Rabies is a deadly virus carried by animals and transmitted to humans through saliva, usually by a bite. Practically eliminated in most first-world countries, it still persists in the developing world and has hit the news this year in Southeast Asia.
What Is Rabies?
Classified as a ‘neglected tropical disease’ by the World Health Organisation (WHO), alongside diseases like dengue and leprosy, rabies predominantly afflicts poor people in developing nations.
The virulent pathogen exists on every continent except Antarctica. All warm-blooded animals can be infected by rabies, although birds and rodents tend to be less effective carriers than other species.
The carriers which put humans most at risk are the kind of animals you expect living in and around human settlements; dogs, cats, racoons, bats, foxes and monkeys, for example.
According to the World Health Organisation, dogs are the number one transmitter of rabies to humans, accounting for up to 99 percent of all rabies transmissions.
After infection there is an incubation period before symptoms begin to display, usually one to three months in humans. In one case, an incubation period of more than six and a half years was recorded, as have shorter incubation periods.
Initial symptoms are flu-like in nature with fever, vomiting, nausea and headaches being common. In later stages the brain swells and symptoms like hyperactivity, erratic or irrational behaviour and hydrophobia — a fear of water — are exhibited.
The good news is that rabies is entirely treatable if dealt with early. The process is known as post-exposure prophylaxis and involves a series of rabies vaccine and immunoglobulin injections.
The bad news is, if it is not caught early, by the time symptoms present themselves, it is too late for the patient to make a recovery.
Thailand’s Rabies Outbreak
The rest of the world has managed to minimise the risk of rabies in domesticated animals through vaccinations. By vaccinating pets, especially dogs, the virus loses its main carrier and mode of transmission to humans.
This is partly why the disease remains such a threat in developing countries that lack the infrastructure to enact successful, widespread vaccinations. Having a large rural population with a lack of knowledge and medical care exacerbates the issue.
An example of these factors playing out in real life happened earlier in 2018, when Thailand found itself in the midst of a rabies outbreak.
At least eight people died from the disease, outpacing last year’s figure of 11 deaths.
As of September this year, the death toll stands at 16.
But this is not Thailand’s worst outbreak of rabies. In fact, in 1980, 370 Thais succumbed to the disease.
Out of 77 provinces, 35 were designated ‘red-zones’, areas where rabies infection is confirmed in both humans and animals in the last two years.
In response to the outbreak, the Thai government distributed millions of vaccines to local administrations across the country.
The story has a twist, however, as some claims of impropriety related to the sourcing of the government-held vaccines has led to doubts about their efficacy.
The implication is that sub-standard vaccines could mean people and animals were improperly vaccinated, helping to enable this latest outbreak.
As of May 2018, roughly 3.5 million pets in Thailand have been vaccinated, less than half of the government’s target of 8.2 million.
John Dalley, founder of Soi Dog Foundation in Phuket, says, ‘It will cost some money, but the World Health Organisation has a functional program to curb the disease. If you vaccinate 70 percent of dogs, you have basically eradicated rabies.’
Current Risks and Future Goals
Rabies is a very real threat in the developing world and Southeast Asia in particular.
In 2015 the Global Alliance for Rabies Control reported that seven out of eleven ASEAN countries were endemically infected with rabies, putting an estimated 608 million people at risk.
If you are travelling to countries with a rabies problem you should get vaccinated. Children especially should be vaccinated as they are more likely to play with animals and might not report being bitten.
Knowledge and vaccinations are the main tools we have to fight the virus.
The WHO wants to rid the world of rabies by 2030.
According to the global health watchdog, 15 million post-bite rabies vaccinations are given every year worldwide, saving hundreds of thousands of lives.