In April 2021, the World Health Organisation’s rabies bulletin reported two fatal cases of rabies in South Africa. In September, another victim died of rabies, reported by the Nelson Mandela Bay Municipality. Tragically, these three cases were young boys, two, seven and nine years old, who had been bitten by dogs infected with rabies virus.
Every nine to ten minutes somebody dies of rabies worldwide. Between 24 000 and 70 000 human deaths are recorded in Africa alone.
In 2020, a total of seven cases of rabies were confirmed by laboratories in South Africa and each year we see new cases, often affecting children.
Children are particularly at risk due to their close contact with dogs and are more likely to suffer multiple bites, which impose a higher risk of contracting rabies.
“The heartbreak with rabies is that it’s fatal for humans and animals once symptoms appear and yet it is completely preventable with a vaccine,” says Tarryn Dent, Business Unit Manager for Companion Animals at Zoetis South Africa, a global animal health company.
Dent is a passionate advocate for the prevention of rabies through vaccinations. “If anyone suspects that their pet has been exposed to rabies, bitten by a stray aggressive dog and they have no rabies vaccination history, a vet can euthanize on the spot and test brain samples to confirm for Rabies later. It’s an extremely serious, reportable disease and veterinarians won’t take a chance,” says Dent.
Understanding the dangers of rabies
Rabies is a serious viral illness that can affect any warm-blooded animal and it is also a zoonotic disease (which means that people can become infected by an infected animal). In South Africa, Rabies is an endemic disease, which means many species of animals are carriers, from honey badgers, meerkats and mongooses to both feral and domestic cats and dogs. With so many roaming animals in urban centers, the risk is even higher.
The rabies virus is present in high concentrations in the saliva of affected animals. The virus is transmitted in saliva from close contact with an infected animal. Bites, scratches or even licks on broken skin and mucous membranes can transmit the virus.
Once an animal or human is bitten by a rabid animal, it replicates in the muscle before travelling up the nerves to the spine and brain, causing inflammation of the brain (encephalitis). The incubation period is quite variable, but the average time is three to six weeks. Early symptoms in pets include a fever, licking or chewing at the site of a bite, dilated pupils, changes in behavior, anxiety, and seeking solitude. The second stage including avoiding light, snapping at imaginary things, lack of co-ordination and restlessness. The final stage, which usually lasts two to four days, is known as the ‘furious’ stage, in which infected animals are unable to swallow, will drool, have a ‘dropped’ jaw and their voice changes. Dramatic behavioural alterations, such as wild animals losing their fear of humans may be an indication of infection.
In humans, the early symptoms of rabies are non-specific and may include fever, headache, nausea, vomiting, agitation, anxiety, and confusion, followed by rapid progression of nervous signs, sleepiness or agitation.
“The challenge is that the list of symptoms is a long one, but by the time they appear, treatment is no longer possible. By that stage, rabies is fatal to both humans and animals, and animals need to be quarantined and euthanized,” says Dent.
“Our first line of defense should therefore be vaccination. We cannot control wild animals or feral domesticated animals, but we can protect our pets – and we can protect ourselves and our children if our pets are protected.”
Urgent call to vaccinate
Rabies vaccination of domestic dogs and cats is mandatory by law in South Africa, but the onus is on pet owners to ensure that their pets are vaccinated on schedule. “Pets that contract rabies are usually bitten by a wild animal that has come into a yard, so simply keeping pets in urban gardens isn’t enough to prevent infection,” says Dent.
“However, we can achieve zero rabies deaths through vaccinations, bite prevention education and awareness of rabies,” says Dent. “Tragically, most human deaths are the result of untreated bites. Timely treatment, including wound cleaning, vaccines and occasionally rabies immunoglobulin, are required for people exposed to rabies. Unfortunately, even though the best post-exposure treatment systems are available, many people do not seek treatment, either because they are not aware of what’s available, or because they are too far away from support. The administration of rabies post-exposure prophylaxis is urgent and must be done as soon as possible after a bite, lick or scratch.”