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Walk softly and carry a big net: The global fight against rabies

dvm360dvm360 September 2019
Volume 50
Issue 9

Nearly 60,000 people die from rabies every year, almost half of which are children. Here are some of the human and veterinary health efforts designed to stop this from happeningcompletely.

A volunteer vaccinates a dog in Goa, India. Image courtesy of Mission Rabies.

Few veterinary professionals in the U.S. are haunted by the specter of widespread human rabies deaths in their communities. For others in the rest of the world, it's very real.

An estimated 59,000 human deaths occur globally every year, according to the World Health Organization (WHO)-the majority of which occur in Asia and Africa. Of those estimated deaths, 99% result from the bite of a rabid dog. What's more, 40% of them are children.

The mission behind the movement

In light of these findings, WHO has partnered with the Food and Agriculture Organization of the United Nations, the World Organization for Animal Health and the Global Alliance for Rabies Control to create a strategic plan that provides a phased, all-inclusive, intersectional approach to eliminate human deaths from rabies, according to a recent WHO report.

Called the Zero by 30 campaign, this plan aims to end human deaths from dog-mediated rabies by 2030, the report states. To reach the most underserved populations-those that are most impacted by canine-mediated rabies-the campaign will lead and strengthen elimination efforts, including strengthening both human and veterinary health systems around the world.

“Rabies is 100% vaccine-preventable,” the report states, “yet the disease kills almost 59,000 people every year-or one person every nine minutes. … The world has the knowledge, technology and vaccines that are needed to eliminate rabies.”

The biggest hotspot for rabies is India, where thousands of people die of the disease and hundreds of thousands of dogs are inhumanely killed for fear of the disease. Mission Rabies, a branch of Worldwide Veterinary Service (WVS), aims to solve this. In 2014, a year after it launched, the charity set its sights on Goa, India, with a challenge: to make it a rabies-free state.

In that year, according to the Mission Rabies website, volunteers sterilized 20,400 dogs across Goa in just six months. The next year they delivered 94,753 rabies vaccines across the Indian projects. Today they continue to break their own records and cover more ground.

“Five years on and we are working in six different countries,” the website states, “with volunteers from across the world getting to the heart of rabies-stricken countries and combating this disease with the combination of vaccination, education, technology, research and lots of hard work.”

Managing and preventing the disease

In the poor, rural communities where rabies is most prevalent, care is often lacking.

“Most of these patients are managed, at least initially, in peripheral or even village health [centers],” the WHO report states, “where human and material resources for basic wound care and rabies prevention are often extremely limited or absent. There is no effective curative treatment for rabies once clinical signs have appeared. Almost all patients with rabies will die.”

What's more, many human rabies patients are turned away from hospitals and receive terminal care only from their families, according to the WHO report.

However, there is much healthcare providers can do to manage rabies victims' care, even with limited access to equipment and drugs, the WHO report says. This means adequate hydration, sedation and care in an appropriate medical facility-or at the very least, a calm, draft-free room with physical and emotional support.

For nonhuman rabies cases, of course, humane euthanasia is the only viable option.

On a brighter note, preventing rabies from spreading is the first step to fighting this deadly disease, and it's much more easily attained. This is where volunteers come in-wielding really, really big nets.

Mission Rabies' prevention operation is threefold: catching, vaccinating (and often also sterilizing), and educating the public about the disease.

“Most of the time, I have been working with one of the catching teams in the Mission Rabies base in Margao,” says volunteer Gemma Annetts in a statement on the organization's website. “We have a great rapport and I enjoy going out with the guys catching dogs to bring back to the hubs, our Mission Rabies animal hospitals, for vaccination and sterilization, speaking to the local people and educating them as to what we are doing.”

Many stray dogs that are already found to be sterilized are vaccinated right there on the spot-the volunteers are trained to do this beforehand, Mission Rabies' website states. Otherwise, they are brought to professionals who will diagnose the disease if clinical signs are present and spay/neuter if necessary.

“On a typical day,” says U.K. veterinary student and Mission Rabies volunteer Kaz in an online comment, “I would set out in the morning with the catcher boys … to bring back a canine haul that would occupy the surgical team. … From midmorning, being by far the most junior of the veterinary team, I helped out where I was needed and was very patiently taught the art of intravenous anesthesia in the field by [veterinarians].”

For education, Mission Rabies relies heavily on community engagement. “Children are at high risk of dog bites and contracting rabies,” the education page states. “The educational sessions are aimed to empower children, their teachers and their families with the knowledge to protect themselves from bites, preventing rabies and [saving] lives.”

Today, the Mission Rabies education efforts in India have reached more than 15,000 children, along with hundreds of teachers and community leaders. According to the website, global education efforts have reached millions.

Education revolves around five key messages:

  • Rabies is serious. Knowing how the rabies virus is transmitted and affects the body is vital.
  • Keep yourself safe. This means understanding canine behavior for safe and friendly interactions-and knowing the warning signs to prevent being bitten.
  • First aid. When a dog bite does occur, it's important to know the lifesaving steps to take.
  • Community protection. Educating the public on how vaccination works and encouraging community action.
  • Population management. With the help of WVS, this entails promoting humane dog population control and encouraging pet owners and authorities to spay or neuter dogs.

It seems like hard work, and it is, but the results are worth their weight in gold, according to volunteers and organizations alike.

“Truthfully, when I heard the name ‘Mission Rabies' I was skeptical,” Kaz says. “I thought it was a smidge melodramatic. On reflection, I could not have been more wrong-‘mission' is an apt description, and Tom Cruise would have been sent running. Rabies is preventable but the process of containment and eradication continues to be a Herculean, volatile and wholly baffling affair. I highly recommend you get involved.”

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