Did you know that 28th September is World Rabies Day? Sadly, this disease still exists, and claims 59,000 human lives each year, not counting the thousands of infected animals. There is, however, an umbrella organisation trying to change that – the Global Alliance for Rabies Control (or GARC for short). They’ve set themselves the (difficult, but achievable!) goal of “Zero by 30” – in other words, no human cases by 2030. The World Rabies Day is there to promote their work, to raise awareness, and to build support.
So, for World Rabies Day and in support of GARC, in this blog I’m going to look at rabies, it’s impact on animals, humans, and whole societies; and at how we can all take action – however small – to help us achieve Zero by 30.
Surely this doesn’t affect us in the UK?
Sadly, the UK is not free of rabies risk. There are two potential threats here:
- Bat rabies, or more properly, European Bat Lyssavirus, is naturally present (enzootic) in the UK. Although it is relatively rare, there are periodic cases (the latest was earlier this month!). In addition, there have been human fatalities, within the mainland UK, associated with bat bites.
- Importation, especially from Eastern Europe. While it is illegal to import a dog who has not been vaccinated against rabies, there are two possible loopholes:
Firstly, it is no longer legally necessary for the vaccinated dog to have a blood test to prove that the rabies vaccine has “taken” and has been effective. So, it is theoretically possible (although very, very unlikely) that a vaccinated dog could contract and transmit rabies.
However, by far the biggest risk is probably illegal imports with falsified papers – this is, tragically, becoming more and more common, especially from some Eastern European countries. In these areas, puppies are farmed for export to the UK, and then sent over with fake vaccination documents. You can read more about this from the Dogs Trust; ultimately, it’s only a matter of time before someone imports a dog who is incubating the disease.
What is rabies?
Rabies is a viral disease caused by a rhabdovirus. It can infect any warm-blooded mammal, although rodents seem to be relatively resistant. The main vector are canids – dogs and foxes. The infection is transmitted primarily by bites via saliva from the rabid animal. After a bite, the virus multiplies in the tissues near the bite site, then slowly migrates up the nerves into the spinal cord, and from there into the brain and salivary glands. At this point, the symptoms develop and any human, or animal, who comes into contact with the infected creature’s saliva is at risk.
However, the incubation period can be very long – up to six months – depending on how far the initial site of infection was from the brain.
What are the symptoms in animals?
In almost all cases, the first symptom is a marked behavioural change. Thereafter, there are progressive changes in brain activity and behaviour, as well as progressive muscular paralysis. There are often considered to be two distinct forms of the disease, although there is a lot of overlap:
- Furious Rabies. By far the most recognisable, this is the “classical” rabid animal, who runs around, frothing at the mouth, unable to swallow, and biting anything that moves or gets in its way. This hyperaggression is triggered by the virus, to increase the chance that it will be transmitted to another host before the initial animal dies.
- Dumb Rabies is characterised by depression and progressive paralysis, and hypersalivation without hyperaggression. Death results from paralysis in most cases, but may occur within hours. If furious rabies occurs, this paralytic phase usually develops after some hours or days.
Animals with both sets of symptoms can transmit the virus, as can animals in the late stages of incubation, before symptoms occur.
What about people?
The symptoms are generally the same in any species; in humans, confusion, hallucination, aggression and hypersalivation occur, followed by seizures, coma and death.
How is it treated?
Once symptoms have developed, there is no treatment. There have only ever been a handful of recorded cases when a person recovered from symptomatic rabies; to all intents and purposes, it is universally fatal.
In humans, vaccination immediately after exposure, before symptoms occur, is usually sufficient to prevent development of the disease; the effectiveness of vaccination is increased if the wound is cleaned thoroughly with soap and water immediately after the bite. Sadly, this “post-exposure vaccination” is not considered an option in animals.
How can the disease affect “whole societies”?
Because of the cost of the post-exposure vaccination if someone is bitten – it is one factor that drives communities into poverty. You can read more about how rabies perpetuates poverty here.
Surely the answer is vaccination?
Exactly – about 90% of human cases come from infected dogs. By vaccinating the dogs, the disease’s life-cycle can be broken, and GARC believe that if all domestic dogs were vaccinated, rabies would almost completely cease in the human population (as well as a LOT of dogs being saved!). In addition, the dog vaccine is a lot cheaper than the human post-exposure jab, so it’s cost effective as well!
What can I do?
Within the UK, you can make sure you never buy dogs if you can’t visit and check the parents – this will put puppy-farmers and illegal importers out of business. In addition, you can join a World Rabies Day event, or donate to GARC!
How can I learn more?
To learn more about the Global Alliance for Rabies Control visit their website.
To learn about rabies in animals, check out the MSD Vet Manual.
To learn about rabies in people, visit NHS Choices.