A trending Huffington Post article earlier this month discussed the enormous global impact of rabies in terms of human and animal health. The article estimated that approximately 189 people die from rabies per day, primarily in developing countries. However, although rabies is an invariably fatal disease once symptoms manifest, there are methods available to both prevent its spread amongst animals and prevent its ability to cause disease in humans who have recently been exposed. The article suggested that if we were to allocate resources to these methods in developing countries then the disease could be virtually eliminated.

When most people think about rabies, they think about wild, crazy, aggressive, salivating animals. In fact, the disease has three stages which can be highly variable in length and severity for both humans and animals. The first stage shows vague non-specific signs, the second stage is excitative and is where the furious form that most people associate with rabies manifests, and the third stage is paralytic where the patient becomes progressively paralyzed and then dies.  Animals do not necessarily always demonstrate the furious form, they may just exhibit the paralytic form and then die or even have minimal clinical signs at all – essentially, rabies should be a possible diagnosis for any mammal that is in an endemic area and is “not acting right”. The only way to definitively diagnose rabies involves looking at the brainstem after death.

Of course, one of the scariest aspects of rabies is that it is zoonotic, which means that it can be transmitted from animals to people. Rabies is transmitted either to people or between animals via the saliva (or brain matter, which is obviously less of a concern in a live animal) of an infected animal, usually through a bite. In developing countries, dogs are thought to be the major vectors of rabies, whereas in developed countries raccoons, skunks, bats, and foxes are more commonly implicated.

On the positive side, the rabies vaccine is remarkably effective for both animals and people. If an animal is current on its rabies vaccine and gets exposed to a known rabid animal, the exposed animal should have the vaccine boosted and be quarantined for safety purposes but you can have a relatively optimistic outlook. Rabies vaccine can be administered either via an injection by a veterinarian, or orally through flavored baits that are dispersed in the environment for wildlife. Many communities and health departmetns offer free rabies vaccination clinics to keep pets and people healthy.

Another example is FARVets, a non-profit organization run by a Cornell veterinary affiliated team that will travel to developing countries to provide services such as rabies vaccination (donated to the communities which it serves) to animals whose owners would not otherwise be able to afford it. Cornell also participates in wildlife rabies bait programs in order to mitigate the spread and effects of the disease in a community. So, if we can control rabies in animals, then its zoonotic potential will be decreased.

Unfortunately, the vaccine and post-exposure shots are expensive so rabies control is currently well managed in developed countries but languishes in developing countries where the need is subsequently much greater. A targeted program to use methods which already exist to control rabies in the kept and wild animal populations as well as to provide rabies post-exposure treatment to humans is sorely needed in underserved communities.

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The post was written by Nikhita De Bernardis, DVM, and is adapted from her personal blog for One Health Week.