World Rabies Day: Prevent rabies with annual vaccination
In early June 2024, the Western Cape Department of Agriculture confirmed that a rabies outbreak amongst Cape fur seals has resulted in these seals attacking water sports enthusiasts and critically injuring healthy seals. The department has warned swimmers, surfers and divers to be aware of aggressive seals and for beachgoers to not approach seals on land. There have been a number of separate incidents, from Cape Town (Blouberg) to the Garden Route (Mossel Bay) and even as far afield as Plettenberg Bay in the Eastern Cape, which prompted an investigation that confirmed the rabies outbreak.
Rabies in wild animals whose habitats we visit makes rabies awareness essential knowledge for everyone. It emphasises the seriousness of the disease (for pets and humans), but it also creates an opportunity to show how simple prevention can keep rabies at bay. Here, we define rabies, explore who is at risk of rabies infection, how to manage a pet who has taken a suspected rabies bite, as well as what to do if you’ve been bitten by an animal that may have rabies.
The rabies virus
The deadly rabies disease is caused by the pathogenic Rabies lyssavirus. It enters the bloodstream through saliva that accompanies a bite or which is licked or smeared on a wound, cut or through the mucous membrane (in the nose or mouth). Rabies targets the nervous system and brain in mammals (it needs a warm-blooded environment), which include wild animals like badgers, bats, mongooses, bat-eared foxes, monkeys and even seals. Rabid wild animals that cross paths with domestic animals like dogs and cats can thus bite and infect pets. Rabies is also a zoonotic disease, which means that it can be transmitted from animals to humans. It’s the most fatal infectious disease in humans, killing approximately 60 000 people every year, with the majority of these deaths occurring in Asia and Africa. About 24 000 of these rabies deaths are children aged 15 and under.
In developing countries where stray animals are pervasive, dog bites are the main cause of rabies in people. In the Americas, bats are the more common vector of rabies in humans. If bite victims don’t receive the necessary post-exposure prophylaxis (PEP) in time, the rabies virus establishes itself, symptoms appear and it’s too late for any treatment: rabies becomes fatal.
Rabies transmission
The rabies virus will target and travel through the central nervous system towards the brain. The virus itself can be found in nerve cells as well as the saliva of the infected animal, which is how it facilitates transmission. When a person or animal is bitten by an animal with rabies, the virus in the infected animal’s saliva finds a new host when the saliva comes into contact with the victim’s blood via a bite, lick or smear.
Rabies is considered to be a ‘behaviour-altering parasite’ – adjusting the host’s movement and behaviour to enable further transmission to other animals that become hosts. This is demonstrated in the way rabid animals foam at the mouth due to the excessive production of saliva. The more saliva, the greater the viral load that can be transmitted to other mammals. Consequently, rabies-infected animals and people are intensely hydrophobic (afraid of water), which prevents them from drinking liquids and swallowing. Any attempts to quench their thirst are met with painful throat spasms, as this would mean diluting or removing the viral load. Rabid animals also display heightened aggression; biting anything within reach, which is simply the virus trying to find new hosts.
Rabies symptoms
The propensity for rabies to target the central nervous system and brain causes behavioural symptoms such as:
- sudden and unexplained changes in behaviour (a sociable animal becomes unsociable, or vice versa)
- wild animals lose their fear of humans
- excitability
- aggression
- confusion/lack of coordination
- twitching
- seizures
- fever
- vomiting & diarrhoea
- excess salivation
- inability to swallow
The majority of rabies victims are prone to ‘furious rabies’ (as above), but some animals can also develop ‘dumb rabies’, which presents with symptoms such as:
- seeking solitude
- paralysis of jaw muscles – lower jaw droops down
- paralysis of the throat – unable to swallow
- progression of paralysis to the rest of the body
Animals most at risk of contracting rabies
Since we don’t know the rabies status of wild animals based on their appearance, pets that are in close proximity to wild animals known for being rabies vectors, are at risk of contracting the disease. You do not need to live in a wildlife reserve for your pets to be at risk – as wild animals are known to frequent urban areas too. A bat-eared fox, a downed bat, a hunting mongoose – these are all potential rabies vectors that may find their way into your backyard and pique the curiosity of your pet dog or cat, who may very well get bitten if they approach. If your pet’s rabies vaccinations are out of date, they are at risk of getting rabies. A pet with up-to-date rabies vaccination status might be exposed to the rabies virus via a bite, but they will be able to fight it off with antibodies they developed due to being vaccinated. Irrespective of their vaccination status, if your pet gets bitten by a potentially rabid animal, you must take them to the vet for medical treatment.
Unvaccinated pets that are exposed to rabies may take (on average) between three and 12 weeks to show the neurological and behavioural symptoms of the disease. As soon as the clinical symptoms become evident, there is no cure and the disease will be fatal. If the animal is in veterinary custody, they may be humanely euthanised to end their suffering and prevent rabies transmission to other animals.
In response to the rabies outbreak in South Africa in 1999, rabies vaccination became mandatory for all pets. The government has rolled out vaccine administration and vaccination checks to ensure compliance with the mandate, although there are still areas where vaccination rates are low and pets and stray animals in these areas are at risk of contracting rabies. Children in these communities are also vulnerable to rabies infection, but the State has committed to eliminating human deaths by dog rabies by 2030. The easiest way to do this is through preventative medicine – or vaccination.
What to do if you think your pet has been bitten by a rabid animal
If you’re concerned that your pet may have been bitten by an animal with rabies, take them to the vet immediately. Your pet will be isolated and observed for any signs of rabies infection. If your pet is vaccinated, they may receive a booster to help them fight the infection. However, if your pet is not vaccinated, or their vaccination is out of date, they will not be recommended to receive post-exposure prophylaxis (PEP). If they develop any symptoms of rabies, the only option is for them to be humanely euthanised.
If your bitten pet does not develop any rabies symptoms, the vet will complete a physical examination, offer supportive treatment for the bite wounds, and discharge your pet when it’s confirmed they do not have rabies.
Preventing rabies infection in pets
Vaccination
Prevention is the safest and easiest way to ensure your pets are protected from rabies. Rabies vaccines must be administered from very early on; the schedule includes:
- puppies and kittens’ first vaccine: three months of age
- puppies and kittens’ second vaccine: 12 months of age
- dogs and cats’ booster vaccines: every 12 months or every 36 months, depending on the manufacturer’s label
Pet rabies vaccination offers a two-fold strategy: it protects pets and humans from rabies infection. If all pet owners vaccinated their pets, it could eradicate canine rabies from our communities.
Keep your pets in your yard
While pet owners cannot control what goes on outside their yard, they can control their pets inside their property. If your pet regularly wanders beyond your property boundary, they are at risk of exposure to rabies – by wild animals as well as unvaccinated stray dogs. Keeping your pet inside your yard and keeping them on a leash while out in public will reduce their risk of interaction (and altercation) with unknown animals. This protects them (and you) from rabies exposure.
Get stray animals to safety
Stray animals may have contracted rabies or may be at risk of contracting rabies. While it can be dangerous to approach stray or lost pets, it’s more dangerous to ignore them. If you are willing and able to pick up a bewildered stray, please take them to the nearest veterinary clinic, SPCA or local welfare organisation, where they can be scanned for a microchip and examined for any injuries or illnesses. If you are not in a position to pick up the stray animal, please contact the nearest animal rescue organisation and keep an eye on the stray so that you can give the rescue an accurate location to collect it.
What to do if you get bitten by a potentially rabid animal
All professionals and workers on the frontlines of animal care should get pre-exposure prophylactic injections (vaccines) to mitigate the risk of infection if they are exposed to the rabies virus. If a person is bitten by an animal thought to have rabies, they need to seek immediate medical attention. The healthcare provider will do a risk assessment to determine if they need post-exposure prophylaxis (PEP). In the absence of lab confirmation of rabies (which can only be done after the animal has died), the risk assessment will include factors such as the location of the animal, any abnormal behaviour, and whether the bite broke the skin.
Wound care must be performed immediately, alongside PEP, which includes:
- thoroughly cleaning and washing the bite wound (for 15 minutes under running water, then with soap, an antiseptic, an iodine-based disinfectant, or 70% alcohol – all of which can inactivate the rabies virus)
- administration of human-rabies immunoglobin (HRIG) – ONLY for those who have not received pre-exposure vaccination
- rabies vaccine in four doses – on days 0, 3, 7 and 14 after potential/exposure to rabies
In the absence of wound care and PEP, the symptoms of rabies can start to show anywhere from a few days to a few weeks after viral transmission. At this stage, it’s too late for any kind of effective treatment and the disease will be fatal. It’s always best to treat any bite from any animal as an emergency and to get treatment as soon as possible.
Conclusion
Rabies is a devastating disease for humans and pets – its consequences should be motivation enough for compliance with the vaccination mandate. There is a lot we can do to mitigate the risks of rabies infection, but vaccinating all pets at least once a year to once every three years is the bare minimum required to keep rabies at bay. With no rabies infections, we can ensure long, healthy lives for everyone – humans and pets – in our communities.
