World Rabies Day: What You Can Do.

Oscar was a surprise baby. His mum and dad hadn’t planned to have any more than the three children they already had, but as far as surprises go, Oscar was a very welcome one. Born into a humble family with very limited resources, money was always scarce, but as the youngest of four children, 8 years younger than his older brother, Oscar was doted upon from the beginning. His dad, Samuel, worked on a nearby cattle farm and his mum, Sara, worked from home sewing clothing to sell at the local market. Working from home also gave Sara the chance to keep an eye on 4-year-old Oscar, who was always eager to help his mum with whatever she was doing. He had just lost his two front teeth and loved to show everyone the gap in his teeth, poking his tongue out at his friends and neighbours in the street when they played football together. Oscar had also just started his first year in the small rural school nearby – the only one available to those who lived outside of the nearest village of Todos Santos.

When Oscar got sick, they thought he had the flu. Confined to bed with a fever, he wouldn’t eat at first and then he wouldn’t drink either. After a few days, his parents became more concerned as his flu seemed to worsen. When they were at the annual veterinary campaign last March in Todos Santos, they had their dog Toby castrated. But while they were there, they also had him vaccinated against rabies because they were told that humans could get the disease from unvaccinated dogs. Living in an area with many free-roaming dogs, however, they knew that they had to be careful and always avoid stray animals. As Oscar was an animal lover from birth – he had never met an animal he didn’t like – they had carefully taught Oscar to stay well away from the dogs, in case they bit him and made him sick and to tell them if he got bitten by a dog. After 3 days of refusing food and water, suffering from a high temperature and slipping in and out of consciousness, Sara searched Oscar’s small, limp body for signs of a dog bite. She couldn’t see any bite marks, she saw nothing bigger than a scratch on his little calf. The site did not appear to be inflamed or swollen, in fact, it was almost healed, and it definitely wasn’t a dog bite. Perplexed but relieved, Sara told her Samuel that it couldn’t be rabies as Oscar didn’t have any bite marks. Unable to speak and seemingly delirious, Oscar couldn’t answer Sara’s frantic questions about how he got the scratch. The nearest public clinic was more than 2 hours walk from their home and even if they could get Oscar to a doctor, they couldn’t afford any treatment. As his condition worsened, Sara, Samuel and the three older siblings remained by Oscar’s side. They stroked his face with a cool cloth, they told him stories and they held him between tremors when his body was still enough. When he started to foam at the mouth and convulse repeatedly, they sent for a neighbour, locally recognized to be a healer. The neighbour was greeted with the sight of five expectant faces, desperately imploring him for help to save their youngest child and brother. Sara promised she would make him and his family clothes for the rest of his life, for free. Samuel promised he would barter six chickens as payment for the neighbour’s help and as much milk as his entire family could drink. They begged. They promised. They offered everything they had and more.

Watching the young boy quietly for few minutes, the neighbour recognized the symptoms that he had seen many times before and knew there was nothing that could be done for Oscar. He sat down next to the bed and took Sara’s hands in his. He gently explained that Oscar couldn’t feel anything anymore and that the only thing they could do now was to wait. Unable to accept his diagnosis, Sara shook her head and wailed as she began to rock Oscar’s small body in her arms, she stroked his damp hair and whispered in his ear that she loved him and that he was always her favourite. When his body finally stopped convulsing, she gently laid him down to rest on his bed. His father and brothers each placed a hand on him, desperate for their youngest to know that he was loved and accompanied, even as he left this earth.

A negleted desease that perpetuates poverty.

“Rabies is a preventable disease that overwhelmingly afflicts the poor, both in terms of its death toll and the financial burden associated with the disease. With a survival rate of less than 0.1%, those exposed to the virus face a stark choice: go in search of post-exposure prophylaxis (PEP, the series of vaccines and immunoglobulin that prevent the onset of the disease) or die. In some cases, PEP costs more than the monthly household income and families are known to either go into debt to pay for PEP, or sell livestock on which they depend for income; both are options that negatively affect families’ future prospects.” Global Alliance for Rabies Control.

When we think of highly contagious, deadly diseases that pose a significant threat to humanity in the year 2017, we think of Ebola, HIV, tuberculosis, and malaria. Most of us would be surprised to hear that rabies is still active in many parts of Latin America, Asia, and Africa; in fact, it is such a plague that the WHO considers Rabies to be one of 17 Neglected Tropical Diseases. This disease claims up to 59,000 human lives per year….just stop and think of this for a second. For our Canadian friends, this is approximately the entire population of Medicine Hat, St. Albert or New Westminster! Or think of it like this- that is the equivalent of about 160 people dying every single day of the year!! This is an incredible number of people dying from a completely preventable disease….it is unthinkable especially since the majority of the victims are children.

Some facts

While our story about Oscar is fictional, it shows a horrific reality. Despite being a preventable disease, rabies has an extremely high fatality rate in people of 99.9% once symptoms start to show. Although it does not discriminate against age, gender, race or socioeconomic level, it is mostly the poor who are affected by this disease. It is almost always those who have the least resources and the least access to education and medical care, who become victims of this preventable disease. Even today, this scourge proves to be such a formidable enemy that just recently in 2016, WHO, FAO and OIE endorsed a vision of zero human deaths by 2030. More than 99% of human cases are due to exposure from a rabid dog.

Again, I ask you to stop and think about these facts:

• 99.9% fatal in people
• There is no treatment and it is a horrible death
• 99% of cases caused by dogs
• Vaccinating dogs against rabies prevents the disease
• Vaccination only costs about $3.00 USD per dog

Does it make sense that there are still almost 60,000 people dying annually from this completely preventable disease?

What is happening in the countries where the GAAP works?

As for the GAAP, we are the most interested in what is happening in Latin America. There has been a huge effort to reduce the number of cases and they have been very successful, but it is still here.

In Guatemala, there continue to be cases close to where we work. Click below to read about some of these tragic cases in the last few years; sadly they are all children.

http://www.prensalibre.com/guatemala/quetzaltenango/fallece-menor-a-causa-de-rabia
http://www.prensalibre.com/guatemala/quetzaltenango/investigan-caso-de-rabia-humana
http://www.prensalibre.com/quetzaltenango/Muere-nina-causa-rabia_0_1076292410.html

What about Chile? We don’t have canine rabies in Chile, but we do have sylvatic bat rabies that can then be transmitted to dogs and in turn, transmitted to people. This is why it is still critical to vaccinate dogs and cats in Chile and other countries that have eliminated the dog strain but still have it in other species. Dog vaccination provides a “buffer” between rabid bats and other animals and people.

Did you know?

There are only SEVEN people in the world that have ever recovered from rabies once they have started to show symptoms! And one of them is in Chile! This is a stunning case in a town called Quilpue where a young man was bitten by a dog while on his motorcycle. He was put in a coma and treated by a team of global experts and subsequently recovered. Here is the story:

http://www.jpgarnham.com/post/76240328911/rabies-and-life

What about animals?

The internet is filled with information about the impact of rabies on the human population, but information on the actual death toll in animals is impossible to measure. Confirmation of cases of rabies in animals is only possible when the animal is a suspect and is therefore sent to a laboratory for testing. So there are many cases of animals, both wild and domestic that will die from rabies and will never be tested. However, it remains true that rabies is nearly 100% fatal in animals, and it is truly a horrible death. To cause almost 60,000 human deaths per year, there must be A LOT of animals that also die from rabies. So why take the risk in your dog or cat when a vaccine is almost 100% effective?

What is the goal for the the GAAP’s rabies projects?
• To reach 70% vaccination of dogs and cats annually in Todos Santos
• To expand our public outreach and education to rural and illiterate residents of the Todos Santos area
• To emphasize the continued importance of rabies vaccination in dogs and cats in Chile through our outreach programs and GAAP Clinic

In the year 2017, although deaths like Oscar’s are completely preventable, they continue to occur at unacceptable levels all over the globe. Deaths like Oscar’s must be prevented. Donate to The GAAP or any organization that is actively working toward the eradication of canine rabies. In Latin America, funds should be targeting rural areas that have little access to outreach programs as well as the illiterate or indigenous populations that are unable to understand outreach materials. We invite you to do something extraordinary: for every $3.00 you can donate toward this global cause, you are vaccinating one pet and saving a life.