Rabies – A Disease of Ignorance

September 28th is World Rabies Day, and we wanted to take the opportunity to talk about a disease which is all too often shrouded in ignorance; and seems to fall dangerously between medical and veterinary responsibility. It is relatively rare in humans so tends to be forgotten by the public and can also be overlooked by doctors when searching for a diagnosis.

World Rabies Day was started in 2007 as an effort to raise global awareness and help prevent the spread of infection. Fortunately, rabies is not present in the UK, except for a rabies-like virus in a small number of wild bats which are not considered high risk for human transmission(2). It is however present in Europe and the rest of the world; especially Asia and Africa, where 95% of human deaths occur(4). Approximately 80% of human cases occur in rural areas, many of whom are children(4).

The importation of animals into the UK from countries which are not rabies-free, requires adherence to stringent travel protocols. Depending on the country of export, this usually includes vaccination of the microchipped animal; blood tests to check that rabies antibodies are sufficient; and a health check by a veterinarian. Animals leaving the UK to countries which are not rabies-free should be vaccinated prior to leaving.

Rabies is a rare but very serious disease which is spread by transmission of a virus. It attacks the nervous system and causes inflammation of the brain tissue. Rabies is fully preventable by vaccination, if performed either prior to exposure or soon after. However, once symptoms begin to show, rabies is virtually always fatal.

The rabies virus is spread in saliva. This happens most commonly through a bite which breaks the skin; but it can also spread if saliva comes into contact with a scratch or enters the eye. After the virus enters the body, it multiplies; invades nerve cells; and travels along the nerves to reach the brain. It causes severe inflammation of the spinal cord and brain, which leads to clinical signs and rapid deterioration.

It is estimated that 99% of human deaths from rabies occur as a result of bites from rabid dogs(3). While all warm-blooded animals can get rabies, some species are more likely to spread it than others. Small mammals such as squirrels and rabbits often do not survive the attack which results in their infection, and so do not pose as much of a risk for transmission as larger animals. Rabies usually causes aggression in animals, or abnormal behaviour (such as a wild animal acting tame). This increases the chances of the virus being spread via bites. Theoretically, transmission of rabies could occur between people, but no such cases have been documented(1).

The time between infection and the appearance of clinical signs can be weeks or months, but once clinical signs appear there is unfortunately no curative treatment. Symptoms may first present as fever or headache, and then progress to confusion, severe agitation, fear of water, hallucinations, coma and death. The widely known symptom of foam at the mouth occurs because the infected individual is unable to swallow.

To date there are less than 30 documented cases of humans surviving clinical rabies, and only a few of them had no history of previous immunisation. Rabies causes approximately 59 000 deaths worldwide every year(1).

A bite from any animal which may be rabid must be considered an emergency. Prompt treatment is almost 100% effective in preventing the disease.

The bite must be thoroughly cleaned and disinfected; and then immediate medical attention is necessary. If rabies exposure is suspected, a course of vaccinations should be given. In some cases, injections of immunoglobulin are also given (this is a type of antibody and helps the immune system to fight infection).

The UK has been Rabies-free since the beginning of the 20th Century(2). While there is a Rabies-like virus present in a small number of wild bats, it is very rare for infected bats to spread the disease to either people or other animals. In fact, there has only been one recorded case of a person in the UK becoming infected from a bat(2). Even so, it is best to avoid touching bats, or to wear thick gloves if it is necessary to handle them(2).

If you are traveling in an area where rabies is a risk, simply being aware is a good start to protecting yourself. Avoid contact with unknown animals, especially if they are behaving strangely or aggressively. If you are visiting a high-risk area, you may consider being vaccinated before you leave. This is particularly advisable if you are likely to interact with animals, or if medical facilities will not be easily accessible.

If you have any questions about this disease or how to protect yourself, don’t hesitate to contact us as meow@katkin.com and we will try our best to help. Also, be sure to join fellow cat lovers to chat all things cat-related in our private Facebook group, the KatKin Club House.

References:

1. Centers for Disease Control and Prevention. (2019). Rabies. U.S. Department of Health & Human Services. Retrieved September 23, 2021, from: https://www.cdc.gov/rabiese/transmission/index.html

2. NHS. (2020). Rabies. Retrieved September 23, 2021, from: https://www.nhs.uk/conditions/rabies/

3. Wilson & Rohde. (2021). 8 things you may not know about rabies – but should. Elsevier Connect. Retrieved September 23, 2021, from: https://www.elsevier.com/connect/8-things-you-may-not-know-about-rabies-but-should

4. 4. World Health Organization. (2021). Rabies. Retrieved September 23, 2021, from: https://www.who.int/news-room/fact-sheets/detail/rabies