Maybe you've heard of it?
Maybe the word conjures up images of snarling dogs, ominous bats and foaming at the mouth?
But what do you really know about rabies?
Did you know that it kills over 59,000 people and thousands of dogs per year? Or that the true number of deaths is actually likely to be far, far higher? This cruel disease disproportionately affects the world's poorest people, who, unable to afford or access treatment, must make the horrific decision to die at home, untreated and overlooked.
Did you know that once a person has rabies symptoms it is already too late for them to be saved? If they are quick enough to get to a hospital after being infected, they can receive lifesaving treatment, but only if they can get there before the disease takes hold, and only then if they can afford it.
Maybe you didn't know that an estimated 40% of those that die from rabies are children under the age of 15. Children who will never live out their potential or have families of their own, whose parents must watch them suffer and die knowing there is nothing they can do to save them.
It's ok if you didn't know. Most people don't. Because no one talks about rabies. That is why it has been allowed to continue to destroy the lives of people and dogs around the world for thousands of years. But it can be stopped.
Rabies is 100% preventable.
Yet every 9 minutes another person dies from rabies. Another needless, preventable death, another life that could have been so much more.
Rabies is a zoonotic disease; this means it can be passed from an animal to a person. It is a worldwide problem, found in all continents except Antarctica. It is particularly deadly in Asia and Africa, where the numbers of human deaths from dog-mediated rabies each year are in the tens of thousands. A staggering 35% of global human rabies deaths occur in India alone.
The true numbers of the people killed or affected by rabies is estimated to be much higher than the numbers show. In Tanzania a comprehensive study showed that the actual number of rabies deaths was 100 times higher than recorded by official statistics, and in Haiti the government found that only 10% of people bitten by a rabid dog were reporting to hospital.
The World Health Organization (WHO) has classified rabies as a Neglected Tropical Disease and, along with the World Animal Health Organisation (OIE) and the Food and Agricultural Organisation of the United Nations (FAO), set a target to end human deaths from dog-mediated rabies by 2030.
Over 99% of human rabies cases are caused by an infected dog bite. Children are the most susceptible as they are less likely to know how to spot a dog with rabies, and in many countries are more likely to be interacting with or taking care of dogs.
The disease is transmitted via direct contact with the saliva of an infected animal e.g. through a bite, scratch or through the virus coming into contact with an open wound or mucous membranes. The virus attaches to a nerve cell at the site of infection and travels along the peripheral nerves to the central nervous system, travelling up to 100mm per day.
By the time the first symptoms develop the virus has already passed through much of the central nervous system and will prove fatal.
Rabies comes in two forms, furious and paralytic. Furious is closest to our stereotypical view of rabies and accounts for 80% of human rabies cases.
In people the furious form of rabies shows itself through:
People with the less common paralytic form of rabies suffer with:
In dogs the furious form of rabies shows itself through:
The paralytic form of rabies in dogs leads to:
For people and dogs, they will suffer through these cruel symptoms, until they fall in to a coma and ultimately die, usually within just 10 days.
From the moment they begin to show symptoms there is no reliable treatment, and they can no longer be saved.
Rabies is 100% preventable.
You may have heard of a rabies vaccine for people, perhaps you have even been vaccinated before a trip abroad. But for many people who live in countries where rabies is an everyday threat the vaccine is too expensive and even if people can afford it, it can still be impossible to get hold of.
Human rabies-specific immunoglobulin (HRIG) can be administered to someone who is suspected to have been infected with rabies and has not had the vaccine, but this needs to happen very quickly, before any symptoms show, to slow the spread of the infection whilst the rabies vaccine starts to work. Rabies is often prevalent in remote rural areas with no easy access to healthcare, meaning getting to a hospital in time is often impossible or completely cost-prohibitive. Even if an infected person could get to hospital in time they may still have to pay for the treatment, which for many people is simply not possible.
Vaccinating dogs against rabies is more effective and less expensive than vaccinating people.
Vaccinating at least 70% of canine populations in a rabies endemic area creates herd immunity. If the dogs do not get rabies, they can't pass it on to people, stopping the disease in its tracks.
A dog vaccine costs far less than the human vaccine, meaning vaccinating dogs reduces the burden on stretched public health infrastructure, protects dogs from inhumane culling through fear of the disease and most importantly prevents the unnecessary suffering and needless deaths of countless people and dogs across the world.
Mission Rabies vaccinates dogs in rabies hotspots and runs education programmes to help communities understand how to avoid the risk of rabies. This approach is working but we need to do more.
But every 9 minutes another person, a mother, father, son or daughter dies of a disease that we already know how to stop.
We must make this The Final Rabies Generation.
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