Vaccines remain one of the most successful public health interventions of all times.
Rabies, arguably one of the deadliest infectious diseases, killing nearly every known person that shows clinical signs of the disease, has had an effective vaccine for more than a century. Rabies is a neglected tropical disease. Typically, these diseases are not common at health facilities so they are not the first diseases healthcare workers think of when a patient seeks health services. Yet appropriate and immediate treatment are critical for saving lives from rabies.
The Zoonotic Disease Unit at the Ministry of Health and Ministry of Agriculture estimates 2,000 people die annually from rabies in Kenya.
It is caused by a virus mainly transmitted to humans through bites from infected dogs. Once the virus is introduced through a bite or scratch by an infected animal, the virus finds its way to the brain where it multiplies, and symptoms of the disease are manifested. Unfortunately, a majority of rabies deaths are in children because they are more likely to play with dogs, and when bitten, tend not to report to their parents for action.
After a dog bite, it is a race against time to prevent the virus from travelling from the bite wound to the brain of the patient – a stage of the disease that has no known cure and death follows, with the most horrifying symptoms.
Critical steps after bite
With this risky bite, there are two critical steps that need to happen in quick succession to prevent disease that leads to death; This includes thorough wound washing with clean running water for at least 15 minutes and the administration of an immediate injection of the rabies vaccine on the day of the bite, followed by multiple follow-up injections in the next 28 days.
A recent study showed that many healthcare workers rarely suspect rabies among bite patients, and were not fully informed of the latest World Health Organization (WHO) recommendations on the treatment of patients presenting with dog bites.
The WHO recommends that the rabies vaccine be given under the skin as an effective and dose-saving route compared to injecting the vaccine into muscles - which is equally effective but requires five volumes more of the vaccine. By adopting this dose-saving route, the healthcare system can serve up to five times more bite patients for the same vaccine amount that treats one patient.
Rabies control and elimination requires concerted efforts by the government, private sector and the community. By providing the rabies vaccine for both humans and animals, and creating awareness amongst healthcare workers and the community, we work towards national and global goals of ending preventable deaths from human rabies by 2030.
The writer is a veterinarian, epidemiologist and infectious disease PhD fellow at Washington State University and the University of Nairobi