Rabies is a viral disease that affects all warm-blooded animals and can be transmitted to humans, primarily through dog bites. In Kenya, the disease is among the top five prioritized zoonotic diseases and remains endemic. Maurice Murungi, a research manager at World Veterinary Service and an epidemiologist, notes that dogs are responsible for about 99 per cent of human rabies infections. The disease kills an estimated 59,000 people globally every year, with about 95 per cent of deaths occurring in Africa and Asia.
Health experts say that rabies is almost entirely preventable through vaccination, yet gaps in dog vaccination, surveillance, veterinary services, and access to post-exposure treatment continue to put lives at risk. In Kenya, an estimated 2,000 human deaths occur annually, primarily from dog bites. Children are particularly vulnerable because they often play with dogs and may not recognize the danger posed by an infected animal. Murungi notes that once a dog contracts rabies, it typically dies within 10 days and can transmit the virus to other animals or people through its saliva, usually through a bite.
Lian Thomas, a senior scientist at the International Livestock Research Institute (ILRI), working on neglected zoonotic diseases, notes that even a scratch from an infected animal can transmit the virus. The virus travels along the nerves to the brain, and once clinical signs appear, the disease is fatal. In dogs and cats, rabies commonly presents as the "furious" form, characterized by aggression, changes in bark or vocalizations, and excessive salivation. Donkeys, horses, and cows often develop the "dumb" form, becoming depressed and withdrawn.
Thomas advises anyone who notices a dramatic change in an animal's behavior to contact a veterinarian immediately. After an infected animal bites a person, the virus enters the body through the wound and multiplies at the site before entering the nerves and traveling towards the brain. The person may appear well during this period, but it is the critical window in which treatment can prevent the disease. The incubation period typically ranges from about a week to a few months, although rare cases have been recorded after as long as two years.
Anyone bitten should immediately wash the wound with plenty of soap and running water for about 15 minutes before going to hospital for post-exposure prophylaxis (PEP). The regimen typically involves five vaccine doses on days zero, three, seven, 14, and 28. Depending on the exposure, rabies immunoglobulin may also be administered around the wound. Once symptoms appear, however, rabies is almost invariably fatal. Experts warn against throwing stones at, chasing, or trying to kill a suspected rabid dog.
A cornered or provoked animal is more likely to bite, and experts advise against approaching it. Instead, one should protect themselves and contact a veterinarian to capture the dog safely. A safely captured animal can be humanely killed, and its brain sent to a laboratory for diagnosis. The same applies to suspected rabid livestock. Thomas also cautions against eating meat from animals slaughtered at home, particularly sick or dead animals, as this can expose people to rabies and other zoonotic diseases.
Vaccinating dogs remains the single most effective tool for preventing human rabies, according to Thomas. An effective vaccine exists, but at least 70 per cent of dogs in an area need to be vaccinated to achieve herd immunity. This can significantly reduce the risk of human rabies infections and deaths. By addressing the gaps in dog vaccination, surveillance, and veterinary services, Kenya can make significant progress in controlling and eventually eliminating rabies.
Key points
- An estimated 2,000 people die from rabies in Kenya annually, primarily from dog bites.
- Gaps in dog vaccination, surveillance, veterinary services, and access to post-exposure treatment continue to put lives at risk.
- Vaccinating dogs remains the single most effective tool for preventing human rabies.
