On World Day UN urges rabies control beyond human and animal health

‹ › Evidence suggests that the threat is especially prominent in areas struck by conflict and natural disasters. Experts have warned that unless coordination and awareness-raising go beyond the ministries of health and agriculture, too many animals and humans will continue to die unnecessarily from the disease, according to the Global Alliance for Rabies Control, a leading organization working for the global prevention of rabies. The organization partners with WHO and the UN Food and Agriculture Organization (FAO), among others. “People live, work and flee with their dogs. We need to change the way ministries work together to roll out regular mass dog vaccination campaigns, to provide more protection in times of peace, conflict and natural disasters,” said Louis Nel, Executive Director of the Global Alliance for Rabies Control. “We have the vaccines and we know they work, so how is it possible that so many people and animals continue to die from this painful, long-known disease?” Though rabies is present in wildlife, more than 95 per cent of the disease is spread via dogs. On the basis of data and evidence collected by the World Organisation for Animal Health, a rise in rabies cases among dogs has been observed in parallel to political instability periods in some North African countries during the past decade. Fact 1: Rabies is almost always fatal once symptoms appear Domestic and wild animals can spread rabies to humans. Transmission occurs through the bites of animals infected with the rabies virus, usually dogs. The incubation period varies but is usually 2–3 months. By the time of clinical onset, the virus is widely disseminated throughout the central nervous system and the infection is invariably fatal. Photo: W Mohd Fact 2: Rabies is present on all continents except Antarctica An estimated 59 000 people die from rabies every year. Up to 99% of human deaths occur in Africa and Asia, 80% of which are in people living in rural, underserved populations. Consequently, rabies deaths are underreported. Photo: WHO/B Abela-Ridder Fact 4: Four out of 10 rabies deaths are in children aged under 15 years Although all age groups are susceptible, children, who due to their playful nature often approach dogs without fear of attack or awareness of the disease, are the most vulnerable. Studies have shown that children tend to conceal their bite wounds from parents for fear of being scolded and therefore may not receive adequate first aid and appropriate healthcare. Photo: K Artor Fact 8: Human rabies is 100% vaccine-preventable While human deaths can be averted by vaccinating people, this intervention alone will never eliminate the disease and costs will only escalate over time. Additionally, for many patients bitten by a rabid animal, post-exposure treatment can cost many times their average daily income – a catastrophic out-of-pocket expense. Photo: G Sampath Fact 3: Apart from dogs, other animals including bats can also transmit rabies Dogs are the main source of up to 95% of human rabies deaths, particularly in Africa and Asia. In the Americas, bats are the main cause of the infection. Human deaths following exposure to foxes, raccoons, skunks, jackals, mongooses, and other carnivore host species are very rare. Photo: Mission Rabies Fact 5: Education and awareness are key to preventing bites from rabid animals Teaching children how to avoid animal bites is an essential component of rabies prevention and control. WHO works with various partners to educate communities by raising awareness of the disease and supporting responsible dog ownership. Photo: A Czupryna Fact 9: Mass dog vaccination breaks the transmission pathway Vaccinating at least 70% of dogs, including strays, prevents rabies being passed to humans and breaks the transmission pathway. Mass dog vaccination campaigns in Bangladesh, South Africa (KwaZulu-Natal province), the Philippines and the United Republic of Tanzania have demonstrated that control of rabies is feasible through mass dog vaccination. Photo: S Cleaveland “Prevention of bites in the first place should be an emphasis of any rabies programme. When a child gets bitten the mother needs to know to wash the wound and to contact a local health worker. Most people who get bitten are too poor to pay for treatment and for transportation to facilities that carry the vaccine. We also need to help countries with forecasting their vaccine needs and building emergency stocks,” said Bernadette Abela-Ridder, Head of Zoonotic Diseases at the World Health Organization (WHO), in a message to observe the Day. World Rabies Day is celebrated annually to raise awareness about rabies prevention and to highlight progress in defeating the disease. In addition, 28 September marks the anniversary of the death of Louis Pasteur, the French chemist and microbiologist who developed the first rabies vaccine. The theme for 2016 is ‘Rabies: Educate. Vaccinate. Eliminate,’ which emphasizes the two crucial actions that communities can do to prevent rabies. It also reflects the global target to eliminate all human deaths from dog-mediated rabies by 2030. Fact 10: Better data improve rabies programme Reliable data are essential for implementing efficient programmes to prevent and control diseases, including rabies. WHO and partners have developed technical guidance to support governments in improving laboratory capacity and strengthening human and animal disease surveillance. Photo: D Stewart Fact 7: Wound-washing and prompt treatment after a dog bite are essential for survival The bite wound must be washed immediately and thoroughly with soap and water for about 15 minutes. Bite victims should seek advice at the nearest health facility. Following a dog-bite, more than 15 million people are vaccinated against rabies every year. Photo: A Abdullah Fact 6: Intersectoral collaboration is crucial to controlling rabies WHO collaborates with strategic partners to support country programmes and regional networks to address rabies from the human and animal perspectives. This includes increasing access to affordable, safe and efficacious human and dog vaccines. Photo: OiE/A Poirer

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