Rabies is caused by a virus and affects all mammals. The World Health Organisation estimates that the disease claims around 60,000 human lives annually, with close to 95% of these deaths occurring in Africa and Asia. Rabies is found on every continent in the world, excluding Antarctica, and in 150 countries and territories. In South Africa rabies occurs in all nine provinces. It is almost always fatal.
Fact 1: Disease entities and presentations
There are two disease entities in South Africa and two clinical presentations of rabies. The two types of rabies found here are canid rabies, adapted to and cycling between dogs, bat-eared foxes and jackals; and a strain found in the mongooses and meerkats. The latter strain is not highly adapted to canids, but scientists generally accept that all species can contract either strain. Over 90% of human rabies cases are transmitted from the domestic dog or cat.
Two clinical presentations of rabies are also found – an aggressive or furious form and a dumb or paralytic form, where the animal does not exhibit aggression but rather weakness, loss of co-ordination and later paralysis. With the later form, wild animals may appear tame. An aggressive guard dog will suddenly behave like a puppy or a stray dog who does not appear to have rabies is actually incubating the virus.
Fact 2: Rabies is transmitted via bites or scratches
The virus is transmitted when the saliva of the infected animal comes into contact with broken skin through bites and scratches. For your own safety, never pick up the carcass of a dead animal, but rather call a conservation body or the nearest state vet for safe disposal. If you find an animal who appears ill, disorientated and/or aggressive, do not approach him. Call the state vet, animal health technician, health department or local SPCA to investigate.
Fact 3: Rabies vaccinations are a legal requirement
Rabies can be prevented through vaccination. Pet owners are required by law to have their pets vaccinated by a duly authorised person and this must be recorded on a vaccination card or certificate. The rabies vaccination is relativity inexpensive.
Puppies and kittens should be vaccinated at 12 weeks and again within the first year, usually at 16 weeks as this is easier to remember. After this, repeat vaccinations were required every three years, but most vets now advocate a yearly rabies vaccination. This depends on the area or province you reside in and how often positive rabies cases are reported in your area. Check with your vet what he or she advises for your pets. The booster shots are often neglected but they are important and should be given. Without the boosters the animal will be deemed unvaccinated. If you adopt a pet from an animal shelter, have the animal vaccinated against rabies.
Government programmes are also in place where free rabies vaccinations are provided. It is important to note for the vaccine to be valid, only vets, vet nurses or animal health technicians can give it. If you vaccinate your animals yourself, or if they are vaccinated by an unauthorised person, they will be seen as unvaccinated when a rabies outbreak occurs. If they are exposed to a positive animal, they will have to be euthanised.
Fact 4: If you are bitten, wash the wound immediately and seek medical attention
If you are bitten by an animal, immediately wash the wound with soap under running water (even if it is bleeding) and continue for 10 to 15 minutes. This will dilute the virus in the wound. Thereafter, head to your nearest doctor, emergency department or local clinic. If you need to assist someone who has been bitten, use rubber gloves.
Wounds should not receive sutures (stitches), as this will assist in spreading the virus within the wound and to the nervous system. If the doctor wants to stitch it, tell him or her you know wounds in suspected rabies cases should not be stitched.
If the animal wasn’t known or his behaviour seemed out of place, medical personnel should give a first rabies vaccination immediately as well as rabies immunoglobulin if the patient has not been vaccinated previously. The incident must be reported to the state veterinarian. The animal may be immediately euthanised and brain tissue sent for analysis, or kept alive and observed for the development of rabies symptoms, usually within 14 days until death occurs. If the brain tissue tests positive for rabies, the post-exposure vaccination protocol will be followed and vaccinations continued for the bite victim. Vaccinations are given on day 0 (the day of the bite or scratch incident or the day the case is reported if not the same day), 3, 7 and 14. Not every dog bite case is due to rabies, but in the case of inappropriate aggression, follow-ups will be made by the state vet and recommendations passed on to the person’s medical doctor for correct post-exposure prophylaxis. If test results come back and the animal did not have rabies, post-exposure vaccinations will be discontinued.
Sources: Dr Anne de Vos (veterinarian) and Dr Didi Janse van Rensburg (Chief State Vet: Free State Department of Agriculture and Rural Development)