Tuesday, April 21, 2015

160 Rabies Deaths a Day

In 2013 a Maryland woman died from rabies after receiving a kidney transplant, and three other organ recipients from the same donor were treated for the disease. Since the organ donor was no longer available for questioning, no one knows how the infection originated*. The Maryland victim was the first Marylander to die from rabies since 1976.

Nobody ever ought to die of rabies. Unlike Ebola, rabies is 100% preventable--and curable if treated early enough.

It hasn't been a problem in the U.S. or Western Europe since the mid-1900's. The very occasional human deaths are attributed to contact with a wild animal, usually a bat, that wasn't recognized as being rabid at the time of contact. Nobody in the developed world gets it from a dog.

In India and sub-Saharan Africa, on the other hand, rabid dogs bite several million people a year, and at least fifty-five thousand of those people, (mostly children under the age of 15) die a ghastly, agonizing death. The deaths don't get a mention in Western news media unless there's something unusual--such as a father who was infected when bitten by his own baby during a 2013 outbreak in the Congo.

Animal Sources of RabiesWorldwide
The response to a rabies outbreak is often to start killing dogs, millions every year--often with strychine or by clubbing them to death. In 2014, 5000 dogs were killed in south Yunnan Province, in China, in response to 5 human deaths. 37,000 were reported to have been killed in Hanzhong in 2009.

Worldwide Rabies Map
Killing dogs does nothing to prevent rabies and may even make the problem worse.

Vaccination and education can solve the problem permanently. They are far less costly than killing dogs or treating people after they've been infected. It can also happen in a fairly short time frame.

In Europe, where almost all domestic dogs are vaccinated, 80% of all rabies cases occur among wild animals, and 80% of the animals who get rabies are red foxes. Trapping and culling the foxes was tried, but failed to reduce the number of rabid foxes..
European Red Fox
In 1978, Switzerland began distributing bait for foxes that contained an oral rabies vaccine from airplanes and helicopters, supplemented by manual distribution in urban and suburban areas. Germany and other European countries quickly followed the Swiss lead. As a result, the number of rabies cases dropped from 21,000 in 1990 to 5400 in 2004. By 2008, 10 European countries were declared free of terrestrial rabies (I guess that means it still could occur in bats).
Image result for oral rabies vaccine bait
A Raccoon Eating Bait Containing Oral Rabies Vaccine
The USDA has distributed oral vaccine in targeted areas on the United States since 1990. Currently16 states distribute oral vaccine for raccoons,  Texas has a program targeting coyotes, skunks, and gray foxes.
Aircraft Used in the Texas ORV Program
This year's program in Texas, distributed about 2.7 million individual vaccine baits. Their website stresses that the baits will not harm pets or livestock if consumed, but cannot be used on pets as a substitute for vaccination by a veterinarian.

If 70% of third world dogs could be vaccinated, rabies would soon be eradicated. But the difficulties stemming from lack of knowledge, lack of infrastructure, and lack of money are substantial. A pilot program carried out in the Philippines using oral vaccine in 2001 spotlighted many of the challenges, but showed promising results. The study concluded that they had succeeded in vaccinating 76% of the dogs in the target area, and that 71% had showed an immune response sufficient to protect them from rabies.
Oral Rabies Vaccine The blue tongue is a marker for its delivery.
In 2007, the World Health Organization published guidelines for the delivery of oral vaccine to dog populations around the world.

Canine Rabies.org has developed a comprehensive blueprint for the elimination of rabies worldwide.and has had numerous successes. A program was started in the KwaZuluNatal Province of South Africa in 2009, and by 2011, the province suffered no human deaths in a one-year period for the first time in 20 years.

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Turkish children participating in a vaccination campaign
In Istanbul, elementary school children gave invaluable assistance to the teams vaccinating dogs. They knew where all the dogs lived, where free-roaming dogs might be hiding, and were often able to approach the dogs without frightening them.

The agonizing death of 160 humans and 8000 dogs every day is simply unacceptable. Let's get behind the organizations that are doing something about it.

*According to the CDC, the organ donor who whose transplanted kidney killed the Maryland victim had an especially rare form of rabies which quite probably came from a raccoon. Organ donors are not regularly screened for rabies unless it is the suspected cause of death, which it wasn't in this case.