RABIES is a zoonotic disease that affects the nervous system of mammals. It is invariably fatal once the clinical signs develop. The disease affects humans, usually when bitten by an infected animal, particularly, dogs and cats or when exposed to saliva or tissues from the central nervous system of the affected animals. The disease is most prevalent in Africa, the Middle East, Asia and Latin America. Globally, rabies is estimated to cause not less than 55,000 deaths, mostly in children. In Nigeria, reported cases of rabies is about 10,000 annually. However, through rigorous control measures the disease has been eliminated from most part of advanced countries. Rabies has two phases; urban rabies and sylvatic rabies. Urban rabies is associated with the spread of the disease to humans through dogs as a result of spill-overs from other animal reservoirs, especially bats. Bats are considered significant reservoirs of rabies disease in the sylvatic (forest) phase of the disease. In most parts of Africa, urban rabies is most predominant. This is so because of the prevalence of high population of unvaccinated and stray dogs which daily roam the streets carelessly. Therefore, to eradicate rabies, the need for responsible dog ownership is key. The first reported incidence of human rabies in Nigeria was diagnosed in 1912 while the first documented case of rabies in dogs was in 1925 at Yaba Rabies Laboratory. The disease is under reported in Nigeria due to many encumbrances facing animal disease reporting system in Nigeria.
The incubation period of rabies in humans range from a few days to several years. However, most cases become apparent between one to three months. The manifestation of the disease depends on the site of bite. The farther the site of the bite to the central nervous system, the longer the incubation period. That explains why some patients must have forgotten that they were once bitten by dogs when the disease eventually manifest. The clinical symptoms of rabies in humans may be non-specific initially, ranging from headaches , fever, pain, sensory alterations, anxiety, confusion, insomnia, hallucination, partial paralysis, hyper-salivation, convulsions etc. ultimately leading to death. In dogs, the clinical signs also include profuse salivation, fear of water (hydrophobia), uncoordinated movement (ataxia), difficulty in swallowing, unwarranted aggression, (even against the owner), paralysis and death. Infected dogs may not survive more than 14-21days after the onset of the disease. The first aid treatment required to reduce the chances of acquiring the disease after a bite from rabid animals include washing of the bite wound copiously with lipid (fat) solvents such as soap solutions especially detergents, 1% sodium hypochlorite, ethanol and iodine preparations after which the victim should be immediately taken to the hospital for rabies post exposure management. The earlier the victim is presented to the hospital, the better.
Moreover, the good news about rabies disease is that it is vaccine preventable. Since the discovery of rabies vaccine by Louis Pasteur in 1885, human and animal rabies could be prevented through vaccination. Dogs aged 3 months and above and cats aged 4 months and above are expected to be vaccinated with anti-rabies vaccines annually to prevent them from contracting the disease and hence break the chain of animal – human transmission. Whereas mass vaccination of dogs and cats is a standard policy globally, only humans who are at risk (veterinarians, animal health workers, and rabies laboratory staff members) are compelled to be vaccinated. In order to achieve the Sustainable Development Goal of eliminating rabies by the year 2030, the theme of this year world rabies day is apt, if one of the major targets of the SDG 3 (target 3.3) would be achieved. This involves the adoption of One Health Approach which involves multidimensional, multi-disciplinary and inter-sectoral participation of everyone including the government, non -governmental organizations, community based organizations, private individuals and religious organizations, working together to confront the monster that rabies represents. Community participatory approaches are essential to eradicate rabies globally. One Health promotes improvement of health and wellbeing of people, protection of animal health while maintaining the delicate balance of the ecosystem. One health approach is the novel paradigm shift required to overcome the challenges of rabies and other zoonotic infectious diseases. The current fragmented framework of health governance for humans, animals and the environment together with the conventional linear approach to solving health problems is failing to meet contemporary health challenges and unsustainable. The value of One Health for all have been demonstrated in the control and prevention of rabies and other infectious diseases in some developing countries such as South Sudan, Chad, Mali, Mauritania, Rwanda and Uganda
The Federal Government of Nigeria should be applauded for supporting One Health Approach in Nigeria for solving contemporary health challenges through the development of national policy developed by the Federal Ministry of Agriculture, Federal ministry of Health and Federal Ministry of the Environment in 2019 (One Health Strategic Plan 2019-2023). But, beyond this policy document, implementation of the plans should be vigorously pursued to the benefit of the Society.
One such step that could be taken to defeat rabies is the incorporation of rabies vaccine for dogs on the platform of the National Program on Immunization in order to use that platform to improve dog vaccination coverage throughout the country. All contentious issues, including lack of agreement among various professionals involved, should be resolved while respecting the ethics of the professions concerned. As of now, rabies vaccine do not reach the rural areas reputed to have huge population of local dogs. This is because many government owned veterinary clinics and hospitals lack adequate personnel and infrastructure. Most private veterinary clinics and hospitals (established for profit) are located in urban centres where their services could be adequately paid for. Incorporating anti rabies vaccine on this platform would undoubtedly bridge the gap.
Unfortunately, haphazard vaccination campaigns would not eliminate dog rabies. At least, 70% of Nigeria’s dog population must be vaccinated annually and consistently for many years before rabies could be kept at bay. Therefore deliberate efforts of all tiers of governments are required to ensure availability of rabies vaccine for dogs free of charge. Apart from this, zoonotic spill-over from the wild (sylvatic rabies) should be monitored through research and active surveillance that incorporates local hunters and bush meat processors who could be used as sentinels. Advocacy and enlightenment of hunters on the need to vaccinate their hunting dogs (demystifying taboos) is also crucial to prevent zoonotic spill- over through hunting dogs.
Extant laws relating to responsible dog ownership and compulsory, verifiable vaccination of dogs (accompanied with vaccination certificates) should be enforced or amended to comply with the current realities across the States of the Federation. Establishment of public animal shelters funded by the government and encouragement of private animal homes and shelters would also go a long way to prevent population explosion of stray dogs that are known to serve as reservoirs and vectors of urban rabies among other measures.
The issue of vaccination of dogs, specifically and treatment, prevention and control of animal diseases generally is an obligation imposed on animal owners by the dictates of animal welfare convention as enunciated by the World Organization for Animal Health (WOAH) i.e. freedom from injury and diseases.
In conclusion, participatory efforts of individuals, communities, religious organizations governmental and non –governmental institutions are urgently needed to successfully eradicate rabies in the spirit of ‘All for 1, One Health for All’. By this, the scourge of rabies would become a thing of the past, in Nigeria and the rest of the world.
- Dr. Faramade, President, Society for Animal Rights Protection, Nigeria, writes in via [email protected]
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