28 September is World Rabies Day, when organisations across the globe, all with the common goal of eliminating human deaths from rabies by 2030, work together to raise awareness of this ‘neglected tropical disease’ under the theme ‘Educate, Vaccinate, Eliminate’. Through better understanding of the risks, of how pre- and post-exposure vaccination can help to protect individuals, and through widespread vaccination of dogs, human deaths from rabies transmitted by dogs can be eliminated.1
Rabies is a viral disease that affects the brain in humans and other mammals.2 Once you have symptoms, which can include hyperactivity in the case of ‘furious rabies’ or paralysis in the case of ‘paralytic rabies’, there is no reliable treatment and the outcome is almost certainly fatal.1 It’s estimated that rabies causes approximately 60,000 deaths worldwide every year.3 But rabies is preventable.4 And by breaking the cycle of transmission, human deaths due to rabies could be eliminated.5
It is well known that vaccines can help protect us against some of the world’s deadliest diseases; childhood and travel vaccination is an established approach to help protect us before we come into contact with viruses or disease-causing bacteria. What’s less well known is that rabies vaccines are some of the most effective available.4
There are a number of measures that can help save lives.
Where rabies exists in an area, vaccination after a bite or scratch is a key part of ‘post-exposure prevention’ that can save lives.
Time is critical in getting treatment after a bite or scratch. Even if you’ve received a rabies vaccine in the past, you must seek medical attention quickly after a suspected exposure. People living in rabies-affected regions should be aware of the risks and understand what they need to do if they are bitten or scratched. The World Health Organization (WHO)-recommended approach following a bite or scratch from an infected animal is to:1
- thoroughly wash the wound with soap
- administer rabies immunoglobulin (RIG) if you have been bitten or scratched and didn’t receive a vaccine beforehand
- give post-exposure vaccination.
Over 90% of rabies cases in humans are caused by bites or scratches from an infected dog.1 Dogs, just like humans, can be vaccinated against the disease. If 70% of the dog population in an area is vaccinated, this can break the cycle of transmission of the disease and help protect humans from becoming infected.5
Philip Cruz, one of GSK’s vaccines medical directors, has first-hand experience of treating patients in rabies-affected areas from his time as a physician in the Philippines.
I remember the first time I saw a patient already infected with rabies. The presentation of the disease is dreadful and distressing, and as a physician I felt pure frustration that all I could offer was supportive care.
"As a physician in training I was assigned to a care referral centre for animal bites in the Philippines. I remember seeing 10-15 dog bite patients in a given day. It came to a point where I was afraid that every patient who came into the emergency room might have rabies, so I made sure I had a fan and a glass of water on my table to help identify those in an advanced stage of disease – fear of air and water. Where time from being bitten to receiving medical care could mean survival, it is crucial that patients in endemic regions learn about the risks, seek medical attention and get access to post-exposure prevention, including vaccines, as soon as possible."
Speak to your doctor if you live in or are travelling to a rabies-affected area to understand the risks and get more information about how to best protect yourself.
 World Health Organization. Rabies: Fact Sheet No.99. March 2016. Available from: http://www.who.int/mediacentre/factsheets/fs099/en/# [Accessed 24 March 2016].
 Fooks AR, Banyard AC, Horton DL, et al. Current status of rabies and prospects for elimination. Lancet 2014; 384: 1389-99.
 Giesen A, Gniel D, Malerczyk C. 30 Years of rabies vaccination with Rabipur: a summary of clinical data and global experience. Expert Rev Vaccines 2015; 14: 351-67.
 Abela-Ridder B. Rabies: 100% fatal, 100% preventable. Veterinary Record 2015; 177: 148-149
 World Health Organization. Investing to overcome the global impact of neglected tropical diseases: Third WHO report on neglected tropical diseases. Available from: http://apps.who.int/iris/bitstream/10665/152781/1/9789241564861_eng.pdf [Accessed August 10, 2016].