Health Opinion

By Dr Rachel Kerubo | Sep. 16, 2024

Rabies a viral, zoonotic tropical disease transmitted primarily through the infected saliva of infected animals via bites, kills.

Reports of hyena attacks in parts of Kiambu County, specifically Juja area have been a chockful of a situation, vexing a population that is already burdened by economic and social issues.

Even more worrying is the emerging, yet unconfirmed information that some of the animals could be carriers of the rabies virus. This makes even worse, owing to virulent nature of this disease.

Rabies is a viral, zoonotic tropical disease transmitted primarily through the saliva of infected animals via bites, scratches, or direct contact with mucous membranes such as eyes, mouth, or open wounds.

Dog bites and scratches account for 99 per cent of human rabies cases, yet can be prevented through canine vaccination and bite prevention strategies..

Being a neurological disease, once the rabies virus infects the central nervous system and clinical symptoms manifest, the disease becomes invariably fatal since at this point it tends to be irreversible.

At this advanced stage, providing comprehensive and compassionate palliative care is recommended and yet essential. World Health Organization says children between the ages of five and 14 years are particularly vulnerable.

Following a bite or scratch from an infected animal, the rabies virus may enter the peripheral nervous system directly and migrate to the brain, or may replicate in muscle tissue, remaining sequestered at or near the entry site during the incubation period.

Before the central nervous system invasion and replication, the clinical manifestation may include fever, pain, and unusual or unexplained paresthesia such as tingling, pricking, and burning sensations at the wound site.

As the virus moves to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops.

Clinical rabies in people can be managed but very rarely cured.

Despite its potency, rabies is one of the most preventable zoonotic diseases globally.

Effective preventive strategies include Mass Canine Vaccination.

Mass vaccination campaigns have demonstrated 100 per cent efficacy in halting the disease’s transmission.

Secondly, public awareness about the importance of canine vaccination and safe animal handling practices, which are crucial in reducing rabies transmission risk is also key.
Lastly, human vaccination tends to play a key role both before and after a bite.

Pre-Exposure Prophylaxis (PrEP) may also help. Individuals at high risk, such as veterinarians and animal handlers, should receive pre-exposure rabies vaccination as a preventive measure. Those with ongoing exposure risk may require a booster dose after one year, followed by periodic boosters.

Post-Exposure Prophylaxis (PEP) for the already affected as part of immediate medical intervention is essential for anyone exposed to a potentially rabid animal. PEP includes rigorous wound decontamination and a series of rabies vaccinations.

Immediate and thorough cleaning of the wound with soap and water for at least 15 minutes to reduce viral load can then be flowed by rabies vaccination. This involves administration of a series of rabies vaccines on days zero, three, seven, and 14.