unreported. In fact, in most countries of Central and West Africa the reporting of rabies is not mandatory, meaning the actual numbers of people infected and dead from the disease is probably higher.
One challenge Arica faces is it landscape, especially in sub-Saharan Africa. Many stray dogs survive in hard-to-reach regions and the inhospitable landscapes south of the Sahara, making it difficult for these countries to implement the 70% of dogs vaccinated necessary to significantly decrease instances of rabies in humans. But there is cause for hope in sub-Saharan Africa; this kind of mass, yearly dog vaccination has proven successful in South Africa, Tanzania, Malawi, and Chad.[4]
Prevention
It’s said that an ounce of prevention is worth a pound of cure. Rabies is vaccine-preventable. Many of us who keep mammalian pets, whether a cat or dog or ferret, make sure they receive their annual rabies vaccination. This simple, effective solution ensures that they are safe from the animals they happen to come into contact with outside our homes, and it protects their owners from being scratched or bitten later on. In spite of this, dog bites and scratches continue to cause 99% of human rabies cases.
WHO and its global partners aim to end human deaths from dog-mediated rabies through a comprehensive One Health approach promoting mass dog vaccination, ensuring access to PEP, health worker training, improved surveillance, and bite prevention through community awareness.
– World Health Organization (WHO)
Prevention starts at the community level. Awareness programs can reduce the number of rabies deaths. By educating people how to avoid animal bites as well as how to recognize a potentially rabid animal, adults and children alike may avoid numerous bites. Understanding the importance of and how to administer first aid following bites or other potential rabies exposures could reduce the number of infections. Even just the immediate, thorough washing with soap and water after a suspected exposure can save lives.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10784771/
[2] https://www.who.int/news-room/questions-and-answers/item/neglected-tropical-diseases
[3] https://academic.oup.com/inthealth/article/7/1/4/2964839