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EDITORIAL

Rabies, A Silent Killer

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World Health Organisation (WHO)

Nigeria and the rest of the world recently marked World Rabies Day, a day set aside by the international public health community to raise awareness on the impact of this deadly, preventable but neglected disease. The yearly celebration is gaining momentum as the 2030 deadline for global eradication of rabies draws near. The theme of this year’s celebration, ’Share the Message; Save Lives’ underscores the importance of sharing the right knowledge about prevention and control of the disease.

Rabies is a highly fatal disease, caused by a virus that is transmissible to humans through the bite, scratch or licks from infected animals. The disease is found in almost all countries of the world and is responsible for an estimated annual death of 70,000 humans worldwide, 90 per cent of which is through bite from infected dogs. About 90 per cent of these deaths occur in rural communities of Africa and Asia, with half of human deaths occurring in children under 15 years of age.

In Nigeria, the disease is highly endemic and still remains an important public health issue since the first human case was reported in 1912 followed by first reported case in dog in 1925. The abundance of a large population of unvaccinated owned and stray dogs, under-reporting of cases and weak communication links between animal health and human health practitioners are some reasons why rabies continues to be a public health challenge.

Rabies is considered one of the most important diseases of man and the fear of it is universal. This is because once symptoms begin to appear, death is almost inevitable. The mere thought of the violent and horrible nature of death of a rabies’ patient is regarded as a nightmare by many health care providers.

The knowledge of peculiar signs of a rabies-infected dog may be useful in prevention and control of the disease in a given community, although not all rabid animals exhibit signs. Fear of water (hydrophobia) is a common sign.

Despite its high fatality rate, the disease has remained largely neglected as also noted by the World Health Organisation (WHO).But why has rabies remained neglected? The reason is simple; it is a disease of the poor. Rabies primarily affects rural communities characterised by poverty, remote locations, poor infrastructures and almost non- existent health facilities.

Another reason for the neglect of rabies is due to perceived non-relevance of the disease impact on livestock production and human health by the relevant government departments. Since rabies does not seem to have a major impact on livestock production, ministries of agriculture tend to ignore it. Also, because rabies does not have a high burden on human health compared to other endemic diseases, it is often ignored by the health departments.

Rabies is a preventable disease in humans and dogs. Therefore, any human death due to rabies is a failure of veterinary and medical health systems. Vaccination of dogs remains the most cost-effective intervention for rabies control. According to the World Organisation of Animal Health, vaccination of 70 per cent of a dog population leads to eradication in endemic areas. However, a massive dog vaccination campaign can only be impactful if there is available data on the estimated population of dogs in Nigeria. No doubt there have been pockets of independent researches   on situation of canine rabies and ecology of dog population, but there is need for a nationally coordinated census of dog population in Nigeria, otherwise vaccination campaigns may not yield fruitful results.

For any meaningful impact to be made on the control of rabies in Nigeria, there has to be a strengthening of collaborations between human and veterinary medical practitioners, starting from grassroots to the national levels. This will help improve early diagnosis, reporting and monitoring and subsequent eradication of this deadly infection.

At individual levels, people are encouraged not to approach strange or stray dogs and should ensure dogs and other animals are vaccinated and registered with licensed veterinary practitioners. Suspicious animals should be reported promptly to the nearest   veterinary practitioners.  In case of a dog bite, the area of the wound should be thoroughly washed with soap and water immediately and promptly report the incidence to the closest medical and veterinary facilities.

In our opinion, there is need for more inter professional collaboration between human health, veterinary health and other relevant professions if rabies elimination must be achieved.



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