Moving Towards Rabies Elimination

 

John Munyinyi, a retiree who lives in Makueni County in south-eastern Kenya, recently experienced a family tragedy. His niece Mbula was bitten by a dog infected with rabies and died from the disease.

Her three children had no other relatives who could take care of them, and he became their guardian. The family is struggling because he has limited income.

The tragedy in Mr Munyinyi’s family could easily have been avoided. If the dog that bit his niece had been vaccinated, she would not have become sick with an illness that is almost always fatal if left untreated.

Benefits of vaccination

“Rabies can be eliminated by vaccinating 70% of the dogs living in an area over several years,” says Dr Bernadette Abela-Ridder, Team Leader of Neglected Zoonotic Diseases at WHO. “More than 90% of people who become ill with rabies catch the disease through a dog bite, and declines in human rabies deaths closely mirrors that of rabies in dogs.”

For this reason WHO is urging countries lacking rabies elimination programmes to undertake them. Kenya has particular need of such a programme because pet dogs and working dogs – which are trained mainly for livestock herding and security – play an important role in this country’s life.

New initiative in Kenya

With the help of World Animal Protection, a non-governmental organization, and technical guidance from WHO, Kenya’s government launched an initiative in September 2014 to vaccinate 70% of the country’s 125 000 dogs. In Makueni County, along with targeting the immediate threat of rabies through vaccination campaigns, World Animal Protection will educate communities about rabies, how to avoid dog bites and what to do in case of a bite.

“Our successes and lessons learnt in rabies elimination will set the standard for the whole of Kenya, and even across Africa. I look forward to the day when the county will be declared rabies-free, and dogs and communities can live in safety and harmony with one another” says Dr Daniel Kisee, the Veterinary Officer and Project Manager for the implementation of rabies elimination in Makueni County.

Need for action across Asia and Africa

Rabies is present on all continents with the exception of Antarctica, but more than 95% of human deaths occur in Asia and Africa.

It is a neglected disease of poor and vulnerable populations whose deaths are rarely reported. It occurs mainly in remote rural communities in children aged 5 to 14 years.

Rabies is almost always fatal after clinical signs of the disease appear. Immediate wound cleansing with soap and water after contact with a suspect rabid animal is the first step in treatment, and can be life-saving. Development of the full-blown disease can be prevented with post-bite vaccinations. In some cases, rabies immunoglobulin (a serum containing rabies antibodies) is needed as an additional treatment.

For the majority of people exposed to rabies today, the price of post-bite rabies treatment can be catastrophic. It can cost US$ 40 in Africa and US$ 49 in Asia, where the average daily income is about US$ 1–2 per person.

That is why vaccination of dogs is so crucial. “The mechanisms and tools for rabies elimination are already available. What we need now is coordinated partnerships to ensure access to affordable vaccines,” Dr Abela-Ridder says. “A well-run rabies vaccination campaign eliminates rabies and alleviates fears about the disease.”

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