tag:theconversation.com,2011:/au/topics/rabies-12590/articles
Rabies – The Conversation
2024-01-09T13:23:53Z
tag:theconversation.com,2011:article/219199
2024-01-09T13:23:53Z
2024-01-09T13:23:53Z
Rabies is an ancient, unpredictable and potentially fatal disease − two rabies researchers explain how to protect yourself
<figure><img src="https://images.theconversation.com/files/567905/original/file-20240104-24-3ionkc.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2048%2C2048&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Rabies virus (red) has an incubation period that can last from days to months.</span> <span class="attribution"><a class="source" href="https://flic.kr/p/2mM8QjD">NIAID/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p><em>A <a href="https://www.usatoday.com/story/news/nation/2023/11/28/nebraska-kitten-with-rabies/71733608007/">feral kitten</a> in Omaha, Nebraska, tested positive for rabies in November 2023. It died of the raccoon variant of the virus, which is typically found only in the Appalachian Mountains. Detecting this variant hundreds of miles away in the Midwest raised concerns about a potential outbreak and launched a public health task force to vaccinate all raccoons in the area.</em></p>
<p><em>While the case was likely contained, a better understanding of how rabies is transmitted can help prevent future outbreaks. Researchers <a href="https://scholar.google.com/citations?user=8XtvOZ8AAAAJ&hl=en">Rodney Rohde</a> and <a href="https://www.researchgate.net/profile/Charles-Rupprecht-2">Charles Rupprecht</a> explain how rabies vaccination works and how to protect yourself from infection.</em></p>
<h2>What causes rabies?</h2>
<p><a href="https://asm.org/articles/2021/september/the-one-health-of-rabies-it-s-not-just-for-animals">Rabies</a> is an ancient viral disease that has been around for <a href="https://doi.org/10.1016/j.antiviral.2017.03.013">thousands of years</a>. Considered a <a href="https://doi.org/10.1186/s44149-023-00078-8">neglected tropical disease</a>, rabies typically occurs in <a href="https://www.who.int/health-topics/neglected-tropical-diseases">poorer communities without the infrastructure</a> for adequate surveillance, prevention and control.</p>
<p>Rabies is <a href="https://pubmed.ncbi.nlm.nih.gov/12144896/">unpredictable</a>. <a href="https://www.ncbi.nlm.nih.gov/books/NBK448076/">Stages of infection</a> include an incubation period that ranges from days to months, early flu-like symptoms, a period of severe neurological effects, coma and then death. Common early-stage symptoms in people, such as fatigue, fever and nausea, are often nonspecific. Neurological symptoms can involve aggression, confusion, difficulty swallowing and paralysis.</p>
<p>The pathogens that cause rabies belong to a <a href="https://doi.org/10.1007/s00705-022-05546-z">genus of viruses called <em>Lyssavirus</em></a> that target warm-blooded vertebrates. Although researchers believe that all mammals are susceptible to infection, only certain animals are <a href="https://doi.org/10.3201%2Feid0812.010317">reservoirs</a>: environments, habitats or populations where a pathogen can live, multiply and transmit. In the U.S., the <a href="https://www.elsevier.com/connect/8-things-you-may-not-know-about-rabies-but-should">highest-risk animal reservoirs</a> for rabies are skunks, bats, foxes, coyotes and raccoons.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/8KGcLs2O-BI?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A kitten found in Omaha infected with rabies spurred a push to vaccinate local wildlife.</span></figcaption>
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<p>Most people who become infected with rabies get it from <a href="https://www.cdc.gov/rabies/transmission/index.html">an animal bite</a>. Less common routes include contact with open wounds or the mucous membranes of the eyes, nose or mouth. Once the virus <a href="https://www.ncbi.nlm.nih.gov/books/NBK8618/">enters the body</a>, it can begin replicating in muscle tissue or after traveling directly to the brain. Once it spreads to other organs, patients typically die of brain inflammation.</p>
<h2>Are rabies cases increasing?</h2>
<p>Measuring the global burden of rabies is difficult because <a href="https://connect.h1.co/prime/reports/b/9/9">surveillance is often inadequate</a>.</p>
<p>While human incidence of rabies are rare in the U.S., averaging <a href="https://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html">one to three cases per year</a>, this disease causes <a href="https://doi.org/10.1371/journal.pntd.0003709">tens of thousands of deaths worldwide</a> annually. </p>
<p>Rabies rates in animals vary each year. During 2021, 54 U.S. jurisdictions reported <a href="https://doi.org/10.2460/javma.23.02.0081">3,663 rabid animals</a>, an 18.2% decrease from the previous year. Lower- and middle-income countries, especially <a href="https://doi.org/10.1093/jtm/taad009">since the COVID-19 pandemic</a>, have experienced disruptions to animal vaccination for rabies due to vaccine production and access issues and increased feral animal populations.</p>
<p>Human rabies cases have risen in several countries because of <a href="https://doi.org/10.3390/idr14060097">multiple ecological and socioeconomic factors</a>. For example, in China, rabies cases are associated with proximity to urban populations and transportation hubs. The closer a susceptible animal is to a community experiencing an outbreak, the greater the likelihood for spread.</p>
<p>Increased temperatures due to climate change are also linked to increased rabies transmission because of changes in animal ranges. For example, as regions warm, the relative distribution and abundance of certain reservoirs, such as tropical species like <a href="https://doi.org/10.1371/journal.pone.0192887">vampire bats</a>, may increase. Rising Arctic temperatures may increase how often <a href="https://doi.org/10.1111/zph.12848">red and Arctic foxes</a> interact and lead to outbreaks.</p>
<p>Higher rates of interactions between humans and animals, as well as lower levels of rabies education and prevention measures, are also linked to an increased risk of infection.</p>
<h2>Has controlling rabies in wildlife been successful?</h2>
<p>Prior attempts to control rabies include animal culling and vaccination. <a href="https://doi.org/10.1111%2Fj.1365-2656.2012.02033.x">Culling animal populations</a> did not lead to reduced infection. Rather, it raised significant economic, ecological and ethical concerns. Besides killing likely healthy animals, culling also isn’t cost-effective. </p>
<p><a href="https://doi.org/10.1007/s10806-021-09868-x">Animal vaccination</a>, on the other hand, can protect both animals and humans with minimal risk and reduced costs. Oral rabies vaccination of wildlife <a href="https://www.npr.org/2023/11/01/1198908463/raccoon-rabies-usda-vaccination-program-airdrop-oral-vaccine">began during the 1970s</a> with the distribution of vaccine-laden baits in the local environment. Officials saw success in rabies control among coyote, fox and raccoon populations in Europe and North America.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/567950/original/file-20240104-25-gwzc6j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Two stray dogs playing with each other on a street" src="https://images.theconversation.com/files/567950/original/file-20240104-25-gwzc6j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567950/original/file-20240104-25-gwzc6j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567950/original/file-20240104-25-gwzc6j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567950/original/file-20240104-25-gwzc6j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567950/original/file-20240104-25-gwzc6j.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567950/original/file-20240104-25-gwzc6j.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567950/original/file-20240104-25-gwzc6j.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Vaccination of strays can reduce the spread of rabies.</span>
<span class="attribution"><a class="source" href="https://phil.cdc.gov/Details.aspx?pid=23838">CDC/Nicholas S. Tenorio, Health Communication Specialist</a></span>
</figcaption>
</figure>
<p>We both participated in the inaugural <a href="https://doi.org/10.2460/javma.2005.227.785">oral rabies vaccination campaign in Texas</a>. This effort eventually led to the elimination of canine rabies <a href="https://www.dshs.texas.gov/rabies/oral-rabies-vaccination-program-orvp">in the state</a>. </p>
<p>Oral vaccines are also being considered for the prevention and control of rabies in animals in other countries, such as <a href="https://doi.org/10.1017%2FS0950268823001334">dogs in India</a> <a href="https://www.who.int/news/item/03-05-2021-oral-rabies-vaccine-a-new-strategy-in-the-fight-against-rabies-deaths">and Thailand</a>.</p>
<h2>How do rabies vaccines work?</h2>
<p>There is <a href="https://pubmed.ncbi.nlm.nih.gov/30747124/">no proven treatment for rabies</a>, so prevention through education and vaccination is critical. Rabies can be prevented by avoiding exposure or receiving vaccination before or after an exposure.</p>
<p><a href="https://www.cdc.gov/rabies/prevention/pre-exposure_vaccinations.html">Preexposure prophylaxis, or PrEP</a>, involves exposing the immune system to a harmless version of the virus to prevent a future infection. For people who work in high-risk occupations, such as wildlife biologists, veterinarians and animal control personnel, two doses of a rabies vaccine can offer <a href="https://www.cdc.gov/rabies/prevention/pre-exposure_vaccinations.html">significant protection</a>. </p>
<p>The Centers for Disease Control and Prevention <a href="http://dx.doi.org/10.15585/mmwr.mm7118a2">currently recommends</a> a booster dose for people at elevated risk of exposure. People traveling to areas with a high prevalence of rabies may also want to consider vaccination.</p>
<p><a href="https://www.cdc.gov/rabies/medical_care/index.html">Postexposure prophylaxis, or PEP</a>, means taking a vaccine or medications to prevent an infection as soon as possible after exposure. In most cases, this involves a dose of <a href="https://www.cdc.gov/rabies/medical_care/hrig.html">human rabies immune globulin, or HRIG</a>, as well as a rabies vaccine dose on the day of exposure. </p>
<p>Also known as passive immunization, HRIG gives your body the antibodies to neutralize rabies virus until your immune system can produce its own antibodies. Three more doses of the rabies vaccine are given three to 14 days after exposure. People who are immunocompromised may receive a fifth dose as well.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/567947/original/file-20240104-21-nh61r5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Microscopy image of clusters of dark circles called Negri bodies against a background of pink brain tissue" src="https://images.theconversation.com/files/567947/original/file-20240104-21-nh61r5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/567947/original/file-20240104-21-nh61r5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/567947/original/file-20240104-21-nh61r5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/567947/original/file-20240104-21-nh61r5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/567947/original/file-20240104-21-nh61r5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/567947/original/file-20240104-21-nh61r5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/567947/original/file-20240104-21-nh61r5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Negri bodies (purple) are proteins that collect in neurons containing rabies virus.</span>
<span class="attribution"><a class="source" href="https://phil.cdc.gov/Details.aspx?pid=3981">CDC/Dr. Daniel P. Perl</a></span>
</figcaption>
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<p>Regular and appropriate <a href="https://www.cdc.gov/rabies/prevention/animals.html">pet and livestock vaccinations</a> are also important to help curb rabies virus exposures. Animals typically receive a <a href="https://www.cdc.gov/rabies/specific_groups/veterinarians/vaccination.html">yearly rabies booster</a>.</p>
<p>There are <a href="https://doi.org/10.1016/j.vaccine.2018.08.039">several new rabies vaccines for animals and people</a> in development to improve their safety, cost and efficacy. Researchers are also <a href="https://doi.org/10.15252/emmm.202216394">developing treatments</a> to control rabies when the infection reaches the central nervous system.</p>
<h2>How do you protect yourself from rabies?</h2>
<p>Some people may not realize they were bitten by an animal if the bites are small. Because of the long incubation period of the virus, they also may not recall a previous interaction with an infected animal.</p>
<p><a href="https://www.elsevier.com/connect/8-things-you-may-not-know-about-rabies-but-should">Laboratory tests</a> can confirm whether an animal has rabies, as well as <a href="https://pubmed.ncbi.nlm.nih.gov/9406651/">which rabies virus variant is present</a>. A physician may begin vaccination even without laboratory confirmation based on the risk factors of a case. For example, since most recent fatal rabies cases in the U.S. have been from unknown bat bites, rabies vaccination is recommended after any <a href="https://www.cdc.gov/rabies/exposure/animals/bats.html">suspected bat exposure</a>.</p>
<p>There are many practical ways to <a href="https://www.elsevier.com/connect/8-things-you-may-not-know-about-rabies-but-should">protect yourself from rabies</a> such as: </p>
<ul>
<li>Vaccinating and supervising your pets.</li>
<li>Never handling wild animals that seem to be acting strangely.</li>
<li>Not touching sick, injured or dead animals.</li>
<li>Never attempting to feed wildlife.</li>
<li>Treating animals respectfully. Do not tease an animal, disturb its sleep or handle its offspring.</li>
<li>Always reporting a bite to an animal control officer, game warden or health care professional.</li>
</ul>
<p><a href="https://www.contagionlive.com/view/on-world-rabies-day-a-reminder-how-far-we-have-come-in-the-us-but-global-concerns-remain">World Rabies Day</a>, which marks the death of rabies vaccine developer <a href="https://theconversation.com/louis-pasteurs-scientific-discoveries-in-the-19th-century-revolutionized-medicine-and-continue-to-save-the-lives-of-millions-today-191395">Louis Pasteur</a>, is <a href="https://www.who.int/campaigns/world-rabies-day">Sept. 28</a>.</p><img src="https://counter.theconversation.com/content/219199/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rodney E. Rohde has received funding from the American Society of Clinical Pathologists, American Society for Clinical Laboratory Science, U.S. Department of Labor (OSHA), and other public and private entities/foundations. Rohde is affiliated with ASCP, ASCLS, ASM, and serves on several scientific advisory boards.</span></em></p><p class="fine-print"><em><span>Charles Rupprecht is a global biomedical consultant for academia, government, industry and NGOs. He is affiliated with LYSSA LLC.</span></em></p>
An unexpected case of rabies found in an animal can raise concerns for a potential outbreak. Proactive vaccination of both wildlife and people can help protect everyone.
Rodney E. Rohde, Regents' Professor & Chair, Medical Laboratory Science, Texas State University
Charles Rupprecht, Affiliate Professor of Veterinary Medicine, Auburn University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/210898
2023-09-04T20:05:24Z
2023-09-04T20:05:24Z
Is it okay to kiss your pet? The risk of animal-borne diseases is small, but real
<figure><img src="https://images.theconversation.com/files/545229/original/file-20230829-19-r94gri.jpg?ixlib=rb-1.1.0&rect=0%2C314%2C4886%2C3197&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Our relationship with pets has changed drastically in recent decades. Pet ownership is at an all-time high, with <a href="https://animalmedicinesaustralia.org.au/media-release/more-than-two-thirds-of-australian-households-now-own-a-pet/">a recent survey</a> finding 69% of Australian households have at least one pet. We spend an estimated A$33 billion every year on caring for our fur babies.</p>
<p>While owning a pet is linked to numerous <a href="https://www.onehealth.org/blog/10-mental-physical-health-benefits-of-having-pets">mental and physical health benefits</a>, our pets can also harbour infectious diseases that can sometimes be passed on to us. For most people, the risk is low.</p>
<p>But some, such as pregnant people and those with weakened immune systems, are at <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/index.html">greater risk</a> of getting sick from animals. So, it’s important to know the risks and take necessary precautions to prevent infections.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-what-bugs-can-you-catch-from-your-pets-40954">Health Check: what bugs can you catch from your pets?</a>
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</em>
</p>
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<h2>What diseases can pets carry?</h2>
<p>Infectious diseases that move from animals to humans are called zoonotic diseases or <a href="https://www.cdc.gov/onehealth/basics/zoonotic-diseases.html">zoonoses</a>. More than <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668296/#B18">70 pathogens</a> of companion animals are known to be transmissible to people.</p>
<p>Sometimes, a pet that has a zoonotic pathogen may look sick. But often there may be no visible symptoms, making it easier for you to catch it, because you don’t suspect your pet of harbouring germs.</p>
<p>Zoonoses can be transmitted directly from pets to humans, such as through contact with saliva, bodily fluids and faeces, or indirectly, such as through contact with contaminated bedding, soil, food or water. </p>
<p>Studies suggest <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500695/">the prevalence of pet-associated zoonoses is low</a>. However, the true number of infections is likely <a href="https://www.mdpi.com/1660-4601/17/11/3789">underestimated</a> since many zoonoses are not “<a href="https://www.healthdirect.gov.au/notification-of-illness-and-disease">notifiable</a>”, or may have multiple exposure pathways or generic symptoms. </p>
<p>Dogs and cats are major reservoirs of zoonotic infections (meaning the pathogens naturally live in their population) caused by viruses, bacteria, fungi and parasites. <a href="https://www.who.int/data/gho/data/themes/topics/rabies">In endemic regions in Africa and Asia</a>, dogs are the main source of rabies which is transmitted through saliva. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-the-rabies-virus-28654">Explainer: the rabies virus</a>
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<p>Dogs also commonly carry <em>Capnocytophaga</em> bacteria <a href="https://www.cdc.gov/capnocytophaga/index.html">in their mouths and saliva</a>, which can be transmitted to people through close contact or bites. The vast majority of people won’t get sick, but these bacteria can occasionally cause infections in people with weakened immune systems, <a href="https://www.cdc.gov/capnocytophaga/signs-symptoms/index.html">resulting</a> in severe illness and sometimes death. Just last week, such a death <a href="https://thewest.com.au/news/wa/tracy-ridout-perth-mum-dies-11-days-after-rare-bacterial-infection-from-minor-dog-bite-c-11748887">was reported in Western Australia</a>.</p>
<p>Cat-associated zoonoses include a number of illnesses spread by the faecal-oral route, such as giardiasis, campylobacteriosis, salmonellosis and toxoplasmosis. This means it’s especially important to wash your hands or use gloves whenever handling your cat’s litter tray.</p>
<p>Cats can also sometimes transmit infections through bites and scratches, including the aptly named <a href="https://www.cdc.gov/healthypets/diseases/cat-scratch.html#:%7E:text=Cat%20scratch%20disease%20(CSD)%20is,the%20surface%20of%20the%20skin.">cat scratch disease</a>, which is caused by the bacterium <em>Bartonella henselae</em>.</p>
<p>Both dogs and cats are also reservoirs for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122942/">methicillin-resistant bacterium <em>Staphylococcus aureus</em></a> (MRSA), with close contact with pets identified as an important risk factor for zoonotic transmission.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/545415/original/file-20230829-27-mpgatg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman with curly hair being licked in the face by a Staffordshire terrier" src="https://images.theconversation.com/files/545415/original/file-20230829-27-mpgatg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545415/original/file-20230829-27-mpgatg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545415/original/file-20230829-27-mpgatg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545415/original/file-20230829-27-mpgatg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545415/original/file-20230829-27-mpgatg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545415/original/file-20230829-27-mpgatg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545415/original/file-20230829-27-mpgatg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Dog saliva hosts a bacterium that can cause serious illness and even death in some people.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/girl-kissing-dog-breed-staffordshire-terrier-200987354">Shutterstock</a></span>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/cats-carry-diseases-that-can-be-deadly-to-humans-and-its-costing-australia-6-billion-every-year-147910">Cats carry diseases that can be deadly to humans, and it's costing Australia $6 billion every year</a>
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<h2>Birds, turtles and fish can also transmit disease</h2>
<p>But it’s not just dogs and cats that can spread diseases to humans. Pet birds can occasionally transmit <a href="https://www.cdc.gov/pneumonia/atypical/psittacosis/">psittacosis</a>, a bacterial infection which causes pneumonia. Contact with <a href="https://www.fda.gov/animal-veterinary/animal-health-literacy/pet-turtles-source-germs">pet turtles</a> has been linked to <em>Salmonella</em> infections in humans, particularly in young children. Even pet fish have been linked to a <a href="https://www.cdc.gov/healthypets/pets/fish.html">range of bacterial infections</a> in humans, including vibriosis, mycobacteriosis and salmonellosis.</p>
<p>Close contact with animals – and some behaviours in particular – increase the risk of zoonotic transmission. <a href="https://pubmed.ncbi.nlm.nih.gov/19398275/">A study from the Netherlands</a> found half of owners allowed pets to lick their faces, and 18% allowed dogs to share their bed. (Sharing a bed increases the duration of exposure to pathogens carried by pets.) The same study found 45% of cat owners allowed their cat to jump onto the kitchen sink.</p>
<p>Kissing pets has also been linked to occasional zoonotic infections in pet owners. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3298380/">In one case</a>, a woman in Japan developed meningitis due to <em>Pasteurella multicoda</em> infection, after regularly kissing her dog’s face. These bacteria are often found in the oral cavities of dogs and cats.</p>
<p>Young children are also more likely to engage in behaviours which increase their risk of <a href="https://www.cdc.gov/healthypets/specific-groups/high-risk/children.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhealthypets%2Fspecific-groups%2Fchildren.html">getting sick</a> from animal-borne diseases – such as putting their hands in their mouth after touching pets. Children are also less likely to wash their hands properly after handling pets.</p>
<p>Although anybody who comes into contact with a zoonotic pathogen via their pet can become sick, certain people are more likely to suffer from serious illness. These people include the young, old, pregnant and immunosuppressed.</p>
<p>For example, while most people infected with the toxoplasmosis parasite will experience only mild illness, it can be life-threatening or <a href="https://www.nhs.uk/common-health-questions/pregnancy/what-are-the-risks-of-toxoplasmosis-during-pregnancy/">cause birth defects in foetuses</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/546103/original/file-20230904-27-lzhdw9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A little blonde girl lying on the floor kissing a large blonde dog" src="https://images.theconversation.com/files/546103/original/file-20230904-27-lzhdw9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/546103/original/file-20230904-27-lzhdw9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/546103/original/file-20230904-27-lzhdw9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/546103/original/file-20230904-27-lzhdw9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/546103/original/file-20230904-27-lzhdw9.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/546103/original/file-20230904-27-lzhdw9.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/546103/original/file-20230904-27-lzhdw9.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Young children under 5 years old are more at risk of zoonotic diseases, and also more likely to engage in behaviours that increase their chances of catching something from their pet.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<h2>What should I do if I’m worried about catching a disease from my pet?</h2>
<p>There are a number of good hygiene and pet husbandry practices that can reduce your risk of becoming sick. These include:</p>
<ul>
<li>washing your hands after playing with your pet and after handling their bedding, toys, or cleaning up faeces</li>
<li>not allowing your pets to lick your face or open wounds</li>
<li>supervising young children when they are playing with pets and when washing their hands after playing with pets</li>
<li>wearing gloves when changing litter trays or cleaning aquariums</li>
<li>wetting bird cage surfaces when cleaning to minimise aerosols</li>
<li>keeping pets out of the kitchen (especially cats who can jump onto food preparation surfaces) </li>
<li>keeping up to date with preventative veterinary care, including vaccinations and worm and tick treatments </li>
<li>seeking veterinary care if you think your pet is unwell.</li>
</ul>
<p>It is especially important for those who are at a higher risk of illness to take precautions to reduce their exposure to zoonotic pathogens. And if you’re thinking about getting a pet, ask your vet which type of animal would best suit your personal circumstances.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/one-in-three-people-are-infected-with-toxoplasma-parasite-and-the-clue-could-be-in-our-eyes-182418">One in three people are infected with _Toxoplasma_ parasite – and the clue could be in our eyes</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/210898/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Animals, including the ones that live in our homes, can carry all kinds of illnesses. Most of the time it’s not a problem, but here’s what you should do to avoid getting sick.
Sarah McLean, Lecturer in environmental health, Swinburne University of Technology
Enzo Palombo, Professor of Microbiology, Swinburne University of Technology
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/191395
2022-09-28T12:32:45Z
2022-09-28T12:32:45Z
Louis Pasteur’s scientific discoveries in the 19th century revolutionized medicine and continue to save the lives of millions today
<figure><img src="https://images.theconversation.com/files/486616/original/file-20220926-26-u8ycb1.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C8764%2C5689&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Louis Pasteur was a pioneer in chemistry, microbiology, immunology and vaccinology.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/louis-pasteur-royalty-free-illustration/1176911773?adppopup=true">pictore/DigitalVision Vectors via Getty Images</a></span></figcaption></figure><p>Some of the greatest scientific discoveries haven’t resulted in Nobel Prizes.</p>
<p><a href="https://doi.org/10.1111/j.1469-0691.2012.03945.x">Louis Pasteur</a>, who lived from 1822 to 1895, is arguably the world’s best-known microbiologist. He is widely credited for the <a href="https://www.ncbi.nlm.nih.gov/books/NBK24649/">germ theory of disease</a> and for inventing the process of pasteurization – which is named after him – to preserve foods. Remarkably, he also developed <a href="https://doi.org/10.1111%2Fj.1365-2249.2012.04592.x">the rabies</a> and <a href="https://www.cdc.gov/anthrax/basics/anthrax-history.html#">anthrax</a> vaccines and made major contributions to <a href="https://www.vbivaccines.com/evlp-platform/louis-pasteur-attenuated-vaccine/#">combating cholera</a>.</p>
<p>But because he died in 1895, six years before the first <a href="https://www.nobelprize.org/">Nobel Prize</a> was awarded, that prize isn’t on his resume. Had he lived in the era of Nobel Prizes, he would undoubtedly have been deserving of one for his work. Nobel Prizes, which are awarded in various fields, <a href="https://www.nobelprize.org/the-nobel-prize-organisation/#">including physiology and medicine</a>, are not given posthumously.</p>
<p>During the current time of ongoing threats from emerging or reemerging infectious diseases, from <a href="https://www.contagionlive.com/view/virus-spillover-and-emerging-pathogens-pick-up-speed">COVID-19</a> and polio to <a href="https://theconversation.com/what-is-monkeypox-a-microbiologist-explains-whats-known-about-this-smallpox-cousin-183499">monkeypox</a> and <a href="https://doi.org/10.12703/b/9-9">rabies</a>, it is awe-inspiring to look back on Pasteur’s legacy. His efforts fundamentally changed how people view infectious diseases and how to fight them via vaccines. </p>
<p>I’ve worked in <a href="https://rodneyerohde.wp.txstate.edu/">public health and medical laboratories</a> specializing in viruses and other microbes, while <a href="https://www.health.txstate.edu/cls/">training future medical laboratory scientists</a>. My career started in virology with a <a href="https://scholar.google.com/citations?user=8XtvOZ8AAAAJ&hl=en">front-row seat to rabies detection and surveillance</a> and zoonotic agents, and it rests in large part on Pasteur’s pioneering work in microbiology, immunology and vaccinology. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/486641/original/file-20220926-8928-88tfgu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A black and white illustration of Pasteur with a group of patients." src="https://images.theconversation.com/files/486641/original/file-20220926-8928-88tfgu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/486641/original/file-20220926-8928-88tfgu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=492&fit=crop&dpr=1 600w, https://images.theconversation.com/files/486641/original/file-20220926-8928-88tfgu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=492&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/486641/original/file-20220926-8928-88tfgu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=492&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/486641/original/file-20220926-8928-88tfgu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=618&fit=crop&dpr=1 754w, https://images.theconversation.com/files/486641/original/file-20220926-8928-88tfgu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=618&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/486641/original/file-20220926-8928-88tfgu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=618&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An illustration of Louis Pasteur, right, supervising the administration of the rabies vaccine at the Pasteur Institute in Paris in 1886.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/an-illustration-shows-french-biologist-louis-pasteur-right-news-photo/1266883710">Library of Congress/Interim Archives via Getty Images</a></span>
</figcaption>
</figure>
<h2>First, a chemist</h2>
<p>In my assessment, Pasteur’s strongest contributions to science are his remarkable achievements in the field of medical microbiology and immunology. However, his story begins with chemistry. </p>
<p>Pasteur studied under the <a href="https://www.britannica.com/biography/Jean-Baptiste-Andre-Dumas">French chemist Jean-Baptiste-André Dumas</a>. During that time, Pasteur became interested in the origins of life and worked in the field of <a href="https://www.pasteur.fr/en/institut-pasteur/history/early-years-1847-1862">polarized light and crystallography</a>. </p>
<p>In 1848, just months after receiving his doctorate degree, Pasteur was studying the properties of crystals formed in the process of wine-making when he discovered that <a href="https://www.nytimes.com/2017/06/14/science/louis-pasteur-chirality-chemistry.html">crystals occur in mirror-image forms</a>, a property known as chirality. This discovery became the foundation of a subdiscipline of chemistry known as <a href="https://doi.org/10.1002/hlca.201900098">stereochemistry</a>, which is the study of the spatial arrangement of atoms within molecules. This chirality, or handedness, of molecules was a “<a href="https://doi.org/10.1007/BF03401596">revolutionary hypothesis</a>” at the time. </p>
<p>These findings led Pasteur to suspect what would later be proved through molecular biology: All life processes ultimately stem from the precise arrangement of atoms within biological molecules.</p>
<h2>Wine and beer – from fermentation to germ theory</h2>
<p>Beer and wine were <a href="https://ageofrevolutions.com/2016/12/05/intoxication-and-the-french-revolution/">critical to the economy of France</a> and Italy in the 1800s. It was not uncommon during Pasteur’s life for products to spoil and become bitter or dangerous to drink. At the time, the scientific notion of “spontaneous generation” held that life can arise from nonliving matter, which was believed to be the culprit behind wine spoiling. </p>
<p>While many scientists tried to disprove the theory of spontaneous generation, in 1745, English biologist <a href="https://royalsocietypublishing.org/doi/pdf/10.1098/rstl.1748.0072">John Turberville Needham</a> believed he had created the perfect experiment favoring spontaneous generation. Most scientists believed that heat killed life, so Needham created an experiment to show that microorganisms could grow on food, even after boiling. After boiling chicken broth, he placed it in a flask, heated it, then sealed it and waited, not realizing that air could make its way back into the flask prior to sealing. After some time, microorganisms grew, and Needham claimed victory. </p>
<p>However, his experiment <a href="https://pubmed.ncbi.nlm.nih.gov/17940406/">had two major flaws</a>. For one, the boiling time was not sufficient to kill all microbes. And importantly, his flasks allowed air to flow back in, which enabled microbial contamination.</p>
<p>To settle the scientific battle, the French Academy of Sciences sponsored a contest for the best experiment <a href="https://doi.org/10.1080/00033798800200281">to prove or disprove spontaneous generation</a>. Pasteur’s response to the contest was a series of experiments, including a <a href="https://doi.org/10.3389%2Ffimmu.2012.00068">prize-winning 1861 essay</a>. </p>
<p>Pasteur deemed one of these experiments as “unassailable and decisive” because, unlike Needham, after he sterilized his cultures, he kept them free from contamination. By using his now famous swan-necked flasks, which had a long S-shaped neck, he allowed air to flow in while at the same time preventing falling particles from reaching the broth during heating. As a result, the flask remained free of growth for an extended period. This showed that if air was not allowed directly into his boiled infusions, then no “living microorganisms would appear, even after months of observation.” However, importantly, if dust was introduced, living microbes appeared.</p>
<p>Through that process, Pasteur not only refuted the theory of spontaneous generation, but he also demonstrated that microorganisms were everywhere. When he showed that food and wine spoiled because of contamination from invisible bacteria rather than from spontaneous generation, <a href="https://doi.org/10.3389%2Ffimmu.2012.00068">the modern germ theory of disease was born</a>.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/OXdbQ1JkX7c?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Pasteur’s discoveries resonate to this very day.</span></figcaption>
</figure>
<h2>The origins of vaccination in the 1800s</h2>
<p>In the 1860s, when the silk industry was being devastated by two diseases that were <a href="https://www.pasteur.fr/en/institut-pasteur/history/middle-years-1862-1877">infecting silkworms</a>, Pasteur <a href="https://doi.org/10.1111/j.1469-0691.2012.03945.x">developed a clever process</a> by which to examine silkworm eggs under a microscope and preserve those that were healthy. Much like his efforts with wine, he was able to apply his observations into industry methods, and he became something of <a href="https://doi.org/10.3390%2Fbiom12040596">a French hero</a>.</p>
<p>Even <a href="https://www.biography.com/scientist/louis-pasteur">with failing health</a> from a severe stroke that left him partially paralyzed, Pasteur continued his work. In 1878, he succeeded in identifying and culturing the bacterium that <a href="https://doi.org/10.3389/fimmu.2012.00068">caused the avian disease fowl cholera</a>. He recognized that old bacterial cultures were no longer harmful and that chickens vaccinated with old cultures could survive exposure to wild strains of the bacteria. And his observation that surviving chickens excreted harmful bacteria helped establish an important concept now all too familiar in the age of COVID-19 – asymptomatic “healthy carriers” can still spread germs during outbreaks.</p>
<p>After bird cholera, Pasteur turned to the prevention of <a href="https://rarediseases.org/rare-diseases/anthrax/">anthrax</a>, a widespread plague of cattle and other animals caused by the bacterium <em>Bacillus anthracis</em>. Building on his own work and that of German physician <a href="https://doi.org/10.12816/0003334">Robert Koch</a>, Pasteur developed the concept of the <a href="https://doi.org/10.3389/fimmu.2012.00068">attenuated, or weakened, versions of microbes</a> for use in vaccines.</p>
<p>In the late 1880s, he showed beyond any doubt that exposing cattle to a weakened form of anthrax vaccine could lead to what is now well known as immunity, dramatically reducing cattle mortality.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/486643/original/file-20220926-25-dha566.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A computer-generated image of the rabies virus, colored brown in this illustration and resembling a pinecone." src="https://images.theconversation.com/files/486643/original/file-20220926-25-dha566.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/486643/original/file-20220926-25-dha566.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/486643/original/file-20220926-25-dha566.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/486643/original/file-20220926-25-dha566.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/486643/original/file-20220926-25-dha566.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/486643/original/file-20220926-25-dha566.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/486643/original/file-20220926-25-dha566.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The deadly rabies virus. Although preventable by vaccination, rabies still kills approximately 59,000 people worldwide every year.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/rabies-virus-illustration-royalty-free-illustration/1191008423">Nano Clustering/Science Photo Library via Getty Images</a></span>
</figcaption>
</figure>
<h2>The rabies vaccine breakthrough</h2>
<p>In my professional assessment of Louis Pasteur, the discovery of vaccination against rabies is the most important of all his achievements. </p>
<p>Rabies has been called the “<a href="https://www.goodreads.com/book/show/13403051-rabid">world’s most diabolical virus</a>,” spreading from animal to human <a href="https://doi.org/10.12703/b/9-9">via a bite</a>. </p>
<p>Working with rabies virus is incredibly dangerous, as <a href="https://www.elsevier.com/books/rabies/wilson/978-0-323-63979-8">mortality approaches 100%</a> once symptoms appear and without vaccination. Through astute observation, Pasteur discovered that drying out the spinal cords of dead rabid rabbits and monkeys resulted in a weakened form of rabies virus. Using that weakened version as a vaccine to gradually expose dogs to the rabies virus, Pasteur showed that he could effectively immunize the dogs against rabies.</p>
<p>Then, in July 1885, Joseph Meister, a 9-year-old boy from France, was severely bitten by a rabid dog. With Joseph facing almost certain death, his mother took him to Paris to see Pasteur because <a href="https://www.pbs.org/newshour/health/louis-pasteurs-risky-move-to-save-a-boy-from-almost-certain-death">she had heard</a> that he was working to develop a cure for rabies.</p>
<p>Pasteur took on the case, and alongside two physicians, he gave the boy a series of injections over several weeks. Joseph survived and Pasteur shocked the world with a cure for a universally lethal disease. This discovery opened the door to the widespread use of Pasteur’s rabies vaccine around 1885, which <a href="https://doi.org/10.3390%2Ftropicalmed2020005">dramatically reduced rabies’ deaths in humans and animals</a>. </p>
<h2>A Nobel Prize-worthy life</h2>
<p>Pasteur once famously <a href="https://www.nhlbi.nih.gov/directors-messages/serendipity-and-the-prepared-mind">said in a lecture</a>, “In the fields of observation, chance favors only the prepared mind.” </p>
<p>Pasteur had a knack for applying his brilliant – and prepared – scientific mind to the most practical dilemmas faced by humankind.</p>
<p>While Louis Pasteur died prior to the initiation of the Nobel Prize, I would argue that his amazing lifetime of discovery and contribution to science in medicine, infectious diseases, vaccination, medical microbiology and immunology place him among the all-time greatest scientists.</p><img src="https://counter.theconversation.com/content/191395/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rodney E. Rohde has received funding from the American Society of Clinical Pathologists (ASCP), American Society for Clinical Laboratory Science (ASCLS), U.S. Department of Labor (OSHA), and other public and private entities/foundations. Rohde is affiliated with ASCP, ASCLS, ASM, and serves on several scientific advisory boards. See <a href="https://rodneyerohde.wp.txstate.edu/service/">https://rodneyerohde.wp.txstate.edu/service/</a>.</span></em></p>
On World Rabies Day – which is also the anniversary of French microbiologist Louis Pasteur’s death – a virologist reflects on the achievements of this visionary scientist.
Rodney E. Rohde, Regents' Professor of Clinical Laboratory Science, Texas State University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/173613
2022-06-12T12:11:32Z
2022-06-12T12:11:32Z
Cats that are allowed to roam can spread diseases to humans and wildlife
<figure><img src="https://images.theconversation.com/files/467255/original/file-20220606-13103-fk8xfg.jpg?ixlib=rb-1.1.0&rect=7%2C15%2C5077%2C3369&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Domestic cats are allowed to roam can transmit parasites and diseases to humans and wildlife.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><iframe style="width: 100%; height: 100px; border: none; position: relative; z-index: 1;" allowtransparency="" allow="clipboard-read; clipboard-write" src="https://narrations.ad-auris.com/widget/the-conversation-canada/cats-that-are-allowed-to-roam-can-spread-diseases-to-humans-and-wildlife" width="100%" height="400"></iframe>
<p>For decades, scientists have warned that ecologically destructive activities increase the risk of <a href="https://doi.org/10.1126/science.287.5452.443">diseases spilling over between wildlife and human populations</a>. Examples of these drivers include climate change, <a href="https://doi.org/10.1038/nature09575">habitat loss, wildlife trafficking</a>, environmental contamination, expansion of anthropocentric activities and invasive species introduction. </p>
<p>Domestic animals also contribute to the movement of diseases between species. Free-roaming domestic animals, like cats, can facilitate the spread and transfer of diseases, impacting both humans and wildlife.</p>
<h2>Infectious parasites</h2>
<p>Free-roaming cats — which include feral, stray and house cats — present a particularly compelling case because of their large population sizes and their central role in the life cycle of a parasite called <em>Toxoplasma gondii</em> (<em>T. gondii</em>) that infects both wildlife and humans. Most people may have only heard of toxoplasmosis from their doctors during a pregnancy or <a href="https://www.science.org/content/article/reality-check-can-cat-poop-cause-mental-illness">in articles on “brain-altering” parasites</a>. </p>
<p>However, <em>T. gondii</em> is one of the most common zoonotic parasites globally and is estimated to affect <a href="https://doi.org/10.1371/journal.pone.0090203">about 30 to 50 per cent of the global human population</a>. <em>T. gondii</em> infections can have <a href="https://doi.org/10.1016/J.PT.2017.04.001">severe and life-threatening consequences</a>; especially for immunocompromised people and infants infected during pregnancy.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/467258/original/file-20220606-18-9z8rjl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="a woman in a pink shirt holds a black cat" src="https://images.theconversation.com/files/467258/original/file-20220606-18-9z8rjl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/467258/original/file-20220606-18-9z8rjl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/467258/original/file-20220606-18-9z8rjl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/467258/original/file-20220606-18-9z8rjl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/467258/original/file-20220606-18-9z8rjl.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/467258/original/file-20220606-18-9z8rjl.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/467258/original/file-20220606-18-9z8rjl.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Pregnant women are often advised to avoid interacting with cat feces because of the risk posed to their unborn children.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p><em>Toxoplasma gondii</em> forms a permanent resting tissue cyst in the muscle or nervous tissue of a host, so even healthy infected people are impacted. Chronic toxoplasma infections have been linked with illnesses including degenerative neurological diseases, schizophrenia and <a href="https://doi.org/10.1016/j.canep.2022.102119">brain cancer</a>. </p>
<p>Domestic cats or wild felids — like lions, jaguars or cougars — <a href="https://www.routledge.com/Toxoplasmosis-of-Animals-and-Humans/Dubey/p/book/9780367543129">intermittently excrete millions of <em>T. gondii</em> eggs (called oocysts)</a> into the environment <a href="https://doi.org/10.1016/j.vetpar.2017.10.021">through their feces</a>. These oocysts persist under favourable conditions for years in water and soil, <a href="https://doi.org/10.1371/journal.pone.0255664">with the capacity for long-distance dispersal</a>.</p>
<p>If any warm-blooded animal ingests an oocyst, it can become infected with <em>T. gondii</em>. This can happen if a person or animal ingests oocysts in contaminated water or food, or through eating another animal that has already become infected.</p>
<h2>Spreading diseases</h2>
<p>Although both wild felids and domestic cats are sources of toxoplasma, domestic cats outnumber wild felids by several orders of magnitude. We recently tested whether mammals living in environments with greater densities of domestic cats would show higher infection rates of <em>T. gondii</em>. </p>
<p>While there are no global data sets showing domestic cat densities, domestic cats are closely associated with humans, and therefore, measures of human population density can act as a surrogate for the density of free-roaming cats. Using data from over 200 studies, we demonstrated that indeed, <a href="https://doi.org/10.1098/rspb.2021.1724">wildlife living in areas of higher human density</a> had higher infection rates of <em>T. gondii</em>. </p>
<p>We concluded that this higher infection rate occurred due to a combination of two phenomenon: high densities of free-roaming domestic cats producing infected feces, and the loss of natural habitats. Natural ecosystems have important roles in filtering, sequestering and <a href="https://doi.org/10.1128/AEM.01435-10">removing <em>T. gondii</em></a> and <a href="https://doi.org/10.1023/A:1013169401211">other pathogens</a> from human, livestock and wildlife exposure pathways. Breaking the lifecycle by preventing cats from hunting and landscape restoration are key preventative measures.</p>
<p>If wildlife have an increased risk of exposure to <em>T. gondii</em> in certain areas, then humans and livestock can also be unintended targets. Public health researchers have shown this repeatedly by <a href="https://doi.org/10.1016/j.vetpar.2014.08.003">sampling soil</a>, <a href="https://doi.org/10.1007/s10096-011-1414-8">vegetable gardens</a> and <a href="https://doi.org/10.1016/j.vetpar.2010.02.045">playgrounds</a>.</p>
<h2>Rabies risk</h2>
<p>Rabies is another disease whose risk is increased by free-roaming cats. In the United States, cats are <a href="https://doi.org/10.2460/JAVMA.258.11.1205">the most common rabies positive domestic species</a>, with cats posing <a href="https://doi.org/10.1111/zph.12077">two-and-a-half times the rabies exposure risk compared to bats in Pennsylvania</a>. In Canada, we recently found similar public health concerns of free-roaming cats when we <a href="https://doi.org/10.1371/JOURNAL.PGPH.0000357">examined patterns of rabies submissions of bats in Canada</a>. </p>
<p>In Canada, free-roaming cats were associated with 10 times more bats being submitted for rabies testing compared to indoor cats. In fact, in our dataset, there were five records of free-roaming cats bringing bats into the house that subsequently were found to be rabies positive. This hunting activity by cats is obviously dangerous for people in the household, and is a very simple explanation for cases of cryptic rabies infections (rabies cases without an identifiable source).</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/467910/original/file-20220609-12-wecu74.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="a silver-haired bat" src="https://images.theconversation.com/files/467910/original/file-20220609-12-wecu74.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/467910/original/file-20220609-12-wecu74.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=394&fit=crop&dpr=1 600w, https://images.theconversation.com/files/467910/original/file-20220609-12-wecu74.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=394&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/467910/original/file-20220609-12-wecu74.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=394&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/467910/original/file-20220609-12-wecu74.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=495&fit=crop&dpr=1 754w, https://images.theconversation.com/files/467910/original/file-20220609-12-wecu74.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=495&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/467910/original/file-20220609-12-wecu74.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=495&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">In areas with large numbers of free-roaming cats predating bats, the risk that a human will be exposed to rabies is expected to increase.</span>
<span class="attribution"><span class="source">(Jared Hobbs)</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>This risk is directly proportionate to the frequency of free-roaming cats killing bats, which is unfortunately common. Single cats have been known to <a href="https://doi.org/10.1080/03014223.2011.649770">kill a hundred bats in a week</a>. </p>
<p>In our dataset, one free-roaming cat killed nine endangered little brown bats in one month, with another record of a cat killing 14 bats in a single evening. Many bat populations have undergone severe declines, especially due to <a href="https://doi.org/10.1111/nyas.14045">an introduced fungal disease</a>. Bats are <a href="https://doi.org/10.1007/s11284-012-1010-0">long-lived with low reproduction</a>, so this additional source of mortality can severely impact bat populations.</p>
<p>Since cats only bring home <a href="https://doi.org/10.1016/j.biocon.2013.01.008">20 per cent of what they kill</a>, prey returns and rabies submissions only provide a tiny glimpse of the true cat predation rates. It is therefore apparent that although natural rabies prevalence in bats is low — <a href="https://doi.org/10.7589/0090-3558-47.1.64">less than one per cent</a> — in areas with cats killing large numbers of bats, rabies exposure risks will increase.</p>
<h2>Protecting health and wildlife</h2>
<p>There is broad consensus among <a href="https://www.canadianveterinarians.net/policy-and-outreach/position-statements/statements/free-roaming-owned-abandoned-and-feral-cats/">veterinarians</a>, <a href="https://doi.org/10.1016/j.biocon.2019.04.002">ecologists</a>, <a href="https://doi.org/10.1111/j.1863-2378.2012.01522.x">public health experts</a> and <a href="https://www.peta.org/about-peta/why-peta/feral-cats/">animal rights activists</a> that free roaming by domestic cats is detrimental for feline welfare, wildlife welfare, conservation and human health. Wildlife have the same capacity for distress and pain as domestic animals, and perform irreplaceable ecosystem services with <a href="https://doi.org/10.1007/s11284-012-1010-0">tangible economic benefits</a>, making their predation unjustifiable from an ethical or economic perspective. </p>
<p>Free-roaming cats suffer from increased mortality through <a href="https://doi.org/10.2460/javma.2004.225.1377">traumatic injury, disease, neglect and abandonment</a>. This marginalization of cats needs to be replaced with <a href="https://www.adventurecats.org/about/">progressive enrichment resources</a> and <a href="https://doi.org/10.1111/CSP2.12706">responsible management that does not foster an inhumane and biased disregard</a> for feline welfare standards, wildlife welfare, conservation and human health. </p>
<p><em>David Lapen, research scientist with Agriculture and Agri-Food Canada, co-authored this article.</em></p><img src="https://counter.theconversation.com/content/173613/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Wilson has done research contract work for Environment and Climate Change Canada. </span></em></p><p class="fine-print"><em><span>Scott Wilson works for and receives research funding from Environment and Climate Change Canada </span></em></p>
Allowing cats to roam unsupervised is detrimental to humans, wildlife and the cats themselves. Managing free-roaming cats should consider the risks they pose to other species.
Amy Wilson, Adjunct Professor, Forest and Conservation Sciences, University of British Columbia
Scott Wilson, Adjunct Professor, Forest and Conservation Sciences, University of British Columbia
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/182722
2022-06-02T14:19:42Z
2022-06-02T14:19:42Z
People will continue to die of rabies if Kenya doesn’t educate healthcare workers
<figure><img src="https://images.theconversation.com/files/465656/original/file-20220527-17-9sel6k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In Kenya, rabies is endemic across the country and has been estimated to cause 2,000 deaths annually.</span> <span class="attribution"><span class="source">Author provided</span></span></figcaption></figure><p>Rabies – a viral disease spread through an animal bite – has had an <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7612399/">effective vaccine</a> for more than a century. Yet people continue to die from it. Rabies <a href="https://apps.who.int/iris/bitstream/handle/10665/272364/9789241210218-eng.pdf">kills nearly every known person that shows clinical signs of it</a>, making it arguably one of the world’s deadliest infectious diseases. </p>
<p>Africa accounts for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4400070/">36.4% of the 59,000 rabies deaths in humans annually</a>. In Kenya, rabies is endemic and has been estimated to cause 2,000 deaths annually. </p>
<p>The country is implementing a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7117960/">strategy</a> to end human deaths from rabies by 2030, starting with select pilot counties and progressively extending to the rest of the country.</p>
<p>Kenya’s rabies elimination strategy, launched in 2014, combines mass dog vaccination, prompt provision of rabies vaccines, public education, and enhanced surveillance of the disease in animal and human populations. But, as in many other developing countries, progress is slow. The obstacles include low levels of political commitment, partly owing to the <a href="https://caninerabiesblueprint.org/IMG/pdf/sare_outline_2017_f.pdf">absence of data</a> on the true public health impact of the disease. </p>
<p>In the past few years, many countries have strengthened rabies control efforts by scaling mass dog vaccination programmes. They have also provided pre-exposure and post-exposure vaccines and educated communities about rabies. Most industrialised countries have <a href="https://apps.who.int/iris/bitstream/handle/10665/272364/9789241210218-eng.pdf">eliminated</a> rabies from domestic dog populations.</p>
<p>Apart from these interventions, an important aspect of ending deaths from rabies is ensuring that healthcare workers are aware of the disease, and knowledgeable about what to do. In our <a href="https://www.frontiersin.org/articles/10.3389/fpubh.2022.769898/full">recent study</a> we set out to determine levels of awareness about rabies and its management among healthcare workers in south eastern Kenya, a region with <a href="http://guidelines.health.go.ke:8000/media/Strategic_plan_for_elimination_of_Rabies.pdf">high numbers of rabies cases</a>. </p>
<p>We found that many were ill-prepared to diagnose the disease in all its forms. Fewer than a quarter knew about World Health Organization (WHO) categorisation of bite wounds. Few were conversant with international guidelines on the use of post-exposure vaccines. </p>
<p>We also noticed stockouts of effective vaccine and immunoglobulin. </p>
<p>Our study highlights opportunities to tailor healthcare training programmes – preservice and then continuous – for rabies elimination. The emphasis should be on prevention and control.</p>
<h2>Our study</h2>
<p>Man’s best friend, the domestic dog, is the primary source of human cases of rabies. Following a risky bite, two critical steps need to be taken in quick succession to prevent disease and death. </p>
<ul>
<li><p>First, the wound needs to be washed thoroughly with clean running water and soap for at least 15 minutes. </p></li>
<li><p>This should be followed by an injection of rabies vaccine on the day of the bite. </p></li>
</ul>
<p>Multiple injections over the course of one month must follow. In the case of a severe bite, the patient would need immunoglobulin as well as the vaccine.</p>
<p>The reduction of risk exposure to rabies depends on the type of treatment received at a health facility. A person bitten by a dog carrying rabies is more likely to develop the disease if the wound isn’t cared for properly and if they don’t receive the rabies vaccine (and immunoglobulin for severe exposure). This can be due to a lack of awareness of bite management by healthcare workers, unavailability of rabies vaccines and immunoglobulin, or availability of poor quality vaccines. </p>
<p>We visited 42 health facilities, and interviewed 73 healthcare workers. They included medical officers, nurses, clinical officers, pharmacists, pharmacy and laboratory technologists, and public health officers. </p>
<p>Many of the healthcare workers didn’t know that encephalitis – inflammation of the brain – is a differential diagnosis for rabies. They therefore didn’t suspect rabies in patients with encephalitis. Less than a quarter of the healthcare workers were aware of the WHO categorisation of bite wounds that guides the use of post-exposure prophylaxis. One in 12 reported they knew the indication of rabies immunoglobulin.</p>
<p>In addition, healthcare workers were not fully informed about the latest WHO recommendations on the appropriate treatment of patients presenting with <a href="https://cdn.who.int/media/docs/default-source/immunization/position_paper_documents/rabies/pp-rabies-summary-2018.pdf?sfvrsn=c9d92ce5_2">dog bites</a>.</p>
<p>A good example is route of administration of the vaccine. WHO has recommended injection within the layers of the skin rather than injecting the vaccine into muscles. By adopting this dose-saving route, the healthcare system could serve up to five times more bite patients for the same vaccine amount that treats one patient.</p>
<p>Thorough wound washing is also key. But only a third of the healthcare workers we spoke to said that they would do so for a <a href="https://medicalguidelines.msf.org/viewport/CG/english/rabies-16689982.html">category two bite</a> – where the animal nibbles on uncovered skin or the patient presents with minor bite(s) or scratch(es) without bleeding.</p>
<p>For category 3 bites, in which for example the animal licks broken skin or the patient presents with single or multiple bites, 43% of the respondents reported they would clean the wound.</p>
<p>The stocking of vaccines was another major issue. In our study, rabies vaccines were available in only 12% of the health facilities we visited with stock-out periods reported of up to 28 weeks.</p>
<p>We found that none of the health facilities had rabies immunoglobulin in stock at the time of the study. </p>
<h2>Tackling the problem</h2>
<p>Rabies control and elimination requires a concerted effort by the government, private sector and the community. By making the rabies vaccine available for both humans and animals, and creating awareness among healthcare workers and the community, Kenya can achieve the goal of ending deaths from human rabies by 2030.</p>
<p>But deliberate efforts need to be made. The most important is that healthcare workers need to be fully informed about the latest best practice. Integrating mass dog vaccination, provision of rabies vaccines for humans, adopting the latest WHO recommendations, risk assessment through sharing information between the health and veterinary sectors, and continuously training healthcare workers on proper management of bite patients and human rabies cases including diagnosis, are all critical for the elimination of rabies in Kenya.</p>
<p>Nobody should be dying of rabies. Not when there is a 100-year-old effective vaccine.</p><img src="https://counter.theconversation.com/content/182722/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Veronicah Mbaire Chuchu receives funding from the Fogarty International Center and the Institute of Allergy and Infectious Diseases of the National Institutes of Health. </span></em></p><p class="fine-print"><em><span>Thumbi Mwangi receives funding from Bill and Melinda Gates Foundation, USAID, World Health Organization, Wellcome Trust, UK MRC and EPSRC. </span></em></p><p class="fine-print"><em><span>Mutono Nyamai and Philip Kitala do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Kenya should improve access to life saving vaccines, and train healthcare workers on patient management and best practices.
Veronicah Mbaire Chuchu, PhD Candidate, Department of Medical Microbiology, University of Nairobi
Mutono Nyamai, Post-doctoral research scientist, Centre for Epidemiological Modelling and Analysis, University of Nairobi
Philip Kitala, Associate Professor, Epidemiology and Public Health, University of Nairobi
Thumbi Mwangi, Co-Director, Center for Epidemiological Modelling and Analysis (CEMA), University of Nairobi. Chancellors Fellow, Institute of Immunonology and Infection Research, University of Edinburgh. Associate Professor, Paul G Allen School for Global Health, Washington State University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/167482
2021-10-14T12:08:35Z
2021-10-14T12:08:35Z
More ‘disease’ than ‘Dracula’ – how the vampire myth was born
<figure><img src="https://images.theconversation.com/files/426277/original/file-20211013-17-1oj68zn.jpg?ixlib=rb-1.1.0&rect=984%2C1205%2C3394%2C2464&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Modern vampires like Dracula may be dashing, but they certainly weren't in the original vampire myths.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/helen-chandler-is-carried-by-bela-lugosi-in-a-scene-from-news-photo/159821076">Archive Photos/ Moviepix via Getty Images</a></span></figcaption></figure><p>The vampire is a common image in today’s pop culture, and one that takes many forms: from Alucard, the dashing spawn of Dracula in the PlayStation game “Castlevania: Symphony of the Night”; to Edward, the <a href="https://theconversation.com/vampires-rebirth-from-monstrous-undead-creature-to-sexy-and-romantic-byronic-seducer-in-one-ghost-story-114382">romantic, idealistic lover</a> in the “Twilight” series.</p>
<p>In many respects, the vampire of today is far removed from its roots in Eastern European folklore. As <a href="https://slavic.as.virginia.edu/people/profile/sjs2z">a professor of Slavic studies</a> who has taught a course on vampires <a href="https://news.virginia.edu/content/dissecting-dracula-chat-vampire-expert-stanley-stepanic">called “Dracula”</a> for more than a decade, I’m always fascinated by the vampire’s popularity, considering its origins – as a demonic creature strongly associated with disease.</p>
<h2>Explaining the unknown</h2>
<p>The first known reference to vampires appeared in written form in Old Russian <a href="https://www.google.com/books/edition/Slavic_Scriptures/-P_huGq9mV4C?hl=en&gbpv=1&dq=upir+etymology+slav&pg=PA218&printsec=frontcover">in A.D. 1047</a>, soon after Orthodox Christianity moved into Eastern Europe. The term for vampire was “<a href="https://starlingdb.org/cgi-bin/response.cgi?basename=dataievasmer&text_word=%D1%83%D0%BF%D1%8B%D1%80%D1%8C&method_word=beginning&ww_word=on">upir</a>,” which has uncertain origins, but its possible literal meaning was “the thing at the feast or sacrifice,” referring to a potentially dangerous spiritual entity that people believed could appear at rituals for the dead. It was a euphemism used to avoid speaking the creature’s name – and unfortunately, historians may never learn its real name, or even when beliefs about it surfaced.</p>
<p>The vampire served a function similar to that of <a href="https://simmonslis.libguides.com/c.php?g=1107583&p=8076095">many other demonic creatures</a> in folklore around the world: They were blamed for a variety of problems, but particularly disease, at a time when knowledge of bacteria and viruses did not exist.</p>
<figure class="align-center ">
<img alt="A 19th-century engraving depicts men in coats and hats shooting at a vampire in a cemetery in Romania." src="https://images.theconversation.com/files/425551/original/file-20211008-18-19q5vyz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/425551/original/file-20211008-18-19q5vyz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=392&fit=crop&dpr=1 600w, https://images.theconversation.com/files/425551/original/file-20211008-18-19q5vyz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=392&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/425551/original/file-20211008-18-19q5vyz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=392&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/425551/original/file-20211008-18-19q5vyz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=492&fit=crop&dpr=1 754w, https://images.theconversation.com/files/425551/original/file-20211008-18-19q5vyz.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=492&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/425551/original/file-20211008-18-19q5vyz.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=492&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Soldiers witnessing vampire hysteria in Eastern Europe – such as people desecrating the graves of suspected vampires – carried tales back home.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/men-shoot-at-a-vampire-lying-staked-through-the-heart-in-a-news-photo/593280150?adppopup=true">Leemage/ Corbis Historical via Getty Images</a></span>
</figcaption>
</figure>
<p>Scholars have put forth <a href="https://theconversation.com/vampire-myths-originated-with-a-real-blood-disorder-140830">several theories</a> about various diseases’ connections to vampires. It is likely that no one disease provides a simple, “pure” origin for vampire myths, since beliefs about vampires changed over time.</p>
<p>But two in particular show solid links. One is rabies, whose name comes from a Latin term for “madness.” It’s <a href="https://www.penguinrandomhouse.com/books/308182/rabid-by-bill-wasik-and-monica-murphy/">one of the oldest recognized diseases on the planet</a>, transmissible from animals to humans, and primarily spread through biting – an obvious reference to a classic vampire trait.</p>
<p>There are other curious connections. One central symptom of the disease is hydrophobia, <a href="https://doi.org/10.1002/ccr3.1846">a fear of water</a>. Painful muscle contractions in the esophagus lead rabies victims to avoid eating and drinking, or even swallowing their own saliva, which eventually causes “foaming at the mouth.” In some folklore, vampires cannot cross running water without being carried or assisted in some way, as an extension of this symptom. Furthermore, rabies can lead to a fear of light, altered sleep patterns and increased aggression, elements of how vampires are described in <a href="https://doi.org/10.1212/WNL.51.3.856">a variety of folktales</a>.</p>
<p>The second disease <a href="https://journals.sagepub.com/doi/pdf/10.1177/014107689709001114">is pellagra</a>, caused by a dietary deficiency of niacin (vitamin B3) or the amino acid tryptophan. Often, pellagra is brought on by diets high in corn products and alcohol. After Europeans landed in the Americas, they transported corn back to Europe. But they ignored <a href="https://doi-org.ezp-prod1.hul.harvard.edu/10.1525/nua.1998.22.1.1">a key step in preparing corn</a>: washing it, often using lime – a process called “nixtamalization” that can reduce the risk of pellagra.</p>
<p>Pellagra causes the classic “<a href="https://doi.org/10.11604/pamj.2020.36.219.24806">4 D’s</a>”: dermatitis, diarrhea, dementia and death. Some sufferers also experience high sensitivity to sunlight – described in some depictions of vampires – which leads to corpselike skin.</p>
<h2>Social scare</h2>
<p>Multiple diseases show connections to folklore about vampires, but they can’t necessarily explain how the myths actually began. Pellagra, for example, did not exist in Eastern Europe <a href="http://dx.doi.org/10.17159/sajs.2018/4597">until the 18th century</a>, centuries after vampire beliefs had originally emerged. </p>
<p>Both pellagra and rabies are important, however, because they were epidemic during a key period in vampire history. During the so-called <a href="https://news.virginia.edu/content/how-spread-disease-juiced-lore-vampires-pandemic-proportions">Great Vampire Epidemic</a>, from roughly 1725 to 1755, vampire myths “went viral” across the continent. </p>
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<p>As disease spread in Eastern Europe, supernatural causes were often blamed, and vampire hysteria spread throughout the region. Many people believed that vampires were the “undead” – people who lived on in some way after death – and that the vampire could be stopped by attacking its corpse. They carried out “<a href="https://doi.org/10.1017/S0959774314000754">vampire burials</a>,” which could involve putting a stake through the corpse, covering the body in garlic and a variety of other traditions that had been present in Slavic folklore for centuries.</p>
<p>Meanwhile, Austrian and German soldiers fighting the Ottomans in the region witnessed this mass <a href="https://www.google.com/books/edition/The_Twilight_Symbols/aMnDXCq9hRkC?hl=en&gbpv=1&dq=upir+etymology+slav&pg=PA398&printsec=frontcover">desecration of graves</a> and returned home to Western Europe with stories of the vampire.</p>
<p>But why did so much vampire hysteria spring up in the first place? Disease was a primary culprit, but a sort of “perfect storm” existed in Eastern Europe at the time. The era of the Great Vampire Epidemic was not just a period of disease, but one of political and religious upheaval as well.</p>
<p>During the 18th century, Eastern Europe faced pressure from within and without as domestic and foreign powers exercised their control over the region, with local cultures often suppressed. Serbia, for example, <a href="https://www.britannica.com/place/Serbia/The-disintegration-of-Ottoman-rule">was struggling between the Hapsburg Monarchy in Central Europe and the Ottomans</a>. Poland was increasingly under foreign powers, Bulgaria was under Ottoman rule, and Russia was undergoing <a href="https://www.jstor.org/stable/j.ctv1pncq7q?turn_away=true">dramatic cultural change</a> due to the policies of Czar Peter the Great.</p>
<p>This is somewhat analogous to today, as the world contends with the COVID-19 pandemic amid political change and uncertainty. Perceived societal breakdown, whether real or imagined, can lead to dramatic responses in society.</p><img src="https://counter.theconversation.com/content/167482/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stanley Stepanic does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
The past century’s vampires have often been a bit dashing, even romantic. That’s not how the myth started out.
Stanley Stepanic, Assistant Professor of Slavic Languages and Literatures, University of Virginia
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/168325
2021-09-26T08:36:12Z
2021-09-26T08:36:12Z
Vaccinating domestic dogs reduces rabies in the wild. Why this matters
<figure><img src="https://images.theconversation.com/files/422948/original/file-20210923-17-po9qlu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Vaccinating domestic dogs is a successful and cost-effective way to prevent rabies in dogs. </span> <span class="attribution"><span class="source">Sarah Cleaveland</span></span></figcaption></figure><p>Every year nearly 60,000 <a href="https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003709">people</a> globally die of rabies, a deadly virus most commonly transmitted to humans by animal bites. Over <a href="https://apps.who.int/iris/bitstream/handle/10665/272364/9789241210218-eng.pdf">99%</a> of these deaths are due to bites from domestic dogs. Rabies is invariably fatal once <a href="https://rabiesalliance.org/about/about-rabies/signs-and-symptoms-rabies">symptoms</a> develop, so it’s vital that person gets treatment when they are exposed. </p>
<p>Treatment consists of a course of vaccinations known as post-exposure prophylaxis. These are highly effective at preventing rabies when promptly administered. But sometimes people do not seek treatment because they are unaware of the risk of rabies. Even when they know that treatment is urgent, some may still struggle to access it due to its <a href="https://www.sciencedirect.com/science/article/pii/S0264410X1930475X#b0040">high cost and often limited availability</a>. </p>
<p>Instead of relying solely on post-exposure prophylaxis, an alternative strategy is to focus interventions on the animal populations responsible for maintaining the virus and transmitting it to people. Vaccination of domestic dogs has been shown to be a <a href="https://www.sciencedirect.com/science/article/pii/S0264410X17301950#b0005">successful and cost-effective</a> way of preventing human rabies. But it is still not routinely undertaken in the countries worst affected by rabies. </p>
<p>While this is mainly due to lack of investment, concerns are often expressed that wildlife may play a role in maintaining rabies transmission and that dog vaccination may, therefore, be ineffective. This is of particular concern in wildlife-rich areas of sub-Saharan Africa, for example in the <a href="https://besjournals.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2664.2008.01468.x">Serengeti ecosystem</a> where rabid wild carnivores including hyenas and mongoose have led to human rabies deaths. </p>
<p>Domestic dogs have been shown to be the only species necessary to maintain rabies across most of Africa. This means that <a href="https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0000626">dog vaccination</a> should control the disease in all species. But in parts of Namibia and South Africa rabies is thought to be independently maintained in wildlife like jackals and bat-eared foxes.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/422919/original/file-20210923-27-y2nbmi.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="People injecting a dog" src="https://images.theconversation.com/files/422919/original/file-20210923-27-y2nbmi.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/422919/original/file-20210923-27-y2nbmi.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=902&fit=crop&dpr=1 600w, https://images.theconversation.com/files/422919/original/file-20210923-27-y2nbmi.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=902&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/422919/original/file-20210923-27-y2nbmi.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=902&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/422919/original/file-20210923-27-y2nbmi.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1134&fit=crop&dpr=1 754w, https://images.theconversation.com/files/422919/original/file-20210923-27-y2nbmi.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1134&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/422919/original/file-20210923-27-y2nbmi.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1134&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Rabies vaccination.</span>
<span class="attribution"><span class="source"> Katie Hampson</span></span>
</figcaption>
</figure>
<p>The purpose of <a href="https://besjournals.onlinelibrary.wiley.com/doi/10.1111/1365-2664.13983">our study</a> was to evaluate the impact of dog vaccination on rabies in south-east Tanzania, where no vaccination had previously been conducted. The study took place from January 2011 to July 2019 in the rural regions of Lindi and Mtwara. Five rounds of domestic dog vaccination campaigns took place between 2011 and 2016, each covering over 2000 villages. These regions contain many areas of suitable wildlife habitat including forest reserves, plantations and the Selous Game Reserve. The regions were selected for vaccination so that the potential impact of wildlife on rabies elimination could be evaluated. </p>
<h2>Contact tracing to uncover rabies cases</h2>
<p>We aimed to collect detailed data on the rabies situation to understand the impacts of these vaccination campaigns. But official figures for rabies deaths often <a href="https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002510">under-report</a> the true burden of disease as most people die from rabies at home and are not counted in statistics. To combat this issue we used data from healthcare facilities to guide extensive contact tracing. </p>
<p>Hospital records of animal bite patients were used to identify people potentially exposed to rabies. We then traced and interviewed these people to determine the details of the bite including the species involved and whether or not the biting animal was likely to have been rabid. During contact tracing, additional bite victims and owners of rabid animals were identified and further traced. So in addition to collecting valuable data, we advised people of the risks of rabies and the importance of seeking care.</p>
<p>Somewhat unexpectedly we found that over 40% of the animal rabies cases that we detected were jackals. This is very unusual given that domestic dogs usually account for the vast majority of cases. We also found evidence of chains of rabies transmission within jackals and frequent cross-species transmission – that is transmission from dogs to jackals and vice versa. </p>
<p>Over the period of widespread dog vaccination we saw substantial declines in animal rabies cases and human rabies exposures throughout the study area. In 2011 we recorded 218 potential human exposures to rabies and 18 deaths. This dropped to just 15 exposures in 2017 and a single death in 2016 and 2019. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/422922/original/file-20210923-15-1aea4x4.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Researchers collecting sample from a jackal head surrounded by trees and the ground." src="https://images.theconversation.com/files/422922/original/file-20210923-15-1aea4x4.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/422922/original/file-20210923-15-1aea4x4.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/422922/original/file-20210923-15-1aea4x4.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/422922/original/file-20210923-15-1aea4x4.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/422922/original/file-20210923-15-1aea4x4.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/422922/original/file-20210923-15-1aea4x4.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/422922/original/file-20210923-15-1aea4x4.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Collecting brain tissue from the head of a rabid jackal.</span>
<span class="attribution"><span class="source"> Eliud Kissinger</span></span>
</figcaption>
</figure>
<p>Despite the high level of wildlife involvement, vaccination of domestic dogs alone appeared to reduce the risk of rabies in all species. During 2017 there were only 12 reported rabies cases in dogs and 7 in jackals compared to 77 and 74 respectively in the first year of the study. After mass dog vaccination ceased in early 2017, dog rabies cases began to increase in some districts. We suspect this may be due to waning immunity in the dog population.</p>
<h2>Why does this matter?</h2>
<p>These regions have unusually large proportions of wildlife rabies. But our study still found that domestic dog vaccination reduced the number of rabies cases in all animal species – this also greatly reduced the risk of rabies to people. </p>
<p>The importance of sustained annual dog vaccinations is highlighted by the observed increase in dog rabies after the dog vaccination campaigns ended. </p>
<p>If we are to <a href="https://rabiesalliance.org/resource/objectives-zero-30-global-strategic-plan-end-human-deaths-dog-mediated-rabies-2030#:%7E:text=In%202015%2C%20the%20world%20CALLED,United%20Against%20Rabies.">stop people dying unnecessarily</a> from this preventable disease, it is critical that there is continued investment in domestic dog vaccination and the presence of rabies within wildlife should not be seen as a barrier to implementing these programmes.</p><img src="https://counter.theconversation.com/content/168325/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah Hayes' PhD is funded by the Engineering and Physical Sciences Research Council. </span></em></p><p class="fine-print"><em><span>Katie Hampson's current research is funded by the Wellcome Trust and the Medical Research Foundation, UK. I have previously received funding from the WHO to conduct research on rabies. The research reported in this article was funded by the Wellcome Trust and the Bill and Melinda Gates Foundation.
</span></em></p><p class="fine-print"><em><span>Kennedy Lushasi works for Ifakara Health Institute, in Tanzania. He is affiliated with the University of Glasgow, UK, and is currently, a Ph.D. student in his final year at the Nelson Mandela African Institution of Science and Technology, Arusha-Tanzania. </span></em></p>
Domestic dogs have been shown to be the only species necessary to maintain rabies across most of Africa. This means that dog vaccination should control the disease in all species.
Sarah Hayes, PhD Candidate, Imperial College London
Katie Hampson, Professor of Disease Ecology and Public Health, University of Glasgow
Kennedy Lushasi, Kennedy Lushasi, Ifakara Health Institute
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/146925
2020-09-27T09:24:49Z
2020-09-27T09:24:49Z
Coping with COVID-19 need not derail progress against rabies
<figure><img src="https://images.theconversation.com/files/360006/original/file-20200925-18-1k9dd1h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The canine vaccine is inexpensive and prevents transmission to people.</span> <span class="attribution"><span class="source">Ulet Ifansasti/Getty Images</span></span></figcaption></figure><p>Before the emergence of the newest animal-borne disease, <a href="https://theconversation.com/africa/covid-19">COVID-19</a>, the world was in the last mile of eliminating one of the oldest animal-borne diseases – rabies.</p>
<p>For around <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082082/">4,000 years</a>, humanity has been contending with this infectious disease. Rabies has the highest case fatality rate of any conventional infectious agent at close to 100%. And it is <a href="https://www.who.int/news-room/fact-sheets/detail/rabies">almost always</a> transmitted to people through bites from infected dogs.</p>
<p>A vaccine for dogs was developed as early as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082082/">1799</a>. Widespread vaccination and other preventative measures have since saved an estimated <a href="https://rabiesalliance.org/resource/estimating-global-burden-endemic-canine-rabies">2.9 million</a> human lives annually.</p>
<p>The canine vaccine is inexpensive and prevents transmission to people. But this painful disease continues to kill around <a href="https://rabiesalliance.org/resources/search?type=912#teaser-6024">60,000</a> every year – often children under the age of 15 across Africa and Asia. Part of the challenge is that rabies control has been a victim of its own success: with millions of lives saved and vast progress in recent years, momentum for the last mile is difficult to maintain, as the victims are often the poorest of the poor living in rural communities.</p>
<p>Now the world is the grip of a new pandemic which sets back the fight against rabies. </p>
<p>Restrictions imposed to control the novel coronavirus outbreak, for example, have made monitoring rabies cases more challenging. Community health workers would ordinarily be vaccinating dogs and reporting bites, infections, and deaths. But many have been diverted to the COVID-19 response, while others have faced limitations on travel. Many government and NGO programmes in Africa stopped for a period while imports of canine vaccines were delayed by up to three months in Malawi.</p>
<p>Rabies control efforts must innovate and adapt to protect the life-saving gains of the last century. It’s important to maintain momentum towards eliminating deaths in the context of the new global health landscape created by COVID-19 by re-committing to surveillance, vaccination and education.</p>
<h2>Keeping track of cases</h2>
<p>The COVID-19 pandemic has heightened global awareness of the importance of health surveillance. This is true in terms of cases of infection as well as vaccination levels. </p>
<p>Canine vaccination against rabies can only be effective if it is targeted at populations where the virus exists. But it’s also important to track where vaccination has already taken place to monitor and avoid duplicating efforts. Both rely on accurate data gathering.</p>
<p>One solution during the pandemic has been to develop new “One Health” surveillance systems. These must link communities to veterinary laboratories and medical doctors. The Pan-African Rabies Control Network, for example, gathers key indicators for more than 47 African countries so that both the animal disease and its risk to people is properly recorded by all those who play a role in protecting public health.</p>
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Read more:
<a href="https://theconversation.com/whats-needed-to-do-a-better-job-of-pre-empting-disease-outbreaks-104160">What's needed to do a better job of pre-empting disease outbreaks</a>
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<p>The <a href="https://rabiesalliance.org/">Global Alliance for Rabies Control</a> has also pioneered a simple and robust tracking device, as well as a mobile phone application, to allow animal vaccinators to track vaccine drives in the field.</p>
<p>These approaches allow rabies control efforts to continue amid the pandemic. They also offer lessons for public health in responding to and recovering from COVID-19.</p>
<p>Better surveillance of animal-borne disease is critical for protecting human health against threats like rabies and coronavirus, but so too is vaccination. Once a COVID-19 vaccine is available, health agencies and governments will need to be able to track coverage to know how much of the population is protected and how much remains at risk.</p>
<p>Away from the frontline of public health, national authorities are also adapting to new circumstances, which includes revising and managing competing health priorities.</p>
<p>With countries experiencing the pandemic to varying degrees and scale, there can be no “once size fits all” health policy, neither for COVID-19 nor for rabies control.</p>
<p>This is why the Global Alliance for Rabies Control works with governments using a step-wise approach that allows for rabies control strategies to be set according to the national conditions, needs and resources.</p>
<p>Over the next few months, the Global Alliance for Rabies Control will work alongside the UN’s Food and Agriculture Organisation to support eight central African countries to develop strategies to tackle rabies. This partnership is also aimed at moving each nation closer towards the goal of reducing human deaths from rabies to zero by 2030.</p>
<p>Finally, rabies control, even before the novel coronavirus outbreak, was embracing the potential of technology to reach and connect audiences in new ways.</p>
<p>Educating children about rabies risks and precautions is an important element of a control strategy, particularly given the high prevalence of cases among children aged fifteen or under.</p>
<p>And as more children are learning virtually and remotely, rabies education has also moved online across Africa and Asia to reach those being homeschooled during lockdowns, with online lesson plans available for schools.</p>
<p>Meanwhile, the Global Alliance for Rabies Control continues to develop professional training for national rabies stakeholders and communities to deliver their national plans, including elements of the existing alliance’s education platform, a set of online certification courses.</p>
<h2>Keeping momentum</h2>
<p>The COVID-19 pandemic may have compounded other health threats like rabies and added pressure on already stretched services and authorities worldwide.</p>
<p>But the world can’t afford a resurgence of this disease after coming so far towards ending the misery and suffering it brings to thousands of people every year.</p>
<p>Rabies control efforts must adapt and innovate – but they can’t stop.</p><img src="https://counter.theconversation.com/content/146925/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Louis Nel is the executive director at the Global Alliance for Rabies Control. He receives research grants including from the University of Pretoria, National Research Foundation (South Africa).</span></em></p>
The world is in the grip of a new pandemic which sets back the fight against rabies.
Louis Nel, Professor, University of Pretoria
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/142673
2020-08-16T09:11:41Z
2020-08-16T09:11:41Z
Lessons from a community-driven rabies vaccination campaign in Kenya
<figure><img src="https://images.theconversation.com/files/348639/original/file-20200721-25-1ats89y.png?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Vaccination campaign roll outs in Laikipia's pastoralist communities.</span> <span class="attribution"><span class="source">Laikipia Rabies Vaccination Campaign</span></span></figcaption></figure><p>Every year, approximately <a href="https://www.oie.int/infographic/rabies/">60,000 people</a> die from rabies. Most of these deaths are <a href="http://dx.doi.org/10.1371/journal.pntd.0003709">children</a> – who are often less able to defend themselves from animals – in sub-Saharan Africa and Asia. </p>
<p>Rabies is usually transferred through saliva from the bite of an infected animal, with dogs being the <a href="https://www.who.int/news-room/fact-sheets/detail/rabies">most common transmitter</a>. The disease infects the central nervous system causing disease in the brain and eventual death. Once clinical symptoms appear, rabies is virtually 100% fatal.</p>
<p>In Kenya, rabies is estimated to kill up to 2,000 people every year. To address this, Kenya’s Zoonotic Disease Unit <a href="http://guidelines.health.go.ke:8000/media/Strategic_plan_for_elimination_of_Rabies.pdf">launched a strategic plan</a> with the aim of zero human deaths from dog transmitted rabies by 2030.</p>
<p>Rabies can be prevented through vaccination campaigns that target domestic dogs or, in the case that someone is bitten, the administration of a human vaccine. Dog vaccination is a more cost-effective measure to prevent rabies, as animal vaccines are much <a href="https://www.who.int/features/2012/world_rabies_day/en/">cheaper</a> than human vaccines.</p>
<p>In 2015 my colleagues and I launched a <a href="https://mpala.org/outreach/eradicating-rabies/">campaign</a> in response to an increased incidence of rabies in humans in Laikipia County. Coupled with this was the need to protect the local population of wild dogs – a globally endangered wildlife species – from the disease.</p>
<p>Laikipia is a unique landscape composed of privately-owned conservancies and agro-pastoral communities, where humans, wildlife, and domestic animals, including domestic dogs, regularly interact. This shaped our desire to create a partnership between conservancies, communities and government entities that would work together to eradicate rabies. </p>
<p>Mass vaccinations of domestic dogs are effective at eliminating rabies but require large amounts of resources, planning, and political will to implement. However, this is a challenge in low-resource settings where rabies might not be a public health priority.</p>
<p>Our <a href="https://dx.plos.org/10.1371/journal.pntd.0008260">project</a>, by contrast, was driven by the grassroots and was volunteer-led. It raised awareness and provided vaccines for cats and dogs in an area of about 1500km². Over three years (from 2015 to 2017), we vaccinated 1,040 cats and 13,155 dogs in 17 communities. </p>
<p>The project also grew. It went from being a local campaign to a county-wide rabies elimination effort after the county and national governments recognised it as an effective programme. </p>
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<p>This provided us with some key insights into the successes, failures, and challenges with rolling out a grassroots rabies campaign. </p>
<p>It proved that a community-based low-cost campaign could successfully implement a rabies campaign. This is important in pastoralist communities where domestic dogs are less likely to be vaccinated and also where people are less informed about rabies and vaccines.</p>
<p>In the following years, we aim to vaccinate at least 70% of dogs in the region, with a particular emphasis on mobile communities. This vaccination coverage rate is sufficient to control canine rabies. </p>
<h2>Marginalised communities</h2>
<p>There are a couple of major challenges when it comes to rolling out rabies campaigns in more marginalised areas. </p>
<p>Firstly, the communities are mobile, which means their dogs are less likely to be vaccinated and it’s hard to reach them.</p>
<p>Secondly, the communities are less informed about rabies and how the vaccinations work. For instance, in 2016 and 2017 we experienced a 50% decline in vaccination coverage in three pastoral communities because they believed the vaccines killed their dogs. During the same period, <a href="https://www.sheldrickwildlifetrust.org/news/meru-mobile-veterinary-unit/meru-mobile-veterinary-unit-october-2017">there was a</a> canine distemper virus outbreak across the county which killed many domestic dogs and wild carnivores. </p>
<p>These challenges highlight that vaccines alone are not enough. There is a need for local engagement and community involvement, even before vaccination efforts begin. These must be carefully planned so that they effectively raise awareness of rabies control. Three core groups of people were instrumental in this effort: veterinarians, researchers, and university students. </p>
<p>We used various avenues to educate the public about rabies. For instance, we engaged 12 primary schools and taught hundreds of children about rabies, its side effects, and how we can work to eradicate it together. We also tried to educate communities using sound trucks.</p>
<p>These efforts helped to increase buy-in from local communities.</p>
<p>After the community was sensitised about rabies, people would then bring their dogs to the vaccination station on a particular day. Upon arrival, the dog’s details are taken down and it’s issued with a shot of rabies vaccine. The dog was then marked on the forehead with paint so that follow-up teams know it’s been vaccinated, and the owner is issued with a vaccination card signed by a veterinarian. For remote pastoral communities we had an additional mobile team for door-to-door vaccinations. </p>
<h2>Volunteer based</h2>
<p>Our project also wanted to test the hypothesis that a grassroots campaign could implement a successful vaccination campaign, similar to well-funded and permanently staffed efforts. </p>
<p>Laikipia Rabies Vaccination Campaign team grew from a project of less than 10 people from three organisations (the Mpala Research Centre, International Livestock Research Institute, and Karatina University) to a team of more than 90 people collaborating across 15 organisations. Our operations were out of the Mpala Research Centre. </p>
<p>Money saved from volunteer hours contributed and in-kind support from conservancies meant that we used approximately Ksh4 million (about US$40,000) over the three years. This meant we achieved a cost per dog of about Ksh370 (about US$3). This is <a href="https://www.frontiersin.org/articles/10.3389/fvets.2017.00038/full">within</a> the range of other, large-scale and well-funded campaigns. </p>
<p>Of course, running a completely volunteer-based campaign was not without its drawbacks. Limitations included;</p>
<ul>
<li><p>Sustained funding (beyond in-kind contributions) was a limiting factor for expanding our vaccination efforts at scale.</p></li>
<li><p>Larger and more remote areas characterised by lower human population densities were challenging to work in due to poor accessibility and vast areas to cover.</p></li>
<li><p>Restricted flexibility with scheduling as volunteers may have other commitments.</p></li>
<li><p>The lack of a centrally funded project leader to guide vaccination inhibited our ability to implement a completely successfully campaign. </p></li>
</ul>
<p>Nonetheless, this project provided a unique opportunity to highlight successes and failures for other future campaigns. We look forward to learning from the challenges and amplifying the successes to expand it further and eradicate rabies from Laikipia County.</p><img src="https://counter.theconversation.com/content/142673/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sources of funding that supported this work included a National Science Foundation Postdoctoral Fellowship in Biology FY 2014, Award No. DBI-1402456 (AWF, PWW) <a href="https://www.nsf.gov/">https://www.nsf.gov/</a> and a Smithsonian Mpala Postdoctoral George E. Burch Fellow at the National Zoological Park, Smithsonian Institution (AWF, DJM, SM) <a href="https://www.smithsonianofi.com/fellowship-opportunities/mpala-postdoctoral-fellowship/">https://www.smithsonianofi.com/fellowship-opportunities/mpala-postdoctoral-fellowship/</a>. DKN was supported through the National Geographic Society and the Rufford Foundation. SM Thumbi receives funding support from the Wellcome Trust (Grant numbers 110330/Z/15/Z). Some personnel (EMF, DM, other ILRI staff) involved with this study were supported by the UK Medical Research Council, Biotechnology and Biological Science Research Council (UK), the Economic and Social Research Council (UK), the Natural Environment Research Council (UK), through the Environmental & Social Ecology of Human Infectious Diseases Initiative (ESEI), Grant Reference: G1100783/1. These staff were also supported in part by the CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), led by the International Food Policy Research Institute (IFPRI); we acknowledge the CGIAR Fund Donors (<a href="https://www.cgiar.org/funders/">https://www.cgiar.org/funders/</a>). Financial support was also provided by Mpala Wildlife Foundation, Laikipia Ranches and Conservation Community and Conservancies, Veterinarians International, D. and C. Keller, Bruce L., and G. and J. Wintroub. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</span></em></p><p class="fine-print"><em><span>Dedan Ngatia and Dishon Muloi do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
In Kenya, rabies is estimated to kill up to 2,000 people every year.
Dishon Muloi, Postdoctoral research fellow, International Livestock Research Institute
Dedan Ngatia, PhD Student, University of Wyoming
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/125672
2019-10-29T13:14:37Z
2019-10-29T13:14:37Z
Rabies’ horrifying symptoms inspired folktales of humans turned into werewolves, vampires and other monsters
<figure><img src="https://images.theconversation.com/files/298932/original/file-20191028-113998-liuu8u.jpg?ixlib=rb-1.1.0&rect=336%2C266%2C3286%2C2145&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A rabid dog's bite can make a person seem to have animal characteristics.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/red-glowing-eyed-doglike-aggressive-demonic-540753655">Taras Verkhovynets/Shutterstock.com</a></span></figcaption></figure><p>In 1855, the Brooklyn Daily Eagle reported on the gruesome murder of a bride by her new husband. The story came from the French countryside, where the woman’s parents had initially prevented the couple’s engagement “on account of the strangeness of conduct sometimes observed in the young man,” although he “otherwise was a most eli[g]ible match.”</p>
<p>The parents eventually consented, and the marriage took place. Shortly after the newlyweds withdrew to consummate their bond, “fearful shrieks” came from their quarters. People quickly arrived to find “the poor girl… in the agonies of death — her bosom torn open and lacerated in a most horrible manner, and the wretched husband in a fit of raving madness and covered with blood, having actually devoured a portion of the unfortunate girl’s breast.” </p>
<p>The bride died a short time later. Her husband, after “a most violent resistance,” also expired.</p>
<p>What could have caused this horrifying incident? “It was then recollected, in answer to searching questions by a physician,” that the groom had previously “been bitten by a strange dog.” The passage of madness from dog to human seemed like the only possible reason for the grisly turn of events. </p>
<p>The Eagle described the episode matter-of-factly as “a sad and distressing case of hydrophobia,” or, in today’s parlance, <a href="https://www.cdc.gov/rabies/index.html">rabies</a>.</p>
<p>But the account read like a Gothic horror story. It was essentially a werewolf narrative: The mad dog’s bite caused a hideous metamorphosis, which transformed its human victim into a nefarious monster whose vicious sexual impulses led to obscene and loathsome violence.</p>
<p>My new book, “<a href="https://jhupbooks.press.jhu.edu/title/mad-dogs-and-other-new-yorkers">Mad Dogs and Other New Yorkers: Rabies, Medicine, and Society in an American Metropolis, 1840-1920</a>,” explores the hidden meanings behind the ways people talked about rabies. Variants of the rabid groom story had been told and retold in English language newspapers in North America since at least the beginning of the 18th century, and they continued to appear as late as the 1890s.</p>
<p>The Eagle’s account was, in essence, a folk tale about mad dogs and the thin dividing line between human and animal. Rabies created fear because it was a disease that seemed able to turn people into raging beasts. </p>
<h2>A terrifying and fatal disease</h2>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/298838/original/file-20191027-113991-1gz753x.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/298838/original/file-20191027-113991-1gz753x.png?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/298838/original/file-20191027-113991-1gz753x.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=774&fit=crop&dpr=1 600w, https://images.theconversation.com/files/298838/original/file-20191027-113991-1gz753x.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=774&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/298838/original/file-20191027-113991-1gz753x.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=774&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/298838/original/file-20191027-113991-1gz753x.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=973&fit=crop&dpr=1 754w, https://images.theconversation.com/files/298838/original/file-20191027-113991-1gz753x.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=973&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/298838/original/file-20191027-113991-1gz753x.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=973&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A werewolf wreaks havoc in this 1512 woodcut.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Werwolf.png">Lucas Cranach the Elder, Herzogliches Museum/Wikimedia Commons</a></span>
</figcaption>
</figure>
<p>The historian Eugen Weber once observed that French peasants in the 19th century feared “<a href="https://www.sup.org/books/title/?id=3200">above all wolves, mad dogs, and fire</a>.” Canine madness – or the disease that we know today as rabies – conjured up the canine terrors that have formed the stuff of nightmares for centuries.</p>
<p><a href="https://www.rutgersuniversitypress.org/hives-of-sickness/9780813521589">Other infectious diseases</a> – including cholera, typhoid and diphtheria – <a href="https://babel.hathitrust.org/cgi/pt?id=uc1.b3546115&view=1up&seq=493">killed far more people</a> in the 19th and early 20th centuries. The cry of “Mad dog!” nonetheless sparked an immediate sense of terror, because a simple dog bite could mean a protracted ordeal of grueling symptoms, followed by certain death. </p>
<p>Modern medicine knows that rabies is caused by a virus. Once it enters the body, it travels to the brain via the nervous system. The typical lag time of weeks or months between initial exposure and onset of symptoms means that rabies is no longer a death sentence if a patient quickly receives <a href="https://www.mayoclinic.org/drugs-supplements/rabies-immune-globulin-intramuscular-route/description/drg-20065738">injections of immune antibodies</a> and vaccine, in order to build immunity soon after encountering a suspect animal. Though it’s rare for people to die of rabies in the U.S., the disease still <a href="https://www.who.int/publications-detail/who-wer9207">kills tens of thousands of people globally every year</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/298839/original/file-20191027-114011-1yx3lh0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/298839/original/file-20191027-114011-1yx3lh0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/298839/original/file-20191027-114011-1yx3lh0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=388&fit=crop&dpr=1 600w, https://images.theconversation.com/files/298839/original/file-20191027-114011-1yx3lh0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=388&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/298839/original/file-20191027-114011-1yx3lh0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=388&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/298839/original/file-20191027-114011-1yx3lh0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=488&fit=crop&dpr=1 754w, https://images.theconversation.com/files/298839/original/file-20191027-114011-1yx3lh0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=488&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/298839/original/file-20191027-114011-1yx3lh0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=488&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The virus affects the brain, as seen with the darker purple inclusions, called negri bodies, in the brain cells of someone who died of rabies.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Rabies_negri_bodies_brain.jpg">CDC/Dr. Makonnen Fekadu</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p><a href="https://babel.hathitrust.org/cgi/pt?id=uiuo.ark:/13960/t77t2vj2d&view=1up&seq=85">According to 19th-century sources</a>, after an incubation period of between four and 12 weeks, symptoms might start with a vague sense of agitation or restlessness. They then progressed to the wracking spasmodic episodes characteristic of rabies, along with sleeplessness, excitability, feverishness, rapid pulse, drooling and labored breathing. Victims not infrequently exhibited hallucinations or other mental disruptions as well.</p>
<p>Efforts to mitigate violent outbursts with drugs often failed, and physicians could then do little more than stand by and bear witness. Final release came only after the disease ran its inevitably fatal course, usually over a period of two to four days. Even today, rabies remains essentially <a href="https://doi.org/10.1017/cjn.2015.331">incurable once clinical signs appear</a>.</p>
<p>Centuries ago, the loss of bodily control and rationality triggered by rabies seemed like an assault on victims’ basic humanity. From a real dreaded disease transmitted by animals emerged spine-tingling visions of supernatural forces that transferred malevolent animals’ powers and turned people into monsters.</p>
<h2>Bites that transform people into animals</h2>
<p>Nineteenth-century American accounts never invoked the supernatural directly. But descriptions of symptoms indicated unspoken assumptions about how the disease transmitted the biting animal’s essence to the suffering human.</p>
<p>Newspapers frequently described those who contracted rabies from dog bites as barking and snarling like dogs, while cat-bite victims scratched and spat. Hallucinations, respiratory spasms and out-of-control convulsions produced fearful impressions of the rabid animal’s evil imprint.</p>
<p>Traditional preventive measures also showed how Americans quietly assumed a blurred boundary between humanity and animality. Folk remedies held that dog-bite victims could protect themselves from rabies by killing the dog that had already bitten them, or applying the offending dog’s hair to the wound, or cutting off its tail.</p>
<p>Such preventatives implied a need to cut an invisible, supernatural tie between a dangerous animal and its human prey.</p>
<p>Sometimes the disease left eerie traces. When a Brooklynite died from rabies in 1886, the New York Herald recorded a freakish occurence: Within minutes after the man’s last breath, “the bluish ring on his hand – the mark of the Newfoundland’s fatal bite…disappeared.” Only death broke the mad dog’s pernicious hold.</p>
<h2>Vampires’ roots in rabid dogs</h2>
<p>It’s possible that, along with werewolves, vampire stories also originated from rabies.</p>
<p>Physician Juan Gómez-Alonso has pointed out <a href="https://doi.org/10.1212/WNL.51.3.856">a resonance between vampirism and rabies</a> in the hair-raising symptoms of the disease – the distorted sounds, exaggerated facial appearances, restlessness and sometimes wild and aggressive behaviors that made sufferers seem more monstrous than human.</p>
<p>Extreme oversensitivity to stimuli, which set off the tortuous spasmodic episodes associated with rabies, could have a particularly strange effect. A glance at a mirror might set off a violent response, in a chilling parallel with the living-dead vampire’s inability to cast a reflection.</p>
<p>Moreover, in different eastern European folkloric traditions, vampires turned themselves not into bats, but into wolves or dogs, the key vectors of rabies.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/298934/original/file-20191028-114011-1wmvy3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/298934/original/file-20191028-114011-1wmvy3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/298934/original/file-20191028-114011-1wmvy3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=396&fit=crop&dpr=1 600w, https://images.theconversation.com/files/298934/original/file-20191028-114011-1wmvy3k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=396&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/298934/original/file-20191028-114011-1wmvy3k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=396&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/298934/original/file-20191028-114011-1wmvy3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=498&fit=crop&dpr=1 754w, https://images.theconversation.com/files/298934/original/file-20191028-114011-1wmvy3k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=498&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/298934/original/file-20191028-114011-1wmvy3k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=498&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The fun of a Halloween werewolf hints at the fear of a person becoming an animal.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/Associated-Press-Domestic-News-New-Jersey-Unite-/d8ea2a1fbbe5da11af9f0014c2589dfb/1/0">AP Photo/Daniel Hulshizer</a></span>
</figcaption>
</figure>
<p>So as aspiring werewolves, vampires and other haunts take to the streets for Halloween, remember that beneath the annual ritual of candy and costumed fun lie the darker recesses of the imagination. Here animals, disease and fear intermingle, and monsters materialize at the crossover point between animality and humanity.</p>
<p>Cave canem – beware the dog.</p>
<p>
<section class="inline-content">
<img src="https://images.theconversation.com/files/248894/original/file-20181204-133095-1p2xxs2.png?w=128&h=128">
<div>
<header>Jessica Wang is the author of:</header>
<p><a href="https://jhupbooks.press.jhu.edu/title/mad-dogs-and-other-new-yorkers">Mad Dogs and Other New Yorkers: Rabies, Medicine, and Society in an American Metropolis, 1840-1920.</a></p>
<footer>Johns Hopkins University Press provides funding as a member of The Conversation US.</footer>
</div>
</section>
</p><img src="https://counter.theconversation.com/content/125672/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jessica Wang receives research funding from the University of British Columbia. Over the past decade, she has also received grants and fellowships from the Social Sciences Research Council of Canada, the National Science Foundation (U.S.), the Hampton Fund (UBC), the Killam Trusts, Harvard University, and other sources.
</span></em></p>
Fear of a disease that seemed to turn people into beasts might have inspired belief in supernatural beings that live on in today’s creepy Halloween costumes.
Jessica Wang, Associate Professor of U.S. History, University of British Columbia
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/120643
2019-07-21T11:02:24Z
2019-07-21T11:02:24Z
Rabies: How it spreads and how to protect yourself
<figure><img src="https://images.theconversation.com/files/284847/original/file-20190718-116552-8kplc4.jpg?ixlib=rb-1.1.0&rect=41%2C48%2C4304%2C2938&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Raccoons, foxes, skunks and bats are all hosts of specific rabies virus variants. Humans can be infected by them all. </span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p>A <a href="https://www.cbc.ca/news/canada/british-columbia/rabies-death-bc-vancouver-island-bat-1.5213460">21-year-old Canadian man recently died of rabies</a> — a disease that <a href="https://www.who.int/rabies/epidemiology/en/">kills an estimated 59,000 people a year internationally</a> but hasn’t infected a person in Canada since 2007.</p>
<p>Nick Major, from Parksville, B.C., suffered a small puncture wound after a bat flew into his hand during daylight on the west coast of Vancouver Island. He developed the symptoms of rabies six weeks later.</p>
<p>Should we be concerned about rabies? Yes. It’s an almost invariably fatal infection <a href="http://www.bccdc.ca/health-info/diseases-conditions/rabies">caused by a virus that is widely present in wildlife in Canada</a> and globally.</p>
<p>Should we be more concerned about rabies now than we would have been before Major’s death? No. While tragic — both because of the fatal outcome and the fact that it could have been prevented — the situation does not indicate any change in the risk of rabies in Canada.</p>
<h2>Raccoons, foxes, skunks and bats</h2>
<p>Rabies is a viral infection caused by the rabies virus, which circulates in different “reservoir species.” </p>
<p>Raccoons, foxes, skunks and bats are all hosts of specific rabies virus variants. However, while those rabies virus variants are best at circulating in their host species, they can spillover to other species. </p>
<p>There is no human rabies virus variant, but humans can be infected by any rabies virus.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1151832528359165953"}"></div></p>
<p>Internationally, it is estimated that rabies kills approximately 59,000 people every year, almost all in developing countries in Africa and Asia, and almost all from <a href="https://www.who.int/rabies/epidemiology/en/">dogs in areas where canine rabies virus variant is present</a>. </p>
<p>Canine rabies virus was eradicated in Canada many years ago (although dogs can still get rabies from other species), leaving wildlife as the sources of infection. The distribution of rabies virus in different wildlife species varies across the country, ranging from the notable <a href="https://www.thespec.com/news-story/8928476-hamilton-s-ongoing-rabies-outbreak-traced-to-diseased-raccoon-from-u-s-/">return of raccoon rabies in Hamilton, Ontario</a> to national dissemination of <a href="https://www.inspection.gc.ca/animals/terrestrial-animals/diseases/reportable/rabies/rabies-in-canada/eng/1356156989919/1356157139999">bat variant rabies</a>. </p>
<p>Virtually every Canadian is at some, albeit exceptionally low, risk of rabies exposure given the distribution of this virus in wildlife.</p>
<h2>With treatment, rabies is preventable</h2>
<p>Rabies virus is transmitted from an infected animal to a person through saliva, almost always via a bite. </p>
<p>Rabies deaths in Canada indicate a breakdown in education, communication and health care, since sources of exposure are well understood and rabies is virtually completely preventable. </p>
<p>If people know how rabies is transmitted, report bites to public health personnel and get <a href="https://www.cdc.gov/rabies/medical_care/index.html">rabies post-exposure treatment when indicated</a>, the risk of rabies is essentially zero. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/284846/original/file-20190718-116596-1h0k67z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284846/original/file-20190718-116596-1h0k67z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=413&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284846/original/file-20190718-116596-1h0k67z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=413&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284846/original/file-20190718-116596-1h0k67z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=413&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284846/original/file-20190718-116596-1h0k67z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=519&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284846/original/file-20190718-116596-1h0k67z.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=519&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284846/original/file-20190718-116596-1h0k67z.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=519&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The eastern pipistrelle bat is frequently linked with human rabies cases.</span>
<span class="attribution"><span class="source">(THE CANADIAN PRESS/AP/Merlin D. Tuttle, Bat Conservation International)</span></span>
</figcaption>
</figure>
<p>As with many infectious diseases, the science and medicine are easy. We know how to completely prevent rabies. However, as the recent B.C. case highlights, breakdowns can happen. It’s the human element that causes risk. </p>
<p>In the tragic B.C. rabies case, there was nothing new or surprising, just a lack of understanding of the risk of rabies. In part, this is probably because the successful control of rabies in Canada means there is less public interest and awareness. </p>
<p>The risk of rabies to Canadians is as much from complacency and lack of education as it is from wildlife.</p>
<h2>What to do if you are bitten by a wild animal</h2>
<p>The recent rabies case highlights some important facts. Rabies is present in Canada and probably always will be. While we can control rabies in some animal populations, eradicating it from bats is next to impossible. As a result, we have to learn to live with an ever-present risk of exposure. </p>
<p>If you are bitten by a wild animal, this is what you should do:</p>
<ol>
<li><p>Wash the wound with soap and running water.</p></li>
<li><p>Identify the animal, if possible, so that it can be quarantined or tested.</p></li>
<li><p>Seek medical care.</p></li>
<li><p>Ensure your local public health unit has been contacted or contact them yourself. They will coordinate observation of the biting animal (when possible) and organize post-exposure treatment, if it is needed.</p></li>
</ol>
<p>If anything good can come out of this unfortunate incident, it will be increased awareness of the risk of rabies and how to reduce that risk. Basic awareness is sometimes all that is needed to save a life.</p><img src="https://counter.theconversation.com/content/120643/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>J Scott Weese receives funding from the Canadian Institutes of Health Research, National Sciences and Engineering Research Council, Ontario Veterinary College Pet Trust, Equine Guelph and the American Kennel Club Canine Health Foundation.</span></em></p>
Rabies is almost always fatal once the symptoms appear. It is also completely preventable, so long as you know how to protect yourself.
J Scott Weese, Professor, Ontario Veterinary College, University of Guelph
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/93397
2018-03-15T15:26:56Z
2018-03-15T15:26:56Z
Explainer: what’s behind the rabies outbreak in South Africa
<figure><img src="https://images.theconversation.com/files/210502/original/file-20180315-104659-lubzum.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p><em>In the last four months five cases of rabies in humans have <a href="http://www.nicd.ac.za/index.php/human-rabies-diagnosed-in-south-africa/">been reported</a> in South Africa, and an additional two cases are probable. The country’s National Institute of Communicable Diseases warns that steps need to be taken to curb the trend. The Conversation Africa’s health and medicine editor Candice Bailey spoke to the institute’s Jacqueline Weyer about these concerns.</em> </p>
<p><strong>How prevalent is rabies in dogs in South Africa?</strong></p>
<p>The recent confirmed <a href="http://www.nicd.ac.za/index.php/human-rabies-diagnosed-in-south-africa/">human rabies cases</a> were spread geographically across South Africa and reported from locations in the north and east of the country. This included four provinces: Limpopo, Mpumalanga, Eastern Cape and KwaZulu-Natal. Two probable cases were reported in the Free State and Eastern Cape provinces, but appropriate samples were not available for laboratory confirmation. </p>
<p>Historically, locations in KwaZulu-Natal and Eastern Cape have been affected the most by dog transmitted rabies. But in the past decade cases have been increasingly reported from areas where it has been controlled before. This includes outbreaks of dog transmitted rabies in areas of the Limpopo Province, Mpumalanga, North West and Free State Provinces. </p>
<p>The epidemiology of the disease is dynamic and changes based on factors such as vaccination coverage, the movement of animals and other issues that may affect the ecology of dogs in a given area. For example in 2010, a rabies outbreak was reported in dogs in the south west of Johannesburg. The outbreak could be traced back to a rabid dog from KwaZulu-Natal. With low vaccine coverage in Johannesburg, the outbreak lasted for the better part of year before it was brought under control.</p>
<p><strong>How big of a threat is it to humans?</strong></p>
<p>Rabies is the <a href="https://www.ncbi.nlm.nih.gov/pubmed/2565020">most fatal infectious disease</a> known to mankind. It is spread through the infected saliva of a rabid animal. This means that any encounter that allows the contaminated saliva to enter the body – through a scratch, wound or through contact with mucous membranes – could lead to infection. Most human rabies cases in the world happen when a person has been exposed to a rabid domestic dog. There are very few cases linked to rabid cats and other mammals like wildlife and domestic livestock. </p>
<p>There is no cure for rabies once the symptoms of the disease become evident and the virus has spread to the brain. This is true for both animals and humans. Although there is no cure for the disease, rabies is preventable and a single case of the disease remains a tragedy. </p>
<p>If someone has been <a href="http://www.nicd.ac.za/assets/files/Rabies%20A1%20posterinfographic.pdf">bitten by a rabid animal</a>, the wound, no matter how big or small, must be washed thoroughly with soap and water. In addition the person must see a doctor as a matter of urgency. At the health care facility, the risk for rabies virus transmission will be assessed based on the particulars of the case and rabies vaccination and rabies antibody therapy provided as preventative treatment post exposure.</p>
<p><strong>What needs to be done to control and eliminate rabies?</strong></p>
<p>Dog rabies has been <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5300989/">eliminated in many countries</a> around the world. In the US, this was achieved nearly <a href="https://www.cdc.gov/rabies/location/usa/surveillance/index.html">60 years ago</a>. And in the developing world, Mexico has also managed to control dog transmitted rabies. </p>
<p>Their keys to success were progressive and systematic programmes for rabies vaccination in dogs. And these were underpinned by commitment from their governments as well as the public health and veterinary health authorities. </p>
<p>The fact that rabies is a zoonotic disease, affecting both human and animals, presents a massive obstacle. The control of rabies relies almost solely on the vaccination of domestic dogs. In South Africa one of the challenges is that the country doesn’t have enough resources to make sure this happens uniformly. </p>
<p>Dogs need to be vaccinated when they are puppies (at four months) and then again when they are one year old. After that, vaccinations need to happen every three years. In South Africa, vaccination of dogs and cats are mandatory by law. It’s the pet owners responsibility to ensure that their animals are vaccinated. </p>
<p>South Africa has committed to <a href="https://www.sajei.co.za/index.php/SAJEI/article/view/750/891">eliminate rabies by 2030</a>. In 2014, the National Rabies Advisory Group of South Africa estimated that the country had spent about <a href="https://www.sajei.co.za/index.php/SAJEI/article/view/750/891">R70 million (USD$ 6 million</a>) in vaccine and immunoglobulin purchases. </p>
<p>Bridging the gap in South Africa needs an integrated multisectoral, or “one health” approach for rabies control and prevention. Lessons from countries where dog rabies has been brought under control are ample, and policies and programmes should be adopted with these lessons and local challenges in mind.</p><img src="https://counter.theconversation.com/content/93397/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacqueline Weyer does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Health authorities have raised the alarm after several cases of human rabies were reported in a space of four months.
Jacqueline Weyer, Senior Medical Scientist, National Institute for Communicable Diseases
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/93213
2018-03-14T13:51:07Z
2018-03-14T13:51:07Z
Five diseases you can catch from pets
<figure><img src="https://images.theconversation.com/files/209957/original/file-20180312-30972-vw8rut.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/774928273?src=d7Q8NTEsKBreCshr3n4-cA-1-4&size=medium_jpg">SerPhoto/Shutterstock</a></span></figcaption></figure><p><a href="https://theconversation.com/the-science-behind-why-some-people-love-animals-and-others-couldnt-care-less-84138">Love them or hate them</a>, it is hard to get away from pets. And even if you don’t own one yourself, you are likely to come across them (or things they have left behind) regularly. </p>
<p>Most interactions between humans and pets are likely to be overwhelmingly positive. But pets can carry some diseases that affect us. Such diseases, termed zoonoses, are usually very mild, but the rarer ones can be more severe. </p>
<p>Here are some of the infections people can catch from their pets:</p>
<h2>1. Rabies</h2>
<p>Rabies is perhaps the archetypal zoonosis. A virus whose name alone has the potential to cause fear. The virus is largely found in unvaccinated dogs and other canine populations. </p>
<p>In areas that still have rabies, people – often children – usually become infected when they are bitten by an affected dog. The virus attacks the brain, and once symptoms develop, there is sadly no cure, and those affected die. The good news is, it can be prevented by <a href="https://theconversation.com/rabies-a-global-killer-that-dog-jabs-can-eliminate-32289">vaccinating dogs</a> and other wild carnivores. Many parts of the world are now free of the virus, including the UK and large parts of the rest of Europe, and in many others, national campaigns are under way to achieve this. </p>
<h2>2. Ringworm</h2>
<p>Some zoonotic skin infections are not uncommon in pets but usually mild in humans. These can be shared with owners because of our love for warm houses, and close contact with our pets. Ringworm is one such infection.</p>
<p>Ringworm is actually a misnomer. It is not a worm at all but a microscopic fungus, closely related to the cause of athlete’s foot in people. Affected cats, dogs and other animals may show very few signs. However, in its classical form, pets with ringworm usually have circular areas of hair loss. The affected area of skin becomes scaly, flaky and itchy. It is very treatable, but can occasionally cause scarring. </p>
<h2>3. Salmonella</h2>
<p>A variety of potentially zoonotic bugs live in the intestines of pets. These rarely affect humans. However, when they do, they can be severe. We have all probably heard of salmonella, largely because of risks, now thankfully much diminished, from eggs. Dogs and cats can also carry <a href="https://www.ncbi.nlm.nih.gov/pubmed/28864509">salmonella</a>, sometimes causing diarrhoea. Salmonella is also quite commonly present in pet reptiles and amphibians, as well as in so-called “feeder mice” that are fed by some to pet reptiles. </p>
<p>It’s always a good idea to wash your hands after handling both pets and raw pet food. It is also a good idea to have separate areas for preparing raw animal food and human food. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/210142/original/file-20180313-30989-8mb8fi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/210142/original/file-20180313-30989-8mb8fi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/210142/original/file-20180313-30989-8mb8fi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/210142/original/file-20180313-30989-8mb8fi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/210142/original/file-20180313-30989-8mb8fi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/210142/original/file-20180313-30989-8mb8fi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/210142/original/file-20180313-30989-8mb8fi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Pet reptiles can carry salmonella.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/252996154?src=5uGw9g09oBC89-ah1rMh9w-1-33&size=medium_jpg">SGr/Shutterstock.com</a></span>
</figcaption>
</figure>
<h2>4. Toxoplasma</h2>
<p>Toxoplasma is a common parasite in cats that they can also shed in their faeces. For most humans, it is entirely benign. However, if a woman first becomes infected during pregnancy, it can, albeit rarely, have severe complications for the developing foetus. </p>
<p>Pregnant women should take simple additional precautions around hand hygiene, avoiding cat litter trays, especially those not cleaned regularly, and avoiding eating uncooked garden produce where cats may have had access to the soil. </p>
<h2>5. Bites and scratches</h2>
<p>Some argue for bites and scratches to be included as a zoonosis. If we do include them, they are likely to be among the most common zoonoses. Never nice, always painful, and in disturbing, rare cases – usually involving children – they can be fatal. </p>
<p>Cat bites and scratches can transmit a bacterium called <em>Bartonella henselae</em>, the cause of “cat-scratch disease”. Both bites and scratch wounds can become badly infected causing further pain. Scars, both mental and physical, can be lifelong in those that have been attacked. Children and those exposed occupationally, such as postmen, are perhaps most at risk. </p>
<p>As with most infections, zoonotic infections have a greater potential to do harm in people whose immune systems are compromised, such as the elderly and those suffering from immunosuppressive diseases (such as HIV/AIDS), or undergoing immunosuppressive therapies (such as chemotherapy). However, even if your immune system is compromised, you can still benefit from owning a pet. And with care and a little knowledge of the risks, you can avoid infections. </p>
<p>Thankfully, zoonotic infections are not common. Most infections we get are likely to come from other humans. However, the risks of zoonosis can be minimised by being aware of them and by taking simple hygiene precautions at home. And, if in doubt about the risks, you can always consult your GP or a veterinary surgeon.</p><img src="https://counter.theconversation.com/content/93213/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alan Radford does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>
Pets give us a lot of joy … and sometimes a few diseases.
Alan Radford, Professor of Veterinary Health Informatics, University of Liverpool
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/82008
2017-10-19T13:45:32Z
2017-10-19T13:45:32Z
Dealing with local diseases helps countries tackle new outbreaks
<figure><img src="https://images.theconversation.com/files/191009/original/file-20171019-1048-w7aejd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Tackling local diseases like rabies could help health authorities identify new outbreaks more easily.</span> <span class="attribution"><span class="source">N. Bastiaensen/World Organisation for Animal Health</span></span></figcaption></figure><p>It’s hard to predict when and where an infectious disease will emerge. It could be anywhere on the planet. And it could affect humans, animals or plants. </p>
<p>That’s why countries need surveillance systems that can detect and respond to outbreaks wherever and whenever they occur. Detecting them early is vital because it means that measures can be put in place quickly to control the spread of a disease, reducing its size and impact. </p>
<p>Good surveillance capacity to pick up the threat of a new disease depends largely on good basic public health systems in communities. To strengthen this capacity, a good place to start is for countries to develop networks and have enough skilled health workers to detect and respond to diseases that happen everyday. By tackling these threats and controlling <a href="http://science.sciencemag.org/content/357/6347/146">existing diseases</a>, countries can build the capacity they need to deal with future emerging disease threats. </p>
<p>In low and middle income countries the public health infrastructure to manage human and animal health is often limited. Gaps in capacity have implications for both the local capacity to detect and respond to existing and everyday disease threats as well as the surveillance of emerging diseases. </p>
<p>The inability of countries to first detect, and then manage, the spread of diseases can have serious economic implications. The spread of diseases affecting crops and livestock can wipe out the income of a family, and have devastating affect on the agricultural sectors of a country’s economy. This is particularly problematic in most African countries where <a href="https://www.brookings.edu/blog/africa-in-focus/2016/01/22/foresight-africa-2016-banking-on-agriculture-for-africas-future/">agriculture remains a mainstay</a> of people’s income.</p>
<h2>People, plants and animals are affected</h2>
<p>There are three ways to define an emerging disease. When they cause infections in a species for the first time, spread to new geographic areas, or cause an increasing number of cases in a particular population. The <a href="http://www.who.int/csr/disease/ebola/en/">Ebola outbreaks</a> in West Africa and the <a href="http://www.who.int/emergencies/zika-virus/en/">Zika virus</a> outbreaks in many Pacific Island countries and the Americas are examples of emerging infections in humans.</p>
<p>Around <a href="http://rstb.royalsocietypublishing.org/content/356/1411/983">75% of emerging infectious diseases are zoonoses</a> – diseases that can be transmitted between animals and people.</p>
<p>Zoonoses can affect communities in several ways. Aside from ill people there can also be profound economic effects. <a href="https://www.cdc.gov/vhf/rvf/RVF-FactSheet.pdf">Rift Valley fever</a> affects livestock such as cattle, sheep, goats and camels as well as people. Disease in these livestock affects household income as well as national trade, as was clear in several large <a href="http://www.who.int/mediacentre/factsheets/fs207/en/">outbreaks of Rift Valley fever</a> in sub-Saharan Africa in recent decades.</p>
<p>Emerging diseases can also affect plants. Some of the most economically important plant diseases affect crops such as cassava (<a href="http://www.apsnet.org/publications/apsnetfeatures/Pages/cassava.aspx">Cassava Mosaic Virus Disease</a>) , bananas (<a href="http://www.promusa.org/Xanthomonas+wilt">Banana Xanthomonas Wilt</a>) and wheat (<a href="http://www.fao.org/agriculture/crops/rust/stem/rust-report/stem-ug99racettksk/en/">Wheat Rust Ug99</a>). Outbreaks of these plant diseases can also have devastating effects on livelihoods and economies. </p>
<h2>What is needed?</h2>
<p>Whether disease outbreaks occur in people, plants or animals, countries need surveillance systems that help them detect disease and respond quickly.</p>
<p>There are several key steps and processes that are needed for effective disease surveillance. These include:</p>
<ul>
<li><p>detecting case(s), </p></li>
<li><p>collecting samples, </p></li>
<li><p>conducting lab tests to confirm the disease involved, </p></li>
<li><p>reporting the cases to the relevant authorities, and </p></li>
<li><p>organising and implementing effective responses. </p></li>
</ul>
<p>The international Ebola outbreak in 2014/2015 is a case in point. There were cases of Ebola in several countries, for example in Nigeria, that were effectively controlled because the <a href="http://www.who.int/csr/disease/ebola/one-year-report/nigeria/en/">relevant authorities in Nigeria and neighbouring countries</a> were on high alert and able to respond quickly and effectively. </p>
<p>Key factors in these successes were government level support and preparedness, strong laboratory infrastructure, rigorous and comprehensive contact tracing and follow up at the grassroots level and engagement with the community.</p>
<h2>Strengthening the chain</h2>
<p>One way to build the capacity needed to manage emerging diseases is to focus on diseases that occur regularly and directly affect members of the community where the additional capacity is needed. This approach helps local communities to get involved and stay engaged to achieve sustainable improvements in surveillance.</p>
<p>Rabies is an example of a zoonosis that has been controlled in most countries, though <a href="https://theconversation.com/how-to-end-human-deaths-from-rabies-lessons-from-kenya-84726">challenges still remain</a> in some African countries. International initiatives like <a href="https://rabiesalliance.org/world-rabies-day">World Rabies Day</a> are designed to raise awareness, encourage collaboration, and promote the implementation of disease control measures, such as making dog vaccinations available. </p>
<p>Approaches designed to tackle existing disease threats also provide a way to build the communication platforms, networks, leadership capabilities and trust between those involved in surveillance that are necessary for multiple diseases. </p>
<p>By working to control existing diseases, stronger systems can be built to fill current gaps in global surveillance capacity. These capacity gains make it possible to deal more effectively with new disease threats wherever and whenever they emerge. Successes in disease surveillance and response depend on collaboration, partnerships and trust at individual, institutional and national levels.</p><img src="https://counter.theconversation.com/content/82008/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jo Halliday receives funding from the UK Biotechnology and Biological Sciences Research Council and the UK Zoonoses and Emerging Livestock Systems Initiative (BB/L018845/1). </span></em></p>
By tackling local threats and controlling existing diseases, countries are able to build the capacity needed to deal with future emerging disease threats.
Jo Halliday, Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/84726
2017-09-27T17:04:22Z
2017-09-27T17:04:22Z
How to end human deaths from rabies: lessons from Kenya
<figure><img src="https://images.theconversation.com/files/187797/original/file-20170927-24162-xakosi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Awareness and knowledge about rabies at a local level is key. This can help prevent bites and encourage people to get post-exposure treatment</span> <span class="attribution"><span class="source">Sarah Cleaveland</span></span></figcaption></figure><p>When a person hears about rabies, it’s often not thought of as an immediate personal threat. But rabies kills about <a href="http://www.mirror.co.uk/news/world-news/british-study-discovers-60000-people-5531899">60,000</a> people every year – the majority of deaths are in Africa and Asia.</p>
<p>Rabies is a viral disease transmitted to humans through bites from rabid animals. <a href="https://www.cdc.gov/rabies/">The virus infects</a> the central nervous system ending in the brain, at which point death is inevitable.</p>
<p>This year several major international organisations have, for the second year in a row, endorsed the <a href="http://www.who.int/neglected_diseases/resources/who_htm_ntd_nzd_2016.02/en/">global goal of elimination of human deaths</a> from dog rabies by 2030. It also marks three years since Kenya launched a <a href="http://www.who.int/neglected_diseases/WRD_rabies_2014/en/">strategic plan</a> that would progressively reduce human deaths due to dog rabies to make the country rabies free by 2030. </p>
<p>For Kenya, the focus on rabies was informed by results of an <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161576">exercise</a> that mapped diseases in the country. It placed rabies as one of top five animal diseases that affect people in the country. Rabies is estimated to kill 2,000 people every year in Kenya.</p>
<p>I was involved in drafting Kenya’s <a href="http://zdukenya.org/wp-content/uploads/2012/09/National-Rabies-Elimination-Strategy.pdf">strategy</a> for the elimination of dog-mediated human rabies. I have also been actively involved in its implementation in pilot areas. The strategy is quite straight forward: vaccinate 70% of dogs annually (the level needed to break the dog-dog transmission cycle), provide prompt post-exposure vaccines to people bitten by suspected rabid dogs, and execute a public education and awareness campaign.</p>
<h2>Vaccinating dogs</h2>
<p>Effective vaccines against dog rabies are available in Kenya. But there are several challenges associated with vaccinating dogs. </p>
<p>The first important metric is determining the size of the dog population in the country. Data doesn’t exist. The country did a livestock census as part of a population census in 2009, dogs were left out. The country now has the opportunity to capture the data during the 2019 population census. </p>
<p>We use cross-sectional household surveys to determine the human:dog ratio which allows us in turn to estimate the dog population. On average, across most of Africa the human:dog ratio <a href="http://caninerabiesblueprint.org/IMG/pdf/Link46_HumanDogRatios.pdf">estimate</a> is 8:1 in rural areas and higher in urban areas. Kenya, which has a population of <a href="http://databank.worldbank.org/data/Views/Reports/ReportWidgetCustom.aspx?Report_Name=CountryProfile&Id=b450fd57&tbar=y&dd=y&inf=n&zm=n&country=KEN">48 million</a> people, is estimated to have a dog population of 6 million. To meet the 70% target, this means that 4.2 million dogs needed to be vaccinated consistently to achieve rabies elimination. </p>
<p>Our experience in the pilot areas shows that there are two critical elements to success: the first is that people need to buy into the effort, and secondly that local government needs to provide resources to vaccinate the dogs and provide post-exposure treatment.</p>
<p>Makueni County, where elimination activities started, has put in its own resources and organised vaccination campaigns that reaches 60% of its dog population. </p>
<p>What we have learnt is that dog owners will bring in their adult animals, but likely to leave puppies behind. We also learnt that successful campaigns require innovations such as mapping vaccination points as well as rapid analysis of data to avoid leaving geographical pockets of unvaccinated dogs because if they are large enough they allow the virus to continue circulating. </p>
<p>Recent <a href="https://www.ncbi.nlm.nih.gov/pubmed/27729174">reports</a> suggesting that rabies vaccines remains viable after exposure to elevated temperature, presents opportunities to lower the cost of delivery and reach dogs in remote areas, where maintaining the cold chain is challenging.</p>
<h2>Human vaccines</h2>
<p>Bite victims from rabid dogs are protected from infection if they get post-exposure vaccines promptly. For a disease that poorly competes with other health priorities such as malaria, the availability of rabies vaccines as well as their high cost increases the risk of rabies deaths. </p>
<p>In Kenya, we find that in the absence of surveillance data that reports the number of people bitten, the number of rabies positive dogs, or confirmed human deaths due to rabies, the health care system will rarely prioritise provision of these life-saving vaccines. </p>
<p>By providing data we have found that health system administrators are able to predict demand for human rabies vaccines. It also means that they are able to make a stronger case to their local governments to spend money on rabies vaccines.</p>
<p>Nevertheless, the cost of the vaccines is high. International players could help by <a href="http://www.who.int/rabies/news/Gavis_learning_agenda_drives_change_for_rabies/en/">reducing the cost of purchase and delivery of human vaccines</a>. At a local level, broader health solutions, including universal health coverage, would play a part in ending human rabies deaths.</p>
<h2>Public awareness and education on rabies</h2>
<p>But awareness and knowledge about rabies at a local level is key. This can help prevent bites and encourage people to get post exposure treatment. </p>
<p>The Philippines has included <a href="http://caninerabiesblueprint.org/Ministry-of-Health-and-rabies">rabies education in school curricula</a> of rabies, reaching children who are at the highest risk of rabies. </p>
<p>Kenya is taking steps to increase public awareness through a <a href="http://www.rabiesfreekenya.com">website</a>, on <a href="https://www.facebook.com/rabiesfreeKenya/">Facebook</a> and <a href="https://twitter.com/RabiesFreeKenya">Twitter</a> as well as media adverts and talks on rabies prevention and control. This year, for the first time, the 2017 World Rabies Day will be celebrated with a 10km run for rabies in the city of Kisumu accompanied by dog vaccination campaigns in the county. These activities provide opportunities to engage with the public and pass rabies prevention messages.</p>
<p>Ultimately rabies elimination will be achieved through mass community action and a concerted effort by government to provide dog and human vaccines. Every death from rabies is vaccine preventable and failure to prevent it, is a public health failure. The 2030 goal is a commitment to end human suffering from a disease that can be stopped and eliminated.</p><img src="https://counter.theconversation.com/content/84726/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thumbi Mwangi receives funding from the Wellcome Trust Foundation and the World Health Organization for research on rabies.</span></em></p>
The strategy to eliminate human rabies is straight forward: vaccinate dogs, provide prompt post-exposure vaccines, public education and awareness on prevention.
Thumbi Mwangi, Clinical assistant professor, Washington State University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/76328
2017-05-10T13:38:19Z
2017-05-10T13:38:19Z
Battling to save the Ethiopian wolf – Africa’s rarest carnivore
<figure><img src="https://images.theconversation.com/files/168706/original/file-20170510-28055-1bkjxnj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Tight social bonds help Ethiopian wolves protect their families and territories.</span> <span class="attribution"><span class="source">© by lorenzfischer.photo</span></span></figcaption></figure><p>Most members of the Canidae family, such as wolves, dogs and foxes, are versatile and opportunistic animals, thriving in many habitats and some even living in urban and suburban settings. In contrast, Ethiopian wolves are highly <a href="http://ethiopianwolf.org/wolves">specialised</a> to life in the <a href="http://wwf.panda.org/about_our_earth/ecoregions/ethiopian_highlands.cfm">Ethiopian highlands</a>. Also called the “Roof of Africa”, it <a href="https://www.worldwildlife.org/ecoregions/at1008">encompasses</a> 80% of Africa’s land above 3,000m.</p>
<p>They are remarkable rodent hunters, with long muzzles and slender legs. Their tight social bonds help them protect their precious family territories from competitors. For a canid of their size (about 14-20kg - the weight of a medium-sized dog), Ethiopian wolves are unique at surviving on small prey (most highland rodent species weigh less than 100g) and are solitary foragers. With their striking red coats and black and white markings, they appear physically distant from their closest relative, the grey wolf.</p>
<p>These qualities made them successful colonisers of an expanding ecosystem as the African glaciers retreated during the end of the <a href="http://www.livescience.com/40311-pleistocene-epoch.html">last ice age</a>, but paradoxically have contributed to their demise. </p>
<p>Due to a warming continent, in the last 100,000 years the tree line has gone up by 1,000m encroaching on open <a href="http://www.goodreads.com/book/show/4647977-island-africa">Afroalpine grasslands and meadows</a>. Due to the pressure of humans, livestock and domestic dogs, the wolves are now restricted to tiny mountain pockets on either side of the Great Rift Valley and are constantly being pushed up the slopes.</p>
<p>Although they were never particularly common, today there are <a href="http://www.iucnredlist.org/details/3748/0">fewer than</a> 500 adult wolves in the mountains of Bale, Arsi, Simien and Wollo, over half of whom are harboured within the <a href="http://balemountains.org/">Bale Mountains National Park</a>. This makes them Africa’s rarest, and most threatened carnivore species. As an indication this is 10 times fewer than <a href="http://www.iucnredlist.org/details/12436/0">African wild dogs</a> and fifty times rarer than <a href="http://www.iucnredlist.org/details/15951/0">lions</a>.</p>
<p>But there is hope. The <a href="http://ethiopianwolf.org/">Ethiopian Wolf Conservation Programme</a> and its Ethiopian partners continue to put all their strength into fighting the wolves’ various challenges through awareness, education and science-led approaches to disease and population management. </p>
<h2>The challenges</h2>
<p>The challenges they face are diverse.</p>
<p>It’s not for lack of food that wolf numbers are small. Their environments harbour a particularly high rodent biomass, some <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2028.1995.tb01041.x/abstract">3,000kg of rats</a> per km2 in some meadows. The wolves live in large family packs, where all patrol and scent mark the boundaries of small communal territories. This protects their rich food patches from neighbouring wolves and other carnivores such as spotted hyenas and jackals.</p>
<p>The most immediate and real <a href="http://www.ethiopianwolf.org/threats">threat</a> to wolves is in fact domestic animals. While many highland wildlife species have been able to coexist with highland shepherds and their livestock, domestic dogs bring an additional challenge.</p>
<p>The dogs not only compete for food but, as dogs and wolves are inexorably drawn to each other and interact, dogs transmit rabies and canine distemper virus to their wild cousins. This has the potential to decimate wolf populations in a short period of time. In extreme cases dogs may even mate and hybridise with the wolves, threatening the genetic integrity of this rare and endemic canid.</p>
<p>Disease ultimately determines the dynamics of the last remaining wolf havens. Three out of four wolves typically die in populations <a href="http://onlinelibrary.wiley.com/doi/10.1111/acv.12036/abstract">hit by outbreaks</a>, and may result in local extinctions. </p>
<p>In the last three years, populations in the Bale Mountains <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4412237/">have endured</a> back-to-back rabies and distemper outbreaks. Smaller populations are at even greater risk. At the end of last year disease decimated the <a href="http://ethiopianwolf.org/news#let-s-save-the-wolves-of-delanta">smallest wolf population</a> in Wollo, now feared on the brink of extinction.</p>
<p>The other great threat to the wolves is Ethiopia’s a changing landscape due to farming. Expanding populations and the need for arable land bring about an <a href="https://doi.org/10.1017/S0030605303000139">incessant pressure</a> on natural habitats. </p>
<p>By and large the people that live in the Ethiopian highlands are relatively <a href="https://news.mongabay.com/2009/11/saving-the-worlds-rarest-wolf/">tolerant of wildlife</a>, but their priority is survival. Unless their livelihoods can be brought into line with sustainable practices, the meadows and moors they need for grazing, to gather firewood and tend their crops, will soon be degraded to bare rock. </p>
<h2>Bouncing back</h2>
<p>Nevertheless, there are reasons to be optimistic about the future of the Ethiopian Wolf. In the <a href="http://www.ethiopianwolf.org/">Bale Mountains the Ethiopian Wolf Conservation Programme</a> have vaccinated over 80,000 dogs to prevent rabies getting across to wolves. And when the deadly virus strikes, swift interventions to vaccinate the wolves have taken place. </p>
<p>There are early signs that the wolves in Bale are bouncing back. By the end of January, nearly all of 18 focal packs monitored – and most recently vaccinated – had bred successfully. As many as seven pups were born to a dominant female and there were over 80 healthy pups located in the Bale Mountains alone. It was also encouraging to see some of the larger packs split, increasing the number of breeding families.</p>
<p>In a shift from <a href="https://www.nature.com/nature/journal/v443/n7112/full/nature05177.html">reactive vaccination</a> of Ethiopian wolves following outbreaks to a preventive approach, an oral vaccine <a href="https://www.ncbi.nlm.nih.gov/pubmed/27543453">has been</a> trialled. This will offer protection from future rabies outbreaks.</p>
<h2>More to be done</h2>
<p>Rare, ecological specialists such as these wolves, will continue to be threatened as environments change and human populations grow. That means that heavy intervention is needed to secure their survival. </p>
<p>A critical factor in their preservation is the commitment and dedication to finding common ground between the needs of people and wildlife. For example, Ethiopia’s long-term conservation view is that within protected areas there should be no domestic dogs. More can be done to facilitate this, such as improved night protection for people’s livestock with predator-proof enclosures. This would reduce their dependence on guard dogs and, in time, reduce the negative impact of dogs on wild carnivores.</p>
<p>Another key intervention would be to implement a <a href="https://www.researchgate.net/publication/313093956_The_Role_of_Metapopulations_in_Conservation">metapopulation management</a> paradigm under which isolated populations are treated as part of a single (or meta) population and animals are trans-located between them. This enables recovery and a healthy flow of genes. </p>
<p>In the meantime, our vaccination work brings us closer to the local communities and provides a channel of communication to transmit our environmental education message.</p><img src="https://counter.theconversation.com/content/76328/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Claudio Sillero receives funding from the Born Free Foundation, Wildlife Conservation Network, Fondation Segré, Ethiopian Public Health Institute, UK Animal Plant Health Authority, US Fish & Wildlife Agency, and others. He is Head of Conservation of the Born Free Foundation and Chair of the IUCN SSC Canid Specialist Group. </span></em></p>
A critical factor in the preservation of the Ethiopian wolf is the commitment and dedication to finding common ground between the needs of people and wildlife.
Claudio Sillero, Associate Professor of Conservation Biology, Deputy Director of the WildCRU, University of Oxford
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/62074
2016-07-13T09:42:14Z
2016-07-13T09:42:14Z
How deadly is your dog’s saliva?
<figure><img src="https://images.theconversation.com/files/130084/original/image-20160711-9274-1ggwk8b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&autocomplete_id=&searchterm=dog%20drool&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=124096453">Amy Rene/Shutterstock</a></span></figcaption></figure><p>An elderly lady and her pet Italian greyhound – sounds like the lovely opening to a sweet story doesn’t it? The story, however, is rather dark. According to a recent <a href="http://casereports.bmj.com/content/2016/bcr-2016-215450">medical case report</a>, the greyhound was the likely source of an infection resulting in a lengthy hospital stay and potentially fatal sepsis. Thankfully, this particular patient survived, but the story raises some interesting questions about our increasingly close relationship with the domestic dog. </p>
<p>The bug responsible was <em>Capnocytophaga canimorsus</em>, a bacteria commonly found in the mouths of <a href="http://ac.els-cdn.com/S0163445398939184/1-s2.0-S0163445398939184-main.pdf?_tid=a7d88154-4450-11e6-b4fe-00000aacb35f&acdnat=1467902568_4a5d81760a0c4f93018ab722dde7f53d">dogs and cats</a>. It’s estimated that up to three quarters of healthy dogs harbour this bacteria in their mouths. These animals suffer no ill effects and, in truth, humans coming into contact with this bacteria rarely suffer any medical consequences. </p>
<p>But, occasionally, problems might arise, especially if you have reduced immune function. With a reported mortality rate of 30%, awareness of susceptibility to <em>Capnocytophaga canimorsus</em> infection is important for groups who might be at particular risk, such as the elderly. The interesting point about this case is that the patient appeared to have acquired the infection via a lick from her dog and not by a bite as is more <a href="http://ac.els-cdn.com/S1473309909701100/1-s2.0-S1473309909701100-main.pdf?_tid=ceb3c9c0-4449-11e6-8677-00000aab0f6c&acdnat=1467899627_6cc2a4109c715ed1ad172bcbab913ad3">commonly reported</a>.</p>
<p>Where infection is associated with dog bites, the consequences can be extreme, including <a href="http://www.sciencedirect.com/science/article/pii/S0002962915340477">gangrene</a> and <a href="http://www.sciencedirect.com/science/article/pii/S0363502315013659">amputations</a>. The potential for spread of this bacteria from dog licks, which is often perceived as a friendly, bonding gesture by dog owners, might suggest we should re-evaluate how close we get to our dogs’ mouths.</p>
<p>Dog bites have long been associated with illness. <a href="http://www.who.int/mediacentre/factsheets/fs099/en/">Rabies</a> remains responsible for about <a href="http://www.sciencedirect.com/science/article/pii/S0264410X15016783">60,000 human deaths</a> annually, mostly in developing countries. A range of other disease-causing organisms are also known to be transmitted from dogs to humans. Close relationships with our dogs might enhance the transmission of nasties, either <a href="http://www.sciencedirect.com/science/article/pii/S0021997515000523">direct from the dog, or from a contaminated environment</a>. For example, <em>Salmonella</em> causes severe gastrointestinal symptoms and can be acquired by exposure to infected faecal matter. </p>
<p><em><a href="http://cmr.asm.org/content/16/2/265.short">Toxocara canis</a></em> is a parasite that can cause blindness in humans and infection also comes from close contact with infected dog poo. The horrific sounding <a href="http://www.sciencedirect.com/science/article/pii/B9781455748013002927">visceral larva migrans</a> is a rare complication of <em>Toxocara</em> infection, when the larval parasites migrate haphazardly through the body tissues, leaving a trail of damaged tissue in their wake. Equally, there can be few dog owners who haven’t experienced the minor, short-lived irritation of a flea bite. </p>
<h2>On the positive side</h2>
<p>So, how healthy is our relationship with our pet dogs? Many reports detail the diverse benefits of dog ownership, from <a href="http://www.sciencedirect.com/science/article/pii/S1469029216300048">physical activity benefits</a> to their ability to improve and promote <a href="http://www.sciencedirect.com/science/article/pii/S1936657415000989">social interactions</a>. There are even historical accounts of dogs being encouraged and trained to lick human wounds to <a href="http://www.sciencedirect.com/science/article/pii/014067369290480Q">encourage healing</a>. The scientific validity of this method might be questionable, but anecdotal reports remain about the <a href="http://www.sciencedirect.com/science/article/pii/S0140673670916508">potential healing value of canine saliva</a>.</p>
<p>Dogs are increasingly being used as therapy animals in hospitals, hospices and other medical facilities. This is much more about their physical and behavioural attributes than their wound healing ability, however. In these environments it is important that infection control is high, both for the benefit of the patient and the <a href="http://www.sciencedirect.com/science/article/pii/B9780128012925000262">welfare of the visiting dog</a>. With good hygiene, transmission of diseases can be kept to a minimum and, despite this recent report, the value of dogs as companions and therapeutic interventions probably <a href="http://ac.els-cdn.com/S0196655311003312/1-s2.0-S0196655311003312-main.pdf?_tid=75d4dc7a-445f-11e6-9ecf-00000aacb361&acdnat=1467908927_fa2a2f346bf018641e68b088d899353f">outweighs the risk</a>.</p>
<h2>Dogs, how deadly is your human?</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/130370/original/image-20160713-12386-4h285u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/130370/original/image-20160713-12386-4h285u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=480&fit=crop&dpr=1 600w, https://images.theconversation.com/files/130370/original/image-20160713-12386-4h285u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=480&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/130370/original/image-20160713-12386-4h285u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=480&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/130370/original/image-20160713-12386-4h285u.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=603&fit=crop&dpr=1 754w, https://images.theconversation.com/files/130370/original/image-20160713-12386-4h285u.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=603&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/130370/original/image-20160713-12386-4h285u.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=603&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Disease spread is a two-way street.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/s/person+kissing+dog/search.html?page=3&thumb_size=mosaic&inline=398121412">Irina Kozorog/Shutterstock</a></span>
</figcaption>
</figure>
<p>We cannot ignore the fact that we also transmit pathogens to our dogs. <a href="http://www.who.int/entity/neglected_diseases/zoonoses/en/index.html">Zoonotic diseases</a> are those that can be spread from humans to animals and back again. Studies have demonstrated that dogs can carry <a href="http://ac.els-cdn.com/S019567010400516X/1-s2.0-S019567010400516X-main.pdf?_tid=d268c94c-445f-11e6-8093-00000aacb360&acdnat=1467909082_bc45ab5579840b61f43806270b158de7">multi-drug resistant strains of bacteria</a>, many of which have probably been transmitted to them by humans. We have a responsibility for minimising infection risk – yes from our dogs but also to our dogs.</p>
<p>So, should you worry about your dogs’ deadly saliva? In general no, although these rare stories are often a timely reminder that while we often share our lives, homes and sometimes our beds with our dogs, they can harbour “partners” that might not be such ideal companions for us. </p>
<p>The next time your dog tries to lick your face, instead of worrying about_ Capnocytophaga canimorsus_ infection, it might be more prudent to think about what your dog last licked – that might be a scarier consideration.</p><img src="https://counter.theconversation.com/content/62074/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jacqueline Boyd is a member of The Kennel Club's Activities Health and Welfare Sub-Group and is employed as a lecturer in Animal Science by Nottingham Trent University.</span></em></p>
A woman developed sepsis after she was licked by her pet greyhound.
Jacqueline Boyd, Lecturer in Animal Science, Nottingham Trent University
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/60603
2016-06-08T05:35:01Z
2016-06-08T05:35:01Z
How to stop vampire bats wreaking havoc (no stakes or garlic required)
<figure><img src="https://images.theconversation.com/files/125571/original/image-20160607-15049-6lhmjk.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Daniel Streicker/Julio Benavides</span></span></figcaption></figure><p>During the darkest hours of the night, they fly and hunt for prey. They live in caves and ruined buildings and have to drink blood every night to survive. They can bite with their fangs without you even noticing. No wonder these bats are called vampires. Yet when it comes to coping with these bloodthirsty creatures, the good news is that a breakthrough could finally be in sight. </p>
<p>Vampire bats only live in one part of the world – which is a relief, unless you happen to be in Latin America. They exist between northern Mexico and northern Chile, and they are a major problem. They are now the <a href="http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892009000300010">main cause</a> of human deaths from rabies in the region. </p>
<p>Between 2009 and 2013, vampire bats bit 20,000 people in Peru alone, according to the country’s health minister; and in communities across the Amazon, where bites are commonplace, the rate of rabies infection <a href="http://www.ncbi.nlm.nih.gov/pubmed/9025698">could be</a> almost as high as 1% per year. At least 12 children were killed by rabies earlier <a href="http://www.dailymail.co.uk/news/article-3440814/Rabies-spread-bats-kills-12-Peruvian-Amazon.html">this year</a> in a single outbreak. </p>
<p>Meanwhile, <a href="http://www.sciencedirect.com/science/article/pii/S0168170205000705">farmers lose</a> a few thousand livestock every year – or perhaps many more, since the worst-hit remote communities almost certainly under-report infection rates. We found that about 70% of farms in the Andes have at least one animal bitten regularly. </p>
<p>The virus is also steadily expanding into areas that were historically free of the disease, as we discovered through our <a href="http://rspb.royalsocietypublishing.org/content/283/1832/20160328">recent work</a> in Peru. As many as 12 new governmental districts become infected per year on average, which has doubled the number of outbreaks at national level. We found that the virus invades new areas in waves that advance at between 10km and 20km per year. The advance is stalled only by tall mountains that rise above the altitudes where bats thrive. </p>
<p>We don’t know what has sparked the spread of rabies into new territories, but one possibility is that bats nowadays have access to more livestock and man-made structures for roosting. This could be making it possible to allow the disease to spread by connecting previously isolated populations. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/125515/original/image-20160607-15031-1d2fdds.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/125515/original/image-20160607-15031-1d2fdds.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/125515/original/image-20160607-15031-1d2fdds.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/125515/original/image-20160607-15031-1d2fdds.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/125515/original/image-20160607-15031-1d2fdds.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/125515/original/image-20160607-15031-1d2fdds.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/125515/original/image-20160607-15031-1d2fdds.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/125515/original/image-20160607-15031-1d2fdds.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Vampire bats have sharp teeth for feeding on blood.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&language=en&ref_site=photo&search_source=search_form&version=llv1&anyorall=all&safesearch=1&use_local_boost=1&autocomplete_id=&searchterm=vampire%20bats&show_color_wheel=1&orient=&commercial_ok=&media_type=images&search_cat=&searchtermx=&photographer_name=&people_gender=&people_age=&people_ethnicity=&people_number=&color=&page=1&inline=376769797">Wikimedia</a></span>
</figcaption>
</figure>
<h2>Breaking the waves</h2>
<p>We are pleased to report that the waves of rabies in bats move quite predictably. This makes it possible to forecast in some areas when and where the virus is likely to strike next. With this information, which has not been known until now, the authorities in Peru will have the option of anticipating their arrival, allowing them to vaccinate the animals and people before deaths begin. </p>
<p>This would be a big shift from the norm, where livestock and people typically get vaccinated only after an outbreak has been declared. Assuming the virus behaves in the same way in other countries, the same approach could be adopted across Latin America. </p>
<p>Having said that, vaccinating animals and people does nothing to prevent the spread of the virus. It only saves the recipients of vaccines from dying. If you want to stop the virus, you have to tackle the source of the transmission – the bats themselves. </p>
<p>Since the 1970s, Latin American governments’ answer has been bat culls. Yet there is no <a href="http://onlinelibrary.wiley.com/doi/10.1046/j.1439-0450.2003.00713.x/full">convincing evidence</a> that this has made a substantial difference, and it may even have been counterproductive – by <a href="http://rspb.royalsocietypublishing.org/content/early/2012/06/07/rspb.2012.0538.short">mainly targetting</a> adult bats that are already immune and <a href="http://www.pnas.org/content/110/51/20837.abstract">provoking bats</a> to disperse between roosts, it might have hastened the spread of the disease. </p>
<p>Governments across the world have been <a href="http://www.ncbi.nlm.nih.gov/pubmed/15742629">very successful</a> at using mass-vaccination programmes to curb rabies in dogs and other key carrier species such as foxes and raccoons, but this has never been attempted on a large scale with vampire bats. This is despite the fact that an effective vaccine is now an option. Researchers in <a href="http://www.ncbi.nlm.nih.gov/pubmed/9682368">Mexico</a> and <a href="http://www.ncbi.nlm.nih.gov/pubmed/18761044">Brazil</a> have shown that you can prevent bats in captivity from catching rabies by giving them an orally transmitted gel that has been impregnated with the vaccine. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/125570/original/image-20160607-7438-1g0bp43.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/125570/original/image-20160607-7438-1g0bp43.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/125570/original/image-20160607-7438-1g0bp43.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=448&fit=crop&dpr=1 600w, https://images.theconversation.com/files/125570/original/image-20160607-7438-1g0bp43.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=448&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/125570/original/image-20160607-7438-1g0bp43.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=448&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/125570/original/image-20160607-7438-1g0bp43.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=563&fit=crop&dpr=1 754w, https://images.theconversation.com/files/125570/original/image-20160607-7438-1g0bp43.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=563&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/125570/original/image-20160607-7438-1g0bp43.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=563&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Rabies spreads among bats by bites.</span>
<span class="attribution"><span class="source">Daniel Streicker</span></span>
</figcaption>
</figure>
<p>Whether this would work with wild bats is another matter, of course. All the biological and ethical challenges inherent in any wildlife vaccination campaign are likely to apply, not to mention the logistical challenge of remote landscapes in the Andes and Amazon. </p>
<p>But our findings on the way that the disease spreads in waves among bats could change the game here, too: rather than seeking to eliminate rabies from all vampire bats in endemically infected areas, we could try to halt the spread into new areas instead. </p>
<p>It is also important to galvanise interest in bat vaccination among public health officials and conservationists for other reasons. As well as rabies, bat populations are thought to spread other diseases such as <a href="http://www.who.int/mediacentre/factsheets/fs103/en/">Ebola</a> and <a href="http://www.batcon.org/index.php/our-work/regions/usa-canada/address-serious-threats/wns-intro">white-nose syndrome</a> in other parts of the world. </p>
<p>Given that vampire bat rabies has a major impact on human lives and livestock, and we now have both an effective vaccine and a better understanding of how it spreads, we believe this is the right starting point to inspire a new generation of disease control strategies for bats. It is surely something we could all get our teeth into.</p><img src="https://counter.theconversation.com/content/60603/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julio Benavides receives funding from The UK – Peru CONCYTEC Fund for Science and Innovation. He is the vice-president of the not-for-profit group Apes Incorporated.</span></em></p><p class="fine-print"><em><span>Daniel Streicker receives funding from the Wellcome Trust, the Royal Society, the Beit Trust, National Geographic, the UK-Peru CONCYTEC Fund for Science and Innovation and the Leverhulme Trust</span></em></p>
They kill thousands of animals and people every year by spreading rabies. New research findings could solve the problem.
Julio Benavides, Research Associate, University of Glasgow
Daniel Streicker, Research Fellow, University of Glasgow
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/58952
2016-05-20T15:34:31Z
2016-05-20T15:34:31Z
The ‘beating heart’ of the flu virus – and why scientists want to commandeer it
<figure><img src="https://images.theconversation.com/files/122482/original/image-20160513-10679-13bnb0c.png?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Influenza virus.</span> <span class="attribution"><span class="source">Ed Hutchinson/University of Glasgow</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>All it takes is a sneeze. A few days later, you wake up with a fever, a sore throat and a headache. By lunchtime, your nose is running and your muscles hurt. You <a href="https://theconversation.com/five-common-misconceptions-about-seasonal-flu-35683">have the flu</a>. The annual vaccination that you may have received should have stopped the virus, but it was one step ahead and mutated, making the vaccine ineffective. How? Well, there is an enzyme that the flu virus uses to copy itself – its “beating heart” – and create mutations. And understanding how this enzyme works is crucial in our attempts to treat and prevent flu. </p>
<p>Influenza is an RNA virus, a notorious group of pathogens that cause diseases like SARS, measles, Ebola and rabies. It also comes in many different subtypes that can mix and match their genetic material to create new strains. Add to this a rapid mutation rate and you have a pathogen capable of infecting tens of millions of people every year. Up to 5m of these infections result in severe illness and <a href="http://www.who.int/mediacentre/factsheets/fs211/en/">half a million are fatal</a>, particularly in more vulnerable populations like the elderly. Pandemic strains, which are caused by viruses that have never been seen before and to which there is no existing immunity, are even more lethal. </p>
<h2>Blueprint for trouble</h2>
<p>A virus is essentially just genetic material – its genome – contained within a protein coat. When an influenza virus infects a cell, its first goal is to copy the genome. Copies of the genetic material can then be used as a blueprint for making new viral proteins and new genomes can be assembled with new proteins into new viruses. The scale at which this happens is enormous, with a single infection producing millions of new viruses. These can next spread to other cells in your body or to a new victim. </p>
<p><a href="http://link.springer.com/article/10.1007%2Fs00018-014-1695-z">RNA polymerase</a>, the enzyme that is crucial to this process, copies the genome of the influenza virus one unit of information (or nucleotide) at a time. Almost no information is lost during this copying process but it isn’t perfect, and roughly once per copy the enzyme makes a mistake and puts the wrong nucleotide in the wrong place. One mistake per copy of the genome may seem insignificant because it only results in small changes in viral proteins. But consider the millions of copies that a single virus produces and multiply that by the thousands of cells in your respiratory tract – suddenly one error per copy has become a swarm of mutant viruses.</p>
<p>Most countries have vaccine programmes to stop the spread of influenza viruses and many also stockpile drugs such as oseltamivir (Tamiflu) to treat severe cases or fight pandemic flu. However, vaccines and drugs become effectively useless when influenza viruses acquire mutations in the viral proteins that the immune system recognises or that antiviral drugs bind to. RNA polymerase errors are a key reason why new vaccines are needed every year. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/122344/original/image-20160512-16407-72g7ud.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/122344/original/image-20160512-16407-72g7ud.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/122344/original/image-20160512-16407-72g7ud.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/122344/original/image-20160512-16407-72g7ud.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/122344/original/image-20160512-16407-72g7ud.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/122344/original/image-20160512-16407-72g7ud.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/122344/original/image-20160512-16407-72g7ud.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Many stock up on Tamiflu.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/dl2_lim.mhtml?src=g9BQj-3mS2vQ1Y_iNnT00w-1-0&clicksrc=download_btn_inline&id=170422580&size=medium_jpg&submit_jpg=">Stuart Monk/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Universal vaccines are potentially a solution because they can, in theory, trigger an immune response against all influenza subtypes. However, these vaccines <a href="https://theconversation.com/a-universal-flu-vaccine-is-still-some-time-off-18525">are still in development</a>. Vaccines and drugs also can’t prevent influenza viruses from mutating, which can only be done if we manage to understand and stop the RNA polymerase. Alternatively, we could exploit the enzyme and force it to make so many errors that it destroys the flu virus altogether – something that has worked for <a href="http://www.nature.com/nm/journal/v6/n12/full/nm1200_1375.html">other viruses</a> such as hepatitis C.</p>
<h2>Snapshots and new targets</h2>
<p>In order to cripple the RNA polymerase we need to understand its structure, because that tells us how it pumps out new copies of the influenza genome. Over the last decade, a number of research groups have published views of small fragments of the polymerase. But only recently, work from the <a href="http://www.nature.com/nature/journal/v516/n7531/full/nature14008.html">Cusack lab</a> in Grenoble and the <a href="http://www.nature.com/nature/journal/v527/n7576/full/nature15525.html">Fodor lab</a> in Oxford revealed the structure of the entire polymerase, as well as the balletic movements of the flexible parts of the enzyme for the first time.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/QaSe8p1iD1o?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>So what’s next? Using a combination of structural, biochemical and biophysical techniques we are now <a href="http://www.nature.com/articles/nmicrobiol201629">beginning to understand</a> how the enzyme interacts with the viral genome and which parts of the enzyme are important during different stages of the copying process. Hopefully, this will allow researchers to find its weaknesses, exploit them and give us a drug that can help effectively treat flu and get rid of it once and for all.</p><img src="https://counter.theconversation.com/content/58952/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Aartjan te Velthuis receives funding from the Wellcome Trust and the Netherlands Organisation for Scientific Research (NWO). </span></em></p><p class="fine-print"><em><span>Nicole Robb receives funding from the Medical Research Council.</span></em></p>
Understanding how the flu virus copies itself could open a way to killing it.
Aartjan te Velthuis, Wellcome Trust Fellow, University of Oxford
Nicole Robb, Research scientist, University of Oxford
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/57670
2016-04-13T09:59:28Z
2016-04-13T09:59:28Z
New weapon in war on rabies: mobile phones
<figure><img src="https://images.theconversation.com/files/118544/original/image-20160413-23605-z72iyc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Rabies rates are rising in Africa</span> <span class="attribution"><a class="source" href="https://theconversation.com/rabies-a-global-killer-that-dog-jabs-can-eliminate-32289">Andy Wagstaffe</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Outside Dr Chibonda’s clinic in a remote village in the rural heartland of Tanzania, seven families sit waiting anxiously. One mother is with her teenage daughter and two young sons, and finding it particularly difficult to hide her fear. A few days ago, she and her children were bitten by their neighbour’s dog, which has not been seen since. Last month, she was at a funeral in the next village for her friend’s eight-year-old son. That little boy had died of rabies.</p>
<p>All these families are waiting to see whether the doctor’s colleague makes it back in time from the capital, Dar es Salaam, with rabies vaccines. On this occasion the vaccines come through, but there are never guarantees. It is a four-day round trip and it is not easy getting the money together to buy them privately. In the past, Dr Chibonda advised families to go and buy the vaccine themselves, but then one parent returned with her comatose child. That was in 2008 and he is still haunted by it. </p>
<p>Tens of thousands of people die from Rabies each year – one every ten minutes. It <a href="http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003709">kills more</a> people in sub-Saharan Africa than anywhere else besides India, and rates <a href="http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0000626">have been increasing</a> in Africa. Once symptoms begin, death is inevitable within ten days. Muscle control deteriorates; the pain is excruciating and victims lapse between lucidity and severe agitation. Lucid patients are well aware of what the future holds and that nothing more can be done. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/118403/original/image-20160412-15875-tk8s3g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/118403/original/image-20160412-15875-tk8s3g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/118403/original/image-20160412-15875-tk8s3g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=902&fit=crop&dpr=1 600w, https://images.theconversation.com/files/118403/original/image-20160412-15875-tk8s3g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=902&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/118403/original/image-20160412-15875-tk8s3g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=902&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/118403/original/image-20160412-15875-tk8s3g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1134&fit=crop&dpr=1 754w, https://images.theconversation.com/files/118403/original/image-20160412-15875-tk8s3g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1134&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/118403/original/image-20160412-15875-tk8s3g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1134&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Surveillance records in Tanzania medical office.</span>
<span class="attribution"><span class="source">Kate Hampson</span></span>
</figcaption>
</figure>
<p>In low-income countries in Africa, vaccines are often out of stock in rural clinics such as Dr Chibonda’s. The problem is not a lack of vaccines per se, but a supply chain that is not responsive to demand because there are no electronic records and monitoring systems are virtually non-existent. The information available to the authorities tends to <a href="https://theconversation.com/rabies-a-global-killer-that-dog-jabs-can-eliminate-32289">reveal only</a> the tip of the iceberg. And this is not just a problem for rabies, but for essential medical supplies in general. </p>
<p>Mobile phones look like the answer to this information problem. Many sub-Saharan countries went through a technological revolution in the early 2000s when mobile phones arrived, leapfrogging landlines as the commonest communications tool. Over 97% of Tanzanians now <a href="http://link.springer.com/article/10.1007%2Fs11205-006-9079-x">have access to a mobile phone</a>. While most clinics do not have a computer, every health worker has a mobile. </p>
<h2>The app</h2>
<p>A few years ago, former University of Glasgow PhD researcher Zac Mtema developed an application for <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002002">rabies monitoring</a> that could run on the most basic handsets (less than 5% of health workers in Tanzania <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002002">own</a> a smart phone). It lets health workers record information on patients with animal bites and their treatment using a simple form; while veterinary workers can submit records on outbreaks and dog vaccinations. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/VgFlw1y_i68?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>All this information goes to a website that is accessed by government staff. It lets them see where dog bites are occurring, where stocks are running low and where not enough dogs have been vaccinated. Equally important, it lets two sets of workers share information in real time in a place where typically lines of communication between sectors are weak. </p>
<p>It is worth stressing the wider potential here: when it comes to diseases that spread from animals to people, such as anthrax and ebola, you need veterinary and health workers to co-operate. In a similar way, controlling diseases spread by mosquitos, such as malaria and zika, depends on the joint efforts of environmental and health workers.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/118537/original/image-20160413-23635-1akfuzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/118537/original/image-20160413-23635-1akfuzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/118537/original/image-20160413-23635-1akfuzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=765&fit=crop&dpr=1 600w, https://images.theconversation.com/files/118537/original/image-20160413-23635-1akfuzk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=765&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/118537/original/image-20160413-23635-1akfuzk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=765&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/118537/original/image-20160413-23635-1akfuzk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=961&fit=crop&dpr=1 754w, https://images.theconversation.com/files/118537/original/image-20160413-23635-1akfuzk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=961&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/118537/original/image-20160413-23635-1akfuzk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=961&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Dr Chibonda (checks) with veterinary workers.</span>
<span class="attribution"><span class="source">Katie Hampson</span></span>
</figcaption>
</figure>
<p>We have just reached the end of a five-year trial of this system in southern Tanzania. It has involved over 300 health and veterinary workers submitting over 30,000 records across an area that is home to several million people. It has supported a WHO-funded <a href="http://www.who.int/rabies/bmgf_who_project/en/">rabies control programme</a> in which the government has been aiming to vaccinate at least 70% of dogs in the 2,000-plus villages across the region every year since 2011. This is part of a <a href="http://www.who.int/rabies/international_conference_dog_mediated_human_rabies/en/">global push</a> to eliminate human deaths from rabies by 2030. </p>
<p>Our results have been very encouraging. Patients reporting to clinics with dog bites have halved over the past five years, and rabies has disappeared entirely from Pemba, an island with a population of over 400,000. Admittedly, it is much easier to eliminate rabies from an island with a small dog population, but the trajectories across the pilot area are promising, too. Dr Chibonda used to see bite patients almost every day, but now sees just one or two a month; and where previously he didn’t even know the veterinary officer in his community, now they call one another and even carry out joint outbreak investigations. </p>
<p>The system may not solve the problem of chronic underfunding, but it helps make the most of the resources available. The fact that the handsets are so familiar and easy to use is almost certainly one of the reasons why it has taken off. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/118408/original/image-20160412-15885-d4p0yi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/118408/original/image-20160412-15885-d4p0yi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/118408/original/image-20160412-15885-d4p0yi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/118408/original/image-20160412-15885-d4p0yi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/118408/original/image-20160412-15885-d4p0yi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/118408/original/image-20160412-15885-d4p0yi.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/118408/original/image-20160412-15885-d4p0yi.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/118408/original/image-20160412-15885-d4p0yi.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Zac Mtema training a healthworker to use the application.</span>
<span class="attribution"><span class="source">Katie Hampson</span></span>
</figcaption>
</figure>
<p>Our programme is an example of “mhealth” – using mobile phones for healthcare. It’s a promising and rapidly growing area, though there are few examples of programmes of <a href="http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002002">this scope and scale</a>. The government has adopted our application as a pilot in the region for rabies prevention. We hope it will be rolled out across Tanzania, where the disease <a href="http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0002510">remains rampant</a>. Elsewhere in the country, it has already been adapted for other uses including monitoring pregnancies and birth complications, as well as for malaria control. </p>
<p>The more that cheap, easy to use, and familiar tools such as ours can become standard practice to support healthworkers, the better equipped they will be to deal with the entrenched disease problems of today – and for epidemics in the future.</p><img src="https://counter.theconversation.com/content/57670/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katie Hampson receives funding from The Wellcome Trust, but this article represents purely her views. </span></em></p>
New initiative with old handsets halves rates of the disease in southern Tanzania – and is being applied to other conditions, too.
Katie Hampson, Reader, University of Glasgow
Licensed as Creative Commons – attribution, no derivatives.
tag:theconversation.com,2011:article/32289
2014-09-30T13:06:32Z
2014-09-30T13:06:32Z
Rabies – a global killer that dog jabs can eliminate
<figure><img src="https://images.theconversation.com/files/60308/original/nbjxdf7q-1411996094.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Time to run.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/damianathegirl/6242104725/sizes/l">Mytoenailcameoff</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span></figcaption></figure><p>Chacha, a farmer and businessman from northern Tanzania, returned home from market one afternoon to find that his family’s newly adopted puppy had bitten five of his children. The puppy had been playful that morning, but by the evening it was clear that its behaviour was abnormal, snapping at any passing movement and running with an awkward disorientated gait. The puppy was euthanised and tested positive for rabies. </p>
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<span class="caption">Strange behaviour.</span>
<span class="attribution"><span class="source">Katie Hampson</span>, <span class="license">Author provided</span></span>
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<p>Chacha then faced a terrible dilemma; at more than US$100, one course of life-saving vaccination was more than his annual income, so Chacha had to choose which of his five children would get the vaccine.</p>
<p>Post-exposure vaccines are the only lifeline guaranteed to prevent the onset of rabies, if delivered promptly following the bite of a rabid animal. But they are not provided for free in most developing countries. These vaccines are very expensive and hard to find, and often <a href="http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0000511">only accessible</a> from capital cities or major urban centres.</p>
<p>Chacha’s dilemma is not unique. More than 50 people are bitten every minute from a rabid dog. Rabies was eliminated in the UK rabies well over a century ago, and if you live in a developed country it is easy to think of it as a disease of history. But every few years, a shocking news story covers a rabies death on home turf, typically acquired by the victim after being bitten by a dog <a href="http://www.ncbi.nlm.nih.gov/pubmed/24708671">while on holiday</a>. In contrast, more than <a href="http://www.who.int/bulletin/volumes/83/5/360.pdf">50,000 people die every year</a> of rabies following a bite by a rabid dog in Africa and Asia, and it is children who are most at risk.</p>
<h2>Unnerving symptoms</h2>
<p>About 20% of bite victims develop rabies, but the probability gets higher the worse the bite, for example from deeper and/or multiple wounds, and the closer it is to the brain and central nervous system. A bite leads to distressing and unnerving symptoms: initial pain and stiffness starts at the site of the wound, followed by fever, delirium, aggression, strange and uncontrollable vocalisations and inevitable and rapid progression to death. It is no coincidence that your classic scary movie (think zombies, werewolves, vampires) shares more than a passing resemblance to rabies. It is a disease that strikes terror into communities and, to this day, without treatment it is the disease that has the <a href="http://www.sciencedirect.com/science/article/pii/S1474442202000418">highest known fatality rate</a> (100%). This makes succumbing to rabies especially traumatic as victims pass in and out of periods of lucidity and understand their condition, but know that there is no hope.</p>
<p>This disease of the nervous system, which causes animals to bite and transmit infection is straightforward to control. Mass vaccination interrupts transmission in the reservoir population, which in developing countries <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2664.2008.01468.x/full">is domestic dogs</a>. </p>
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<span class="caption">Suspect.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/brownpau/3417131624/sizes/l">Brown Pau</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p>Other species are accidental hosts and short-lived chains of transmission may happen in these species. The slight complication is that different rabies (or rabies-related) variants do circulate in bats and some other terrestrial carnivores (for example raccoons in the US), but these pose much less risk to people since we hardly ever touch them. This seems to pose a real psychological barrier as to why people think rabies is actually much harder to control than it is. In fact, if it was eliminated from dogs then the rabies virus that causes more than 99% of human rabies deaths around the world today would disappear entirely. </p>
<p>To do this, we need to reach at least <a href="http://www.plosbiology.org/article/info%3Adoi%2F10.1371%2Fjournal.pbio.1000053">70% of dogs vaccinated</a>, during sustained vaccination campaigns. This is how rabies was eliminated from most industrialised countries. However, the same effort has not been put into dog vaccination in developing countries. Instead, health services strive to provide post-exposure vaccination, but often at great cost to bite victims, such as Chacha’s family.</p>
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<img alt="" src="https://images.theconversation.com/files/60328/original/4mz4wf6k-1412006412.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/60328/original/4mz4wf6k-1412006412.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/60328/original/4mz4wf6k-1412006412.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/60328/original/4mz4wf6k-1412006412.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/60328/original/4mz4wf6k-1412006412.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/60328/original/4mz4wf6k-1412006412.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/60328/original/4mz4wf6k-1412006412.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Collared and vaccinated.</span>
<span class="attribution"><span class="source">Katie Hampson</span>, <span class="license">Author provided</span></span>
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<p>Great strides have been made in the development of human vaccines to prevent rabies. These previously required a series of very painful injections into the stomach, with occasional adverse events that caused serious neurological problems. Human rabies vaccines today are extremely safe (nerve tissue vaccines have been phased out around the world except for a handful of countries), and <a href="http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0000982">new regimens</a> are making them less costly, but they still require repeat hospital visits. The problem remains, though, that not every bite victim gets vaccinated and so deaths continue.</p>
<h2>Doggy vaccines cheaper</h2>
<p>Dog vaccination is a more cost-effective measure to prevent rabies, not least because animal vaccines are much cheaper than human vaccines.</p>
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<img alt="" src="https://images.theconversation.com/files/60309/original/5dqnmf55-1411996566.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/60309/original/5dqnmf55-1411996566.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/60309/original/5dqnmf55-1411996566.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/60309/original/5dqnmf55-1411996566.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/60309/original/5dqnmf55-1411996566.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/60309/original/5dqnmf55-1411996566.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/60309/original/5dqnmf55-1411996566.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Puppy jab.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/us_mission_uganda/5883947885/sizes/l">US Mission Uganda</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
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<p>Eliminating rabies from dogs means that no family, however poor, has to suffer from the panic and anxiety of a suspect exposure. Thanks to millions of dog vaccinations <a href="http://wwwnc.cdc.gov/eid/article/19/4/12-1482_article">delivered every year</a> rabies is close to being eliminated from the entire American continent. It was eliminated from dogs in North America several decades ago, but occasional reintroductions occurred across the Mexico border every few years. Cases in Latin America and the Caribbean have been <a href="http://rstb.royalsocietypublishing.org/content/368/1623/20120143">declining every year</a>. The only places with continued transmission are the poorest (Haiti and Bolivia), which tells you a great deal about what rabies elimination actually requires. But the situation in the Americas serves as an excellent example of just what is possible, given financial and political commitment. </p>
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<img alt="" src="https://images.theconversation.com/files/60330/original/y8nf8d2w-1412006586.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/60330/original/y8nf8d2w-1412006586.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/60330/original/y8nf8d2w-1412006586.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/60330/original/y8nf8d2w-1412006586.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/60330/original/y8nf8d2w-1412006586.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/60330/original/y8nf8d2w-1412006586.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/60330/original/y8nf8d2w-1412006586.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Community co-opted.</span>
<span class="attribution"><span class="source">Katie Hampson</span>, <span class="license">Author provided</span></span>
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<p>The <a href="http://rabiesalliance.org/">Global Alliance for Rabies Control</a> is advocating just such a strategy for developing countries where rabies remains endemic in domestic dogs. However, linking the fragmented (underfunded) veterinary sector with the similarly fragmented human health sector in the parts of the world where rabies is most prevalent <a href="http://www.sciencemag.org/content/345/6204/1562.summary?rss=1">requires</a> capital investment for rabies vaccination to become a obligatory part of routine veterinary services, as well as community ownership and political momentum. Nonetheless it is possible, we just need to mobilise political will. </p>
<h2>One happy ending</h2>
<p>Luckily for Chacha’s family, they all managed to get vaccines. Because of the incidence of rabies the local government had recently requested more vaccines stock. These had just arrived when Chacha made it to hospital and were given out free. So, amazingly, Chacha’s family got their first vaccine doses for free and he was later able to sell a cow to raise money for subsequent doses. It was a happy ending for this family, however it is unusual. But being rabies free can become a reality for others with increased dog vaccinations.</p><img src="https://counter.theconversation.com/content/32289/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Katie Hampson receives funding from The Wellcome Trust.</span></em></p>
Chacha, a farmer and businessman from northern Tanzania, returned home from market one afternoon to find that his family’s newly adopted puppy had bitten five of his children. The puppy had been playful…
Katie Hampson, Wellcome Trust Research Fellow, University of Glasgow
Licensed as Creative Commons – attribution, no derivatives.