Rabies - Emergence - Your Guide to Transboundary & Emerging Diseases
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18
Total Reported Outbreaks
12
Total Affected Countries
8
Total Affected Species
Key Facts
Clinical Signs
Treatment and Management
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Rabies is one of the most lethal viruses on earth, with almost 60,000 people dying of this terrible disease every year. Almost half of these deaths are children, mostly in Africa and Asia. However, rabies is preventable and there is a global goal of achieving zero human dog-mediated rabies deaths by 2030.

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Rabies

Asia and Africa are the main regions affected by rabies in dogs, whilst wildlife may be affected in many parts of the world. Find out where the latest reported outbreaks are with this map.

Key Facts
Clinical Signs

Clinical signs in dogs with rabies include aggression/unusual behaviour, excessive salivation, and choking/gagging. In animals and humans the disease is 100% fatal once clinical signs/symptoms occur. As such rabies has one of the highest mortality rates of any disease. This Mission Rabies training video gives a detailed explanation of the clinical signs to watch for. 

Treatment

Prevention is the key to controlling and eliminating rabies, with dog vaccination the main tool. People that are bitten by a dog should take appropriate action to wash and clean the wound and seek medical attention.

Management

The disease is 100% preventable. In recent decades countries across Latin America and the Caribbean have made strides towards rabies elimination, and in November 2019, Mexico proved that human canine-mediated deaths can be eliminated when it became the first country in the world to obtain WHO validation for no human rabies deaths. Mexico achieved this by having a national rabies strategy based on mass dog vaccination, raising public awareness, and post-exposure prophylaxis. The cooperation of human and animal health sectors is important in achieving rabies elimination, and rabies is a good example of how a One Health approach can be very effective.

Stray dog in street
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Rabies Hero Dr Ilona Otter - work in pictures
The latest Rabies Hero Award recipient, Dr Ilona Otter, has been instrumental to improving rabies control in Ooty, pioneering new solutions and introducing smart methods to make the efforts to eliminate this disease more sustainable. We are delighted to present a photo impression from the different rabies vaccination programs in the Nilgiris district, Tamil Nadu, South India, and the thoughts that Ilona shared with us about her experience working to eliminate rabies. "Thanks to the annual vaccination campaign by WVS, the district has been maintained free of canine rabies now for over a decade. We vaccinate free-roaming dogs in the municipality areas with a team of dog catchers, using catching nets and we also record the sterilisation status of each dog that we vaccinate. This helps to monitor the percentage of the free-roaming dog population that is sterilised and also helps us to collect data to estimate the free-roaming dog population in the district. Every vaccination drive is also an educational experience to our changing crew of junior resident vets who will take these experiences with them as they eventually return to their home states to work." "In the rural villages, most dogs have owners, even though most of them are let to roam free most of the time. These dogs can be vaccinated by just owners restraining them. One of my goals in rabies control work in India is to break the myth that the main obstacle in controlling rabies by vaccination of dogs is the inability to catch stray dogs. The main challenge is not how to catch stray dogs but how to ensure delivery of quality rabies vaccine for all owned dogs, especially owned dogs in rural India where veterinary services and adequate vaccine stock are not easily available. In rural areas, even if not one stray dog is vaccinated but all owned dogs were vaccinated annually, that would itself be a huge improvement and control rabies transmission significantly. That said, urban areas and cities are a different story where we need to be focusing on the actual stray dogs and how to catch them and how to maintain those programs annually." "I run a small WVS dispensary at my home farm and many villagers bring their dogs there for vaccination. This is result of many years of annual door-to-door vaccination campaigns and awareness raising that has resulted in many owners now actively coming and seeking for vaccine, not just waiting for the team to come to their doorstep. However, the door-to-door approach still continues to be our main mode of vaccine delivery in these villages." To go back to Rabies Heroes homepage and read more click here. The views expressed in this article are those of the author(s) and do not necessarily represent those of MSD Animal Health.
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Eliminating rabies, One Health in action - thoughts from the podcast
Recently, for the occasion of World Rabies Day, we had the honour to speak to Dr Monique Eloit, Director General of the World Organisation for Animal Health (OIE), and Dr Bernadette Abela-Ridder, Team Leader for Neglected Zoonotic Diseases at the World Health Organisation (WHO), on the emergence podcast hosted by Alasdair King, Director of International Veterinary Health, and talk about their views on rabies elimination and One Health. They have been major figures in global rabies control as the world has been trying to eliminate the disease that continues to kill almost 60,000 people every year, both driven by a deep desire to reduce the suffering in the world. It was a great privilege to be able to hear what they find important to stop human deaths from dog transmitted rabies by 2030. Today, we look back at some of the thoughts they shared with us. Listen to the full conversation in this episode. We know what to do, all we need is to act The take-home message was one of hope and confidence. As Bernadette told us: “Rabies is a disease that we can overcome. We do not have to have deaths any more from rabies. We have all the tools that are needed. We know how to eliminate this disease, we just need to scale up our efforts." When asked what gives her the confidence that we can eliminate rabies, Monique replied: “I am confident because we have evidence that it is possible!” and added “We have a direct impact of the vaccination campaign in dogs on human health. We have excellent vaccines. And with long standing commitment, we can eliminate rabies. It is not just a wish; it can be a reality because we have clear data that it is possible.” That confidence comes from the experience in countries who did manage to control this disease. While some countries are only learning how to implement rabies programs, others have already done a lot of progress, and the exchange of that expertise is crucial, setting an example for the others to follow. From barriers to partnerships Over the years, rabies control has faced many struggles due to competing priorities. “One of the biggest problems is that it’s not prioritized in many countries”, said Bernadette. As a disease that affects both animals and people, rabies sits right between the public and animal health sectors. “One of the difficult parts is that it’s the dogs that transmit rabies. Nobody feels the ownership of the dogs”, she continues. But when priorities are aligned, then it is possible to make progress, like in Europe and North America that have been successful in keeping rabies out of the dog population, and people. Thankfully, a lot has changed over the last years and it is very encouraging to see that “more and more authorities have rabies on the top of their priorities” - Monique told us. She is glad to see that the United Against Rabies partnership of the OIE, WHO and FAO, have played a role in that. Both Monique and Bernadette are strong supporters of partnership, which they believe, has the power to overcome the biggest barriers. According to Monique “We have barriers, but when we are convinced that we can succeed, that together we are strong enough, then we have the power to convince people who can support”. Human and animal health sectors collaborating along the vaccine manufacturers, NGOs, and local communities, is how we can make leaps towards the elimination. A model for One Health With an increased public recognition of the interaction between humans, animals and the environment, rabies especially makes a strong case for One Health approach. “If there is one disease that we can show quick progress, which we can use as a poster child for implementing One Health, I think rabies is that example. We can really reduce human deaths very quickly”, said Bernadette. A lot of work must still be done to achieve the goal, but rabies control can help build the know-how for other diseases where different sectors also have to work together. The same holds true for education and engaging with local communities. Bringing in local priorities, and activating people on the ground to build awareness, facilitates working towards broader One Health benefits in the long run. “When we better educate the population and inform communities, when we support the strengthening of veterinary services, indirectly, we support the control of other diseases, we support the health system”, said Monique. A call to scale up – “We just need to get on with it” To Monique, it is clear that “One Health approach must be encouraged and implemented at each level” and she is confident that we are heading in the right direction. “In addition to strategy, tools and data that we have, now we also have political commitment. We have all that we need to succeed and now we need to act”. She stressed that it is time to “move from local initiatives to a larger scale” dog vaccination campaigns, in order to truly build sustainable programs. This call to action was echoed by Bernadette: “The biggest barrier is taking it from a pilot- and project-based type of activities into a true program in countries who have prioritized the disease”. She insisted “Let us scale up the rabies programs as an example of implementing One Health in a very measurable way, where we can see impact within months, if we are able to scale up sufficiently”. There have been a lot of positive changes in the last decade and both our guests are optimistic about the future. Bernadette believes that “We can do it. We just need to get on with it” and make sure that the programs are “translated into a plan on the ground, and that we actually start.” Are we on track for 2030? “2030 is a goal that is going to be a challenge to reach”, admits Bernadette, however, it has also “been a way to drive us in the right direction. We set that goal of zero human deaths by 2030 because we all believed it is possible”. “It was aspirational. What’s important, is that every step we take forward we reduce the number of people who die” agreed Alasdair, “Setting a date gives us something that we can aim for, it gives us a strength to keep on going. Because we know we all got the same vision”, he continued. Finally, we would like to conclude with the words from Monique – we couldn’t have a better message to share today: “Rabies elimination, the eradication of dog mediated rabies is achievable. Everybody can do something, the most important is to act, and to invest in rabies control because we know that it is 100% preventable and that we can save so many human lives. PHOTO CREDITS: CARL SALTER The views expressed in this article are those of our guests and do not necessarily represent those of MSD Animal Health.
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Living One Health for a Sustainable Future
November 3rd is One Health Day.  This is a day that resonates with me, although I have to admit I wouldn’t have said that 10 years ago.  My views on disease control, health, and welfare have really changed a lot from the days when I was a veterinary practitioner as I have developed a broader, global understanding of the needs of the world on every continent. In International Veterinary Health we truly believe in a One Health, One Welfare approach to what we do.  We recognize that humans, animals, and the environment, are inextricably linked, and what happens in one area has both direct and indirect impacts on the other two.  That is why it is important that we look at health and welfare as a whole. We have focused a lot on rabies recently.  But even then, One Health is not forgotten. If you listened to the podcast with Dr Monique Eloit and Dr Bernadette Abela-Ridder that we released for World Rabies Day you will know that we refer to One Health as we all talk together.  Rabies is a simple example of one health, vaccinating dogs saves the lives of dogs, humans, and local wildlife.  But that is not all we do.  For example, in South Africa, we support the anti-poaching teams in the National Parks.  We provide anti-parasitic control and vaccines for the dogs who go out with the rangers.  The dogs are essential for keeping the rangers safe, person and dog as a partnership, and together they keep the rhinos safe. For me, One Health is also about how we approach disease control.  In the past, we would focus on individual diseases.  But the changes made through solving one disease are, while important, small compared to what we can really achieve.  Looking at animal health as a whole, and also the entire infrastructure of access to medicines, is where we can make leaps forward rather than steps.  I hope that we will soon have someone on the podcast to talk more about looking at this overall disease burden. One Health Day.  Let’s celebrate it together, and make it a joint collaboration for a sustainable future. PHOTO CREDITS: CARL SALTER
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Focus On... Exploring the factors affecting the probability for local rabies elimination
Rabies is a terrible disease that continues to kill adults and children in many parts of the world. However, the tools and knowledge to stop this disease already exist with the vaccination of dogs with high quality vaccines being the cornerstone to successful rabies elimination. Achieving this means that resources must be used effectively within well-designed control programmes. A recent paper by Johann L. Kotzé, John Duncan Grewar, and Aaron Anderson explores the factors that affect the probability for local rabies elimination and their practical application in the design of dog-mediated rabies control programs. Read the paper: Modelling the factors affecting the probability for local rabies elimination by strategic control. We recently caught up with the lead author, Johann Kotze, and asked him about the research and his thoughts on the findings. Emergence: Hi Johann, it’s great to have this opportunity to talk with you about rabies elimination and your recent paper. It is known that dog vaccination is vital in stopping rabies, so where does your research fit in towards the elimination of this disease? Johann Kotze: As a campaign manager myself, I was often faced with the dilemma of not having enough resources to vaccinate everywhere the need arose. Not only could I not respond to all the reported outbreaks by vaccinating around them, I didn’t have enough resources to cover my whole area once a year. This was a great predicament. I knew that there were lives at stake that depended on me making the best strategic decisions possible. That’s when I decided that I had to figure out the optimal strategy with my available resources, such as people, vehicles and vaccine, to combat the disease. Emergence: As limited resources will be an issue for many people working on rabies elimination, can you explain how you progressed your ideas considering the Southern African environment you were working in? Johann Kotze: I noticed from studying the history of outbreaks that in many villages the disease disappeared despite us not being able to respond with vaccination campaigns. In other villages the disease would never disappear unless we arranged a large campaign. I then asked myself what common factors were associated with the villages where the disease disappeared. Emergence: And what did you find when you looked at the common factors for those villages? Johann Kotze: I found that they’re generally smaller and very importantly they have more fences, regardless of whether they were 100% dog proof. I also noticed that the more fences there are, the less likely a rabid dog was to contact another dog. Even if the fence just acted as a visual barrier. This confirmed for me that villages with more fences would sustain lower levels of rabies (or the disease would just die out by itself). Emergence: Were there any other key factors? Johann Kotze: A third factor that was important for places where the disease died out naturally was that they were relatively isolated. This is related to the size of the village since a string of villages together is essentially one big village from an epidemiological point of view. Emergence: Having made these observations in the field, what did you do next? Johann Kotze: I had to figure out a way to prove what I had noticed. This turned out to be very difficult. I can say it took me 10 years and I tried many ways. Unfortunately, the data we had on the villages, the vaccinations and the rabies cases turned out to be too weak. There were too many gaps in the data and many uncertainties. Eventually I decided to see if a model would produce the same results. Sure enough it did. And the effect was much stronger than I expected. We also learnt many other things from the modelling approach, so I’m happy we went that route. Emergence: What ‘other things’ did you learn from your modelling approach? Johann Kotze: Two important things. Firstly, sterilization campaigns are nowhere near as effective as dog vaccination campaigns. Secondly that the herd immunity required to keep a disease out of a village is much lower than the immunity required to get rid of it. Emergence: Why is it important to know that dog vaccination is far more important than sterilization, and that the level of herd immunity required varies according to the objective of the vaccination campaign? Johann Kotze: These two points are important because they have great practical significance for campaign managers in their decision making. Emergence: Thank you Johann. Finally, can you tell us what your take-home message is for anyone reading this who works on rabies control? Johann Kotze: I know that there are people out there sitting in the same position that I was in. They don’t have enough resources to vaccinate everywhere. I’m hoping that my research will reach some of those people and assist them to make the best decisions possible about where they focus their resources. In my area I managed to eliminate the disease using such a strategy and I think my success can be duplicated elsewhere. Explore these links to find out more on rabies and its elimination: Listen: to the 'One About A Rabies Free Africa' emergence podcast episodeRead: about World Rabies Day and how you can help raise awarenessSearch: the Community Response to rabies section PHOTO CREDITS: CARL SALTER The views expressed in this article are those of the author(s) and do not necessarily represent those of MSD Animal Health.
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Training - WHO - Rabies & One Health: From basics to cross-sectoral action to stop human rabies deaths
Online course about rabies, the current “Zero by 30” rabies elimination strategy, and how to prevent the disease in people and dogs by taking a One Health approach.
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Rabies Hero Dr Imam Mzimbiri - work in pictures
The latest Rabies Hero Award recipient, Dr Imam Mzimbiri, has done a lot of work for over a decade helping to keep rabies at bay around the Serengeti ecosystem in Tanzania, spending months away from his wife and children. Thanks to his dedication to eliminating this devastating disease, local communities have a chance to live without the fear of rabies. Imam leads a team of field officers and together they vaccinate over 40,000 dogs per year. Imam travels to remote villages and spends months in the field to protect the people and wildlife in Serengeti from rabies. The work by Rabies Free Africa has demonstrated that vaccinating dogs around the Serengeti National Park eliminates rabies in dogs and controls the disease in wildlife. To go back to Rabies Heroes homepage and read more click here.
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Podcast Episode 5 - 2021 - The One About World Rabies Day 2021
In this episode of the emergence podcast I talk to Dr Monique Eloit, Director General of the World Organisation for Animal Health and Dr Bernadette Abela-Ridder, Team Leader for Neglected Zoonotic Diseases at the World Health Organisation, about rabies and global rabies control for World Rabies Day. Links: WHO rabies training: https://Openwho.org/courses/NTDs-Rabies-and-one-health OIE rabies page: https://www.oie.int/en/disease/rabies/ Dr Deborah Nadal’s paper on rabies and the pandemic: https://doi.org/10.1093/trstmh/trab123 #rabies360challenge: https://www.emergence-msd-animal-health.com/event/raising-awareness-around-the-globe-with-rabies360challenge/ Acronyms: GAVI: The Vaccine Alliance OIE: World Organisation for Animal Health WHO: World Health Organisation
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Celebrating World Rabies Day 2021 with #Rabies360Challenge
It’s World Rabies Day, and people around the globe are taking action to help towards rabies elimination. Many of them came together through #Rabies360Challenge, raising awareness about the impact of rabies and its prevention. Every dog vaccinated against rabies, every dog behaviour training, each lesson about rabies and responsible dog ownership, and every single #Rabies360Challenge post on social media, are getting us one tiny step closer to achieving the global goal of ending rabies deaths by 2030. There is still a long way until we reach #ZeroBy30, but we are making progress. Together, we can eliminate this disease. Why is it important? Here are some rabies facts: Rabies is one of the most lethal viruses on earth and causes 60,000 deaths every year – one person dies of rabies every nine minutes!Over 40% of victims are children, mainly in Africa and Asia.Rabies is a zoonotic disease – almost 100% of deaths result from dog bites.Rabies is preventable with dog vaccination. Here’s to the amazing #Rabies360Challenge 2021 participants who were spreading the rabies elimination message with us throughout September! Have a look at some wonderful examples of the challenges taking place around the globe …   Walking... lots of walking, running and taking dogs out... ... and making sure they have fun, including letting them sniff around in local shops, and organizing other activities. Refurbishing a metal kennel. Andrea is raising money for rabies vaccinations. Bronwyn is doing the environment clean up as part of her lovely pledge of "360 min of sprinkling kindness on mankind, animals & the environment". Danielle and Marika go for 360 minutes of reading. Claire is making 360 video clips of dog tricks. Jean collects 360 items of dog and cat food or treats. Brigitte and her colleagues committed collectively to 360 minutes of stair climb from the UK (home) office. Lucille is feeding dogs at a local squatter camp. And Claire keeps bridging the gap in rabies awareness with her hula hoop, engaging with local communities in South Africa, and organizing rabies events anywhere she can.  There were many, many more pledges for #Rabies360Challenge and you can see more here. PHOTO CREDITS: #RABIES360CHALLENGE PARTICIPANTS Participation is entirely voluntary and at the participants own risk. MSD Animal health accepts no liability. Your participation may result in your #Rabies360Challenge posts, including photos and videos, being shared through emergence channels (website and social media).
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