FOCUS ON RABIES:
What you need to know
WITH World Rabies Day being held today, 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 annually of rabies, which 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.
Although these figures may seem relatively low considering the burden associated with HIV, TB and malaria, rabies is an untreatable disease once the brain infection appears, yet we have the tools to prevent the human cases that result from exposure to rabies in dogs.
Rabies is caused by a virus that infects the brain.
The virus is most often transmitted to humans through exposure to infected domestic dogs.
The exposure may include bites, but it is important to note that nicks that break the skin or even licks of the eyes, nose and mouth are regarded as exposure.
Other animals are also affected. In South Africa, reports of rabid jackals, mongooses and cattle are not uncommon, but human cases are seldom 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 as a disease is horrific, and people and animals endure an agonising death.
But it can be controlled through ensuring rabies vaccination in domestic dogs in accordance with national laws.
Globally, 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 dogs are vaccinated appropriately.
In South Africa, dog rabies has been reported since the 1960s after the disease was introduced into the country. Since then, the history of the control of rabies has been marked by intermittent successes but also challenges.
KwaZulu-Natal has always been the most affected, having the most rabid dogs, with many exposed people 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 seen reports of rabies increasing in various other locations in South Africa. For example, in 2010, an outbreak of rabies in southwest Joburg took considerable efforts over a year to control. This also marked the first report of the transmission of the virus in the city and reiterated the vulnerability created if people are complacent regarding vaccination.
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 can’t be reached by conventional measures of control, the vaccination of domestic dogs, cats and cattle is 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 the infection and can’t pass it on to people.
The focus of control and prevention of rabies in domestic animals and humans is to ensure regular vaccination of domestic animals is the owners’ responsibility, with supplemental vaccination campaigns from the various state veterinary departments.
While there is no effective treatment for rabies and all animals and patients will die, there is an opportunity for prevention if a person is exposed to a suspected rabid animal through wound care and the administration of rabies vaccine and pre-formed rabies antibodies as soon as possible.
In South Africa, the uptake of rabies post-exposure pro- phylaxis is considerable. The National Rabies Action Group estimated in 2014 that at least R70 million is spent on this in the country annually. This economic burden will remain a reality until dog rabies can be brought under control.
So how can you be part of the solution? Vaccinate. Rabies vaccinations for your pets are available from your local vet, but also keep your eyes open for community clinics that offer this service.
More information regarding rabies in South Africa can be accessed from the National Institute for Communicable Diseases website, www.nicd.ac.za