10 things you should know about rabies

1. What is rabies?

Rabies is a zoonotic viral disease which occurs in both domestic and wild animals. Essentially, this viral disease attacks the central nervous system of mammals, including humans. Once symptoms of the disease develop, rabies is almost always fatal to both animals and humans.

2. What is the impact of rabies?

The World Health Organization (WHO) lists rabies as one of the world’s most deadly infectious diseases. It still causes tens of thousands of deaths every year¹, is endemic in more than 150 countries, and mostly threatens people in low-resource communities. More than 95 percent of cases are reported in Asia and Africa¹. The Global Alliance for Rabies Control estimates the global economic burden caused by rabies each year to be 8.6 billion USD².

Despite these figures, rabies is 100 percent preventable with the right vaccination and awareness programs.

3. How is rabies transmitted?

The rabies virus is transmitted between animals, and between animals and humans, through close contact with saliva from infected animals, usually via bites, scratches, and licks on broken skin and mucous membranes. Rabies transmission to humans mainly occurs following a bite by an infected dog; even if dogs are involved in up to 99 percent of human rabies cases¹, cats represent a significant risk of transmission as well. Wildlife populations often serve as a reservoir for the rabies virus and can contaminate our domestic animals. Raccoon dogs and foxes are the main wildlife reservoirs in Eastern Europe; raccoons, skunks and bats in North America; jackals and mongooses in Africa and Asia; bats in Latin America; mongooses in Puerto Rico and other Caribbean islands; and raccoon dogs in South Korea and possibly other countries in the region.

Pets can be infected through direct contact with rabid animals. Humans can be infected through contact with rabid animals or through their contaminated pets.For both routes of infection, from pets or the wildlife population, animal vaccination serves as the best defense against this deadly disease.

4. What are the symptoms of rabies?

Once symptoms of the disease appear, rabies is almost always fatal to both animals and humans. In animals, the most reliable signs of rabies are acute behavioral changes and unexplained progressive paralysis. Animals may show signs of agitated, aggressive behavior and/or lethargy and paralysis.
In humans, the first signs of rabies may include headache, fever, anxiety and tingling or altered sensation near the site of the animal bite. In most human cases, it is also characterized by dilation of pupils, unusual sensitivity to sound and light and changes in temperature, as well as seizures, hallucinations and hydrophobia – that is, spasms on touching or even seeing water.

Rabies is fatal once clinical signs appear but is entirely avoidable. The diagnosis of rabies on clinical grounds alone is difficult and often unreliable.

5. How is rabies diagnosed?

Rabies can be diagnosed:

• Through the history of a person or animal that has been bitten or been in contact with an animal suspected of having rabies
• By detection of very early rabies symptoms

In humans and in animals, confirmatory diagnosis can only be carried out post-mortem.

6. What should you do if you suspect you or your pet have been exposed to rabies?

If a person is suspected of having been in contact with an infected animal, early intervention may prevent the disease. The first step is to apply local wound treatment immediately: vigorously wash and flush the wound with water and soap or detergent for about 15 minutes. Then, apply virucidal treatment such as 70 percent alcohol/ethanol, tincture or iodine solution if available. Delay suturing the wound for as long as possible.

A doctor must be contacted immediately and will decide to apply a post-exposure prophylaxis, or preventive medical treatment, to prevent rabies from developing in humans.

The veterinarian will implement the appropriate follow-up of the animal suspected of rabies.

7. Can rabies be prevented?

Rabies is 100 percent preventable with the right vaccination and awareness programs. Rabies can be prevented by:

• Reducing or eliminating the infection at the source through dog mass vaccination, as up to 99 percent of human rabies cases are dog-mediated¹
• Vaccination of other animal populations that are responsible for the spread of rabies (wildlife) or that are in contact with humans (mainly cats, but also ruminants and horses in some risky situations)
• Prevention and treatment of humans by vaccination and anti-rabies immunoglobulin administration
• Education of communities about rabies and the ways to prevent it

Importantly, pet owners and veterinarians can be key partners in the global fight against rabies by ensuring pets are vaccinated.

8. How serious a threat is rabies today?

The World Health Organization estimates that 59,000 people die from rabies annually (or 160 people a day) and more than 29 million people receive treatment after being exposed to animals suspected of having rabies.³

The greatest threat of rabies occurs in the world’s poorest regions, Africa and Asia, where domestic dog vaccination is not widely implemented and access to post-exposure treatment is limited.³ Rabies remains a notoriously neglected and under-reported disease in the most affected countries, largely because healthcare in these regions tends to be severely limited and most victims die at home.³
In more developed countries, even those thought to be free of rabies, movement of animals from other areas means that rabies remains a constant threat.
Partners of the Global Alliance for Rabies Control also estimate an enormous global economic burden, reaching 8.6 billion USD annually.² The vast majority of this burden is shouldered by Africa (36.2 percent) and Asia (59.9 percent). These costs are due to:²

• Premature death, causing loss in productivity (55 percent)
• Post-exposure treatment (20 percent)

9. What is our role in the fight against rabies?

Boehringer Ingelheim is a global leader in the fight to prevent and manage rabies, with a range of vaccines used to prevent the disease in pets, farm animals and wildlife. We strongly believe in joining forces to help control and eliminate rabies, and work closely with veterinarians, pet owners, governmental and non-governmental organizations, health authorities, and other interested parties worldwide to help prevent the spread of the disease.

10. Rabies prevention requires a global community effort

Even if there is a strong willingness to fight against rabies and efficient vaccines are available, rabies prevention and control requires a sustainable effort. The recent SARS-COV-2 pandemic is challenging this effort, mobilizing healthcare workers and economic resources previously dedicated to the fight against rabies.

Therefore, we join veterinarians, pet owners and major professional and health organizations on the World Rabies Day and beyond to increase awareness of this disease and to fight rabies globally.

References

¹https://www.who.int/health-topics/rabies [Last accessed 20/09/2022]

²Hampson K, et al. (2015). PLoS Neglected Tropical Diseases;9(4):e0003709. https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003709 [Last accessed 01/09/2022]

³www.who.int/news-room/fact-sheets/detail/rabies [Last accessed 01/09/2022]