Rabies, a deadly threat to man's best friend

Dog bites and scratches account for 99 per cent of human rabies cases. [Courtesy]

While dogs are often celebrated as man's best friend, they can also pose a deadly risk.

In Kenya, rabies claims an estimated 2,000 lives annually, straining the bond between humans and their canine companions.

As the world marked World Rabies Day on September 28, 2024, with the theme "Breaking Rabies Boundaries," Kenya finds itself at a critical juncture in its battle against a silent killer.

Kenya's Strategic Plan for the Elimination of Human Rabies, launched in 2014, aims to eradicate dog-mediated human rabies by 2030.

This ambitious goal aligns with the global "Zero by 30" campaign, a collaborative effort led by the World Health Organization (WHO), the Food and Agriculture Organization, and the World Organisation for Animal Health.

Recent WHO statistics show that Kenya has made significant progress in rabies control. The country has increased its dog vaccination coverage from less than 10 per cent in 2020 to approximately 35 per cent in 2024. However, reaching the recommended 70 per cent vaccination rate remains a formidable challenge.

Dr Joseph Kipkemoi, Regional Sales Manager for Sub-Saharan Africa East at Boehringer Ingelheim, highlights recent successes: "In Bungoma and Bomet counties alone, we've successfully vaccinated over 20,000 dogs. This represents 20,000 potential rabies transmission chains broken and countless human lives saved."

Rabies, primarily transmitted through the bite of an infected animal, poses a particular threat in areas where humans and wildlife coexist.

Dr Michelle Enslin, Regional Product Manager for Pets at Boehringer Ingelheim, says, "In regions where socio-economic challenges bring people into close contact with wildlife, livestock, and free-roaming dogs, the risk of rabies transmission is significantly higher."

The virus can be transmitted not only through dog bites but also through contact with saliva or other bodily fluids from a rabid animal.

Even a lick from an infected animal on broken skin can potentially transmit the virus. Children are particularly vulnerable, accounting for nearly 40 per cent of rabies-related deaths globally.

The incubation period for rabies in humans typically ranges from 1 to 3 months but can vary from less than a week to over a year.

Initial symptoms include fever, pain or unusual tingling at the bite site, and progressive, fatal inflammation of the brain and spinal cord.

Two forms of the disease can develop furious rabies characterised by hyperactivity, excited behaviour, and hydrophobia (fear of water).

Death occurs within a few days.

Paralytic Rabies accounts for about 30 per cent of human cases. Muscles gradually become paralyzed, starting at the bite site. A coma slowly develops, leading to death.

Behavioral changes for example unusually aggressive or docile behavior) Excessive drooling and difficulty swallowing, paralysis, seizures.

Dr Wahome Maina, a veterinary expert, says the virus typically takes 10 to 14 days to travel from the bite site to the brain. This period is crucial for administering post-exposure prophylaxis (PEP) to prevent the virus from reaching the central nervous system.

“The effectiveness of PEP depends on prompt administration. "We have a 14-day window to administer the vaccine effectively," Dr Maina explains.

He said the vaccine stimulates the production of antibodies, which can neutralize the virus before it reaches the brain.

For animals, the vaccination protocol differs slightly with dogs and other domestic animals needing two booster shots a month apart after the initial vaccination to ensure a strong, lasting immune response.

High-risk counties in Kenya include Kitui, Makueni, Bungoma, and Bomet. These regions have seen increased efforts in both human and animal vaccination campaigns.

The cost of vaccination has become more affordable in recent years, thanks to government subsidies and support from international organizations. However, access remains a challenge in remote areas.

County governments in Kenya play a crucial role in rabies control. While some counties have allocated substantial budgets for vaccination and awareness programs, others lag behind. This disparity in resource allocation poses a significant challenge to nationwide rabies elimination efforts.

According to the World Health Organisation, Nigeria, Ethiopia, the Democratic Republic of Congo, Tanzania and South Africa are among African countries facing significant challenges with rabies

These countries, along with Kenya, account for a large proportion of rabies cases on the continent.

Dr Lucille Blumberg, chair of United Against Rabies, commends Kenya's efforts but emphasizes the need for a holistic approach.

“To stop human rabies deaths completely, we urgently need better data and surveillance, continued dog vaccinations, and increased public education,” said Dr Blumberg.

The recent announcement by Gavi, the Vaccine Alliance, to include human rabies vaccines for post-exposure prophylaxis in its program offers renewed hope. This development is expected to significantly improve access to life-saving vaccines in Kenya and other endemic countries.