ON Christmas Eve, I received a distressing call about a nursing mother exhibiting rabies symptoms. I rushed to the hospital, where I witnessed my third dog-mediated human rabies case in Nigeria. Standing by her bedside, my heart ached as I wondered why anyone should endure such agony. I thought about Nigeria’s long journey to meet the 2030 goal of eliminating dog-mediated human rabies. Sadly, as with most rabies cases, the woman succumbed to the disease, another stark reminder of our public health shortcomings.
She had been bitten by a dog during her pregnancy and received treatment, but crucially, no rabies vaccine was administered. Approximately three months later, she began exhibiting ominous rabies symptoms, including tingling sensation at the bite site, hydrophobia (fear of water), hyperexcitation (excessive restlessness), aerophobia (fear of drafts or air). These symptoms marked the devastating onset of a disease that could have been prevented with timely vaccination.
In my course of community engagement, and field and laboratory-based research on rabies among wildlife, dogs and humans in Nigeria, low level of knowledge, inaccessibility to healthcare/ rabies biologics and low economic power remain major drivers of continued endemicity.
As we continue to grapple with the threat of rabies, it’s imperative to acknowledge that despite being 100% vaccine-preventable, this disease remains a significant public health concern.
The harsh reality is that once rabies symptoms appear, the disease is nearly always fatal. At this stage, the virus has already invaded the central nervous system, where it rapidly multiplies, making recovery virtually impossible.
Key facts about rabies transmission
Rabies virus is primarily transmitted through the saliva of infected animals, usually dogs, via bites, scratches, or licks.
(There are other means of transmission)
How long does it take an exposed person to manifest rabies symptoms?
Rabies symptoms can manifest in as short as less than a week to as long as over a year. The duration depends on many factors, most especially the distance between the site of exposure and the central nervous system.
How is rabies prevented?
Rabies is most effectively prevented by vaccination. The disease is most commonly transmitted by dogs and they should be vaccinated annually in endemic countries like Nigeria.
High-risk individuals, like veterinarians, rabies diagnostic laboratory workers, hunters, etc., should be vaccinated against rabies.
How is rabies prevented after exposure?
Take immediate action when bitten or scratched by a suspected rabid dog
(1.) Wash the wound with soap under running water for at least 15 minutes.
2) Apply an antiseptic
(3) Seek immediate medical attention in a reputable hospital.
Meanwhile, the dog should be seized and quarantined for at least 10 days. This is to prevent its contact with other animals and humans and to keep it under observation.
Postexposure prohylaxis
Prompt administration of human rabies vaccine and rabies immunoglobulin (for previously unvaccinated individuals) is key and completion of the regimen is crucial.
Important notes
Rabies vaccine is safe for pregnant women and nursing mothers. As long as the benefits surpass the risks, vaccine uptake is recommended.
When it comes to rabies, prevention is best, as there is no scientifically proven cure to date.
A call to action
To combat rabies effectively in Nigeria, conscientious efforts must be put into:
(1.) Law enforcement: The Dog Law with provisions on dog registration, vaccination and confinement should be enforced. This will drastically reduce the population of free roaming of dogs which are the major culprits of rabies transmission to humans.
(2.) Mass Vaccination: Mass rabies vaccination campaigns for dogs in rural, periurban and urban communities should be organized. Thus should not be limited to the annual world rabies day marked on September 28.
(3.) Public Enlightenment: There is a need to continuously educate the public on rabies using all available channels. This would keep people informed and reduce rabies.
(4.) Access to adequate rabies biologics- Rabies vaccine and rabies immunoglobulin should very made available in hospitals in both urban and rural communities with alternative sources of power supply for preservation.
(5.) Establishment of diagnostic laboratories Laboratories are critically needed across the country for confirmatory diagnosis of rabies and active surveillance
6.) Effective disease reporting system
Channels for reporting suspected rabid dogs sighted in communities, dog bite and human rabies should be
Are you a dog owner or you know someone who owns dogs? Visit a veterinarian today and get your dog(s) vaccinated.
By joining forces, we can eliminate dog-mediated human rabies in Nigeria.
Dr. Ifeoluwapo O. Akanbi (DVM, MVPH, Ph.D. FCVSN) is a veterinary public health consultant.
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