World Rabies Day: Rabies prevention saves lives

On 7 June 2024, the Western Cape Department of Agriculture confirmed that a rabies outbreak amongst Cape fur seals was the cause of the ongoing attacks of people and other seals along the Western Cape coast. Since October 2023, there have been a few notable incidents – from Blouberg in Cape Town, to Mossel Bay on the Garden Route and Plettenberg Bay in the Eastern Cape. Surfers and swimmers as well as divers and other water sports enthusiasts have been warned to heed the behaviour of seals, to not approach seals on land, and to seek urgent medical attention if they are bitten.

A rabies outbreak in wild animals so close to humans brings this deadly disease back into the spotlight, emphasising the need for awareness. People – and pet owners especially – need to be aware that rabies is a serious viral disease with fatal consequences if we don’t take a preventative approach. In this article, we explain what rabies is, explore the risks of rabies infection, what to do if your pet is bitten by a rabid animal and what you should do if you get bitten.

What is rabies?

The Rabies lyssavirus causes rabies in mammals. This viral pathogen targets the nervous system, causing inflammation along the central nervous system and eventually infecting the brain. Rabies needs a warm-blooded host, so the mammals we usually see infected with rabies include domestic pets and livestock, as well as wild animals such as bat-eared foxes, badgers, mongooses, bats, monkeys and now also seals. It’s a zoonotic disease, meaning it can be passed from animals to humans; and it’s the deadliest of the zoonotic diseases, with an almost 100% mortality rate. There are few cases of survival, and even then, the disease leaves lasting neurological side effects.

An estimated 60 000 people die every year from rabies – the majority of these being in Africa and Asia, with around 24 000 being children under the age of 15. In developing countries, bites from rabid dogs present in dense populations are mainly responsible for rabies deaths, while bat bites are the main culprit in North and South America. Bite victims have a small window in which to receive post-exposure prophylactic (PEP) treatment, but once the rabies virus has established itself and symptoms start to show, the disease cannot be cured and is fatal.

How rabies is transmitted

The rabies virus is transmitted from the saliva of an infected animal to the bloodstream of a healthy animal or person. Either the rabid animal bites its victim or the infected saliva is licked or smeared onto an unhealed cut or broken skin, or comes into contact with mucous membranes in the nose or mouth. 

Rabies has a very interesting modus operandi. It is classed as a ‘behaviour-altering parasite’ for the way in which it affects its infected host in order to boost its transmission to other hosts. The animal that’s been infected with rabies will foam at the mouth and be overly aggressive, trying to bite any object, person or animal within close range. This over-production of saliva and the attempts to bite are caused by the virus trying to find new hosts. A rabies-infected animal or person is also extremely hydrophobic – terrified of water. If it comes close to water, its throat muscles go into painful spasm to prevent it from drinking and swallowing, as this will dilute the viral load in its saliva.

Rabies symptoms

The inflammation in the brain and nervous system causes a range of neurological symptoms in rabies-infected animals, which can include:

  • sudden unexplained changes in behaviour (a sociable animal becomes unsociable, or vice versa)
  • wild animals lose their fear of humans
  • excitability
  • aggression
  • confusion/lack of coordination
  • twitching
  • seizures
  • fever
  • vomiting & diarrhoea
  • excess salivation
  • inability to swallow

Most of these symptoms are the result of ‘furious rabies’, but the virus can also cause ‘dumb rabies’, which manifests as:

  • seeking solitude
  • paralysed jaw muscles – lower jaw droops down
  • paralysed throat – inability to swallow
  • progression of paralysis to the rest of the body

Animals most at risk of contracted rabies

Domestic animals on rural properties that wild animals are known to frequent are at risk of contracting rabies. Dogs will either display curiosity towards wild animals (like bat-eared foxes or mongooses) or will try to chase them off in true guard-dog style, putting themselves at risk of a bite if they get too close to wildlife. Unvaccinated pets or pets not up-to-date with their vaccinations are at risk of developing rabies if they get bitten. If these same pets’ vaccination cards are up to date and they are exposed to the rabies virus due to a bite, their immune system should be primed to fight off the pathogen with the right antibodies. Even if the pet’s rabies vaccination is up to date and they are bitten, they must get medical attention immediately.

Those pets at risk of developing rabies can take from three to 12 weeks to start showing symptoms. At this stage – when clinical symptoms of rabies become evident – the disease is fatal and the animal will need to be humanely euthanised or will die naturally. 

Some pets are more at risk of contracting rabies – such as those in underserved communities, where vaccination uptake is slow or inaccessible. Since 1999, it’s become mandatory for all pets to receive rabies vaccinations; and the State has administrated vaccination and compliance checks to ensure this mandate is upheld. The government aims to eradicate human deaths by dog rabies in South Africa by 2030, despite the many obstacles (including pet owner hesitancy) to all pets receiving adequate vaccines and boosters. The many stray, unvaccinated dogs in the country increase the likelihood of rabies spreading unnecessarily, and also risk the lives of vulnerable children. In order to prevent rabies from spreading, all dogs that can be vaccinated should be – for their own safety and that of humans’.

What to do if your pet has been bitten by a potentially rabid animal

Rabies can only be confirmed with a post-mortem test of brain matter – there are no blood tests for the disease while an infected animal is still alive. Contact the vet immediately if your pet has been bitten by another dog or wild animal with an unknown rabies status. The vet will know what to do, which will be to isolate your pet for a few days to see if they develop any symptoms of rabies. If your pet has been vaccinated, they will receive a booster. However, unvaccinated pets should not receive post-exposure prophylaxis (PEP). If your pet develops any symptoms of rabies, they will need to be humanely euthanised, since there is no cure for the disease. 

If your pet does not develop any rabies symptoms, they will be given symptomatic treatment for the bite wound and the all-clear before they can return home to you.

How to prevent rabies infection in pets

Vaccinate your pets

Making sure your pets are vaccinated is the quickest, easiest way to protect them from contracting rabies. Rabies vaccines are scheduled as follows:

  • puppies and kittens’ first vaccine: three months of age
  • puppies and kittens’ second vaccine: 12 months of age
  • dogs and cats’ booster vaccines: every 12 months or every 36 months, depending on the manufacturer’s label

Rabies vaccines protect your pets as well as you and your family. If all pet owners took responsibility for their pets’ vaccinations, rabies could be eradicated in domestic pets – something that is possible, but will take a communal effort from everyone.

Keep your pets in your yard

If pet owners do not have control over their pets’ movements, they cannot control the animals they may come in contact with – including wild animals. A wandering cat or escaped dog may be exposed to rabid animals. However, if you know where your pet is at all times and keep them in your property (and leash your dog every time you go out in public), you’ll greatly reduce any chance of them having an altercation with stray dogs and wild animals, and risking a rabies-infected bite, which also exposes you and your family to the disease.

Report stray animals

While we don’t recommend the careless handling of stray animals, we encourage animal lovers to either responsibly collect stray animals that look lost and bewildered, or to report strays to your nearest SPCA or welfare organisation. Each stray or lost pet that is brought in for identification and care is one less risk of rabies on the street (the risk being that the stray is not bitten by a rabid or wild animal), and one less risk to small children. If you are not in a position to pick up the stray, please contact the nearest rescue organisation and confirm the exact location of the animal until they arrive there.

What to do if you’ve been bitten by a potentially rabid animal

Everyone on the frontlines of animal care – from veterinarians, nurses and vet staff, to pet rescuers and kennelling staff; wildlife rehab staff; animal inspectors and behaviourists – is encouraged to receive pre-exposure prophylactic vaccines on the off-chance they are exposed to rabies.

If someone is suspected of having taken a rabies bite or a possibly rabid dog licked or salivated on them, they must get medical attention as soon as possible. The doctor or healthcare provider will do a risk assessment (based on the animal’s location, symptoms and behaviour) to determine whether the person needs to endure the post-exposure prophylactic (PEP) protocol. Post-mortem confirmation of rabies is not always possible, but if the animal’s bite broke the person’s skin, it increases the likelihood of rabies transmission and they will need PEP treatment. 

The appropriate wound care and PEP include: 

  • thoroughly cleaning and washing the bite wound (for 15 minutes under running water, then with soap, an antiseptic, an iodine-based disinfectant, or 70% alcohol – all of which can inactivate the rabies virus)
  • administration of human-rabies immunoglobin (HRIG) – ONLY for those who have not received pre-exposure vaccination
  • rabies vaccine in four doses – on days 0, 3, 7 and 14 after potential/exposure to rabies

If wound care and PEP treatment are not performed properly or in a timely manner, the person may develop rabies symptoms. This can happen anywhere from a few days to a few months after exposure to the rabies virus, but when clinical symptoms present, it’s too late for treatment and the person will die. The virus’s dormancy is not an indication of recovery, which is why emergency medical treatment is so critical as soon as possible after a bite from a potentially rabid animal. 

Conclusion

With little to no chance of survival from a rabies infection, this alone should motivate pet owners to get their pets vaccinated for rabies and to avoid exposure to the virus in the first place. Preventative treatments like vaccines given once every one to three years are the bare minimum – all that’s needed to ensure safety from rabies for pets, families and communities.

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