by Amy Robinson
Sniff & Barkens’ Dog Expert
100% fatal; 100% preventable. There are no gray areas when it comes to rabies transmission.
The goal of the World Health Organization (WHO) is to eliminate human rabies by 2030. The goal of World Rabies Awareness Day, September 28th, is to “educate, vaccinate and eliminate” the threat to humans through contact with animals. Louis Pasteur, the French chemist and microbiologist, developed the first rabies vaccine in 1885, yet rabies remains a problem worldwide.
Dogs are responsible for 95% of rabies transmissions. To address that problem, philanthropic groups including the Bill and Melinda Gates Foundation have partnered with WHO in poor areas where risk is highest. In the Philippines, South Africa and Tanzania, proof of concept projects showed that a decrease in human rabies is possible through a combination of interventions involving dog vaccination, improved access to Post-exposure prophylaxis (PEP), and increased surveillance and public awareness raising. The key to sustaining and expanding rabies prevention programs to at-risk parts of the world has been to start small, demonstrate success and cost-effectiveness, and ensure community engagement.
Prevention is the game-changer because no test exists to determine if a person has contracted the disease. Once symptoms start, anywhere from days to months later, the disease cannot be controlled. Fever and pain or an unusual tingling, pricking, or burning sensation at the wound site are among the first signs. One of two forms of the disease can follow.
People with furious rabies exhibit signs of hyperactivity, excited behavior, hydrophobia (fear of water) and sometimes aerophobia (fear of flying). After a few days, death occurs by cardiorespiratory arrest.
Paralytic rabies accounts for about 30% of the total number of human cases and runs a less dramatic and usually longer course than the furious form. The muscles gradually become paralyzed, starting at the site of the bite or scratch. A coma slowly develops, and eventually death occurs. The paralytic form of rabies is often misdiagnosed, contributing to the under-reporting of the disease.
See: Rabies Infographic
After a bite:
The disease is transmitted by bites or scratches from an infected animal. Post-exposure prophylaxis (PEP) covers the treatment of the bite victim starting immediately after exposure to prevent rabies from entering the central nervous system, which would result in imminent death.
PEP consists of washing the wound thoroughly with soap and water for fifteen minutes as soon as possible after exposure; a course of potent and effective rabies vaccines that meet WHO standards; and the administration of rabies immunoglobulin (RIG), if indicated. These post-exposure treatments are less available and much more costly than the vaccination. A course of PEP can cost US $40 in Africa and US $49 in Asia, where the average daily income is approximately US $1–2 per person.
Due to its 100% fatality rate in dogs, rabies is not the vaccine you want to skip when visiting your vet. There are, however, many ways to approach an immunization schedule for other dangerous viruses, including Distemper and Parvo. Dr. Katy Nelson, veterinarian and host of The Pet Show with Dr. Katy, looks at each pet’s history, age, and overall health to determine the best course. Geographic and lifestyle needs vary widely.
“A dog in NYC that goes to doggie day care has a vastly different recommendation than a farm dog in Iowa”, she said.
For example, if you are hitting the dog park daily with your friendly pooch, Canine Influenza and Bordatella (kennel cough) may be indicated.
Lyme disease is prevalent in areas where deer congregate, and Leptospirosis, a spiral bacteria organism found in the urine of affected animals, is easily transmitted to dogs when the active bacteria is washed into rain puddles, standing water, or ponds and lakes in warm-weather locations. Lyme disease and Leptospirosis are both in the spiral bacteria organism class and are extremely harmful and often fatal for dogs. Outdoor cats or dogs that spend time in wooded or swampy areas are more likely to catch leptospirosis by sniffing the urine of a reservoir animal or swimming, wading, or drinking water where the leptospira has been washed into the water by rain. Both Leptospirosis and Lyme vaccines can and should be given independently of any combination vaccine … and not on the same day.
When and how to vaccinate:
Smaller dogs and puppies may be at risk for compromised immune systems, so Dr. Nelson may prefer to separate vaccines for some patients.
“In my practice, with small dogs, dogs with history of vaccine reactions, or dogs with immune compromise (very young, or very old), I try not to give more than two vaccines at a time”, she stated. “This is simply to avoid stimulating the immune system so heavily all at once. Most clients appreciate giving their pet a break between vaccines.”
She stresses the importance of assessing a pet’s individual needs prior to vaccinating, regardless of age.
“Especially in our older and younger patients, immune status is an important consideration, as are any other health conditions they may have.”
Pet owners concerned about over-vaccinating their pets may discuss Titers testing with their veterinarian. A Titers test determines the level of immunity developed post-vaccination in the blood. Some vaccines will have efficacy for three years and possibly longer. Titers testing can give pet owners a way to gauge the pet’s current immune status and mitigate the long-term effects of introducing the vaccine over and over again, especially as the animal ages, but the test can cost more than the vaccine. Knowing the individual pet’s health needs and current condition is a factor in the decision to seek Titers testing.
“In immunocompromised pets or pets with other health conditions that prevent them from receiving regular vaccines, Titers are an option to test for immunity against certain diseases”, according to Dr. Nelson.
In 2011, the American Animal Hospital Association came out with new vaccination guidelines for core vaccines, including the recommendation that fully immunized dogs, after their one-year booster, can wait three years to revaccinate.
Every pet owner can start a conversation with the veterinarian about when and how often to vaccinate. Doing some research before your visit and acting as your pet’s health advocate is a great approach to a sensible and effective vaccination plan.