World Rabies Day highlights the impact of human and animal rabies and promotes how to prevent and stop the disease by combating it in animals. Sponsors - the Alliance for Rabies Control and the United States Centers for Disease Control and Prevention - report that 55 000 people die every year from rabies, an average of one death every 10 minutes.
- About 95% of human deaths occur in Asia and Africa.
- Most human deaths follow a bite from an infected dog. Between 30% to 60% of the victims of dog bites are children under the age of 15.
- Wound cleansing and immunizations, done as soon as possible after suspect contact with an animal and following WHO recommendations, can prevent the onset of rabies in virtually 100% of exposures.
- Once the signs and symptoms of rabies start to appear, there is no treatment and the disease is almost always fatal.
- Globally, the most cost-effective strategy for preventing rabies in people is by eliminating rabies in dogs through animal vaccinations.
The first symptoms of rabies are flu-like, including fever, headache and fatigue, and then progress to involve the respiratory, gastrointestinal and/or central nervous systems. In the critical stage, signs of hyperactivity (furious rabies) or paralysis (dumb rabies) dominate. In both furious and dumb rabies, some paralysis eventually progresses to complete paralysis, followed by coma and death in all cases, usually due to breathing failure. Without intensive care, death occurs during the first seven days of illness.
Wound cleansing and immunizations, done as soon as possible after suspect contact with an animal and following WHO recommendations, can prevent the onset of rabies in virtually 100% of exposures. Recommended treatment to prevent rabies depends on the category of the contact:
- Category I: touching or feeding suspect animals, but skin is intact
- Category II: minor scratches without bleeding from contact, or licks on broken skin
- Category III: one or more bites, scratches, licks on broken skin, or other contact that breaks the skin; or exposure to bats
When humans are exposed to suspect animals, attempts to identify, capture or humanely sacrifice the animal involved should be undertaken immediately. Post-exposure treatment should start right away and only be stopped if the animal is a dog or cat and remains healthy after 10 days. Animals that are sacrificed or have died should be tested for the virus, with results sent to responsible veterinary services and public health officials so that the situation in the area is well documented.
Safe and effective vaccines are available to prevent rabies in animals, and in humans before and after suspected exposures. Vaccination of domestic animals (mostly dogs) and wildlife (such as foxes and raccoons) has led to reduced disease in several developed and developing countries. However, recent increases in human rabies deaths in South America and parts of Africa and Asia evidence that rabies is re-emerging as a serious public health issue.
The most cost-effective strategy for preventing rabies in people is by eliminating rabies in dogs through animal vaccinations. A lack of awareness of the effectiveness and feasibility of this prevention approach hinders elimination of human cases. As shown in several countries - such as Japan and Malaysia - elimination of rabies in dogs can result in elimination of transmissions to people and other animals. Preventing human rabies through control of domestic dog rabies is a realistic goal for large parts of Africa and Asia.
Prevention of human rabies must be a community effort involving both veterinary and public health services. Rabies elimination efforts that focus on mass vaccinations of dogs are financially justified by the future savings of discontinuing post-exposure preventive treatment for people.