Monday, January 9, 2017

What can we do about rabies?

Ms B is fortunate enough not to live in a rabies endemic country. But there are things we can do to help animals and humans who are impacted by rabies.

What is the scariest disease you can think of? There are some top contenders, but rabies is definitely on my list. It is invariably fatal, causes severe pain and suffering, and affects humans and animals (farm animals, companion animals, stray animals, wildlife) alike. It is also entirely preventable and only persists because we just aren’t putting enough resources into prevention (including human behaviour change and education) and post-exposure prophylaxis.

According to the World Health Organisation,

  • Rabies is a vaccine-preventable viral disease which occurs in more than 150 countries and territories.
  • Dogs are the source of the vast majority of human rabies deaths, contributing up to 99% of all rabies transmissions to humans.
  • Rabies elimination is feasible by vaccinating dogs.
  • Infection causes tens of thousands of deaths every year, mostly in Asia and Africa.
  • 40% of people who are bitten by suspect rabid animals are children under 15 years of age.
  • Immediate wound cleansing with soap and water after contact with a suspect rabid animal can be life-saving.
  • Every year, more than 15 million people worldwide receive a post-bite vaccination. This is estimated to prevent hundreds of thousands of rabies deaths annually.

The problem is, not everyone is lucky enough to live in a country where they can afford post-exposure vaccination. It would be good to prevent the exposure in the first place.

What can we do about it? Veterinarians and nurses can volunteer in animal birth control and anti-rabies (ABC-AR) programs overseas. A colleague is doing just this and seeking some funding.

As my colleague wrote, ABC-AR programs "come under the One Health Ecohealth (OHEH) banner, endorsed by WHO, whereby human health is understood to be bound up with environmental and animal health.  Rabies, which is fatal in humans if you don't receive post-exposure vaccinations, cannot be controlled unless the dog population is vaccinated.  The size of the dog population is, to a great extent, determined by the local environment. Rabies can affect all mammals and so rabies is also detrimental for farmers with loss of their stock. Control of rabies is now looked at as the 'canary in the coal mine' for progress in human, environmental and animal health".

"In ABC-AR programmes the local community/street/roaming dogs are caught.  They are taken to a clinic where they are surgically sterilised, vaccinated against rabies and permanently marked (usually an ear notch done under the anaesthetic) and then returned to exactly the place where they were captured within 3 days. This means that, these very socialised dogs will be back on their own territory and now act as a buffer between rabid dogs that may enter the locality from further afield and the human population.  Being sterilised, the dog population will be low and stable. Of course, there is also always an education part to the programmes regarding avoiding bites (usually children), what to do if you get bitten and dog animal welfare."

"On the 15th January I am joining a group of vets and vet nurses, a few of whom I worked with in India, Ladakh, who have organised a self-funded ABC-AR programme in Cambodia.  We are all paying our own way and taking as much as we can with us from Australia. We will not be able to carry any medications with us and will have to purchase them there. Once in Cambodia we are linking up with some established NGO's (Non-government Organisations) that are involved in animal work. They will enable us to have facilities to do ABC-AR camps."

If you wish to support this initiative, visit their Gofundme page here.

Another way to help fight rabies is to undertake a free certificate, through the Global Alliance for Rabies Control, in rabies education, animal handling and vaccination, and/or community coordination. Visit here to enroll (nb. you don't need to be a vet or vet student; the more people that know this information, the better). You can do this from the comfort of your own home, in your pyjamas if you want.

We are fortunate that Australia is currently a rabies-free country - but we should be concerned about its presence in other locations.