More than 59,000 people still die from the terrifying disease, mostly in Africa and Asia, but vaccinating dogs can eliminate the threat.
Dr. Guy Palmer isn’t kidding when he says he got his start in veterinary medicine doing grunt work at a rabies research lab.
The only way to diagnose the deadly virus is to examine an animal’s brain. So Palmer’s job in 1974 was to pick up shipments of dog, skunk and cow heads at the bus depot and cut them open with a hacksaw.
Canine rabies was rare in the United States even back then, and has since been effectively wiped out.
But the disease continues to kill more than 59,000 people every year, mostly in Africa and Asia, said Palmer, founding director of the Paul G. Allen School for Global Animal Health at Washington State University.
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Now, he and his colleagues are working to extend the successes in the developed world to the rest of the globe with the goal of eliminating rabies in dogs by 2030. They’re also enlisting American veterinarians and pet owners in the fight, starting in Seattle.
“It’s not rocket science,” Palmer said. “We have all the tools we need.”
Since 99 percent of human rabies infections are from dog bites, the key is vaccinating enough dogs to shut down the spread of the virus.
It sounds daunting, but recent pilot projects prove it can be done — even in rural African communities.
“There was an attitude that these countries are too poor and too disorganized to possibly control rabies,” Palmer said. “That’s just not true.”
For more than a decade, he and a team of WSU veterinarians have been conducting regular vaccination clinics in communities adjacent to Tanzania’s Serengeti National Park. The project’s original aim was to prevent the spread of rabies from domestic dogs to wildlife in the famous park.
But it quickly morphed into an effort to document and study the best approach to mass vaccination of dogs in an area where many people live in small villages with no electricity, while others herd cattle across vast grasslands.
The WSU teams operate by rolling into villages and setting up at a prominent spot, like the school, said WSU veterinarian Dr. Felix Lankester. It can be a chaotic scene, since African dogs usually roam free. But most actually have owners who lead them in on makeshift leashes, carry them in arms or occasionally tote them in buckets.
“It’s often the children that bring the dogs for vaccination,” Lankester said. On an average day, 300 dogs get jabbed. On busy days, the number can climb to 1,000. One field assistant is expert in breaking up dog fights.
Few villagers turn down the chance for the free vaccinations. “These communities have been blighted by rabies for generations,” Lankester said. “They will have seen it in dogs and sometimes humans.”
About half those killed by rabies are children.
WSU veterinarian Dr. Thumbi Mwangi, a native of Kenya, watched the disease ravage a 12-year-old boy.
Rabies can be prevented with a series of injections administered soon after exposure. But by the time the boy’s parents got him to a hospital, the virus had already attacked his brain. At that point, the infection is almost invariably fatal.
When Mwangi visited, the child was thrashing violently and tried to run out of the hospital. He died soon after.
“Rabies is one of the most terrible diseases,” Mwangi said.
Dogs suffer as well, not only from the virus but from violent purges.
In government-sponsored culls, countries like Bali, China and Morocco club dogs to death or poison them with strychnine, said Louise Taylor, scientific director for the Global Alliance for Rabies Control.
“So much cruelty to dogs happens because of the fear of rabies.”
The massacres continue though the evidence is clear that they don’t lower the risk of rabies. The population rebounds almost immediately and many owners hide their dogs or smuggle them out of the killing zone, Taylor explained.
The evidence is equally clear that vaccination does work.
Since the WSU program began, human rabies infections in the area have been reduced almost to zero.
The Bill & Melinda Gates Foundation also got similar results in pilot projects in South Africa, Tanzania and the Philippines.
At the same time, studies have found that despite its fearsome reputation, rabies doesn’t spread easily between dogs. If 70 percent are vaccinated, the chain of transmission is broken and the virus dies out, Palmer said.
And unlike North America, where bats, skunks, raccoons and other wild animals harbor the virus and can infect dogs, Africa doesn’t seem to have any wild reservoirs where rabies lurks.
“It appears that if you vaccinate the dog population, you don’t see rabies coming back,” Palmer said.
In the U.S., where rabies vaccinations have been mandated since the 1950s, two people died from the disease in 2015 — one apparently infected by a bat and the other by a dog bite in the Philippines. The last human case in Washington was in 1997.
A more recent success story comes from Latin America, where rabies deaths have been slashed by more than 95 percent in the past 30 years, Taylor pointed out.
The next step in Africa is to scale up the efforts, which will take money and commitments from local governments.
Kenya has launched an ambitious program to roll out vaccinations across five provinces over the next three years, then nationwide, Mwangi said. The World Health Organization has also endorsed the 2030 target date.
With costs ranging from 50 cents to a dollar per dog, WSU estimates it will take about $100 million to coordinate a program across Africa and establish a vaccine bank that nations can draw on.
The Gates Foundation has ended most of its rabies funding to focus on other priorities, like malaria and HIV, according to a spokesman.
With no major donor in the picture, Palmer and his team decided to launch their own fundraising effort working with veterinarians in Seattle.
One of the first to sign on was Lien Animal Clinic in West Seattle, owned by WSU vet-school alums.
The clinic donates a dollar for every rabies shot administered, and gives clients the option of chipping in as well.
“The magnitude of rabies in other parts of the world is very shocking to people,” said owner Dr. Timothy Kraabel. “If we can be the start of something where lots and lots of clinics end up helping out, it can make a huge difference.”
Palmer is also working with veterinary drugmakers and hopes eventually to extend his campaign nationwide.
Despite the challenges, the WSU group is convinced that it won’t be long before rabies is reined in across much of the developing world.
“There are lots of things we fight in science, like HIV and malaria, and the end is never in sight,” Mwangi said. “Rabies is different. I think in our lifetimes we will see a day when Kenya has no rabies.”