Rabies

¹⁾ Figure 1. A German Shepard showing signs of the rabies virus.

Rabies is a viral infection that can only be carried by mammals. ²⁾ It belongs to the viral family of Rhabdoviriae. It is known for having a long incubation period. Once infected with rabies, symptoms may appear as short as one week, or as long as one year. The variation is because of the long incubation period. ³⁾ It is an RNA virus that invades cells. Once it invades a cell, rabies can start to use that cell to replicate. Replication can cause the death of nerve cells along with T-cells that help to fight infections. The rabies virus makes its way to the brain which can cause swelling of the brain, and eventually death. ⁴⁾ Rabies kills about 60,000 people every year worldwide and about 40% of these deaths occur in Africa. Children under the age of 15 are more likely to die from rabies. ⁵⁾ Sadly, rabies will never be eradicated. This is due to too many animals harboring the virus. It is very difficult to vaccinate all animals, but vaccinations can help to lower the deaths of both people and animals who were infected with rabies.

⁶⁾ Figure 2. Man infected with rabies.

Humans may experience symptoms similar to the flu when they first contract rabies. ⁷⁾ These flu-like symptoms can include a fever, headache, nausea, or vomiting. This will eventually progress as it travels to the brain. ⁸⁾ As it travels to the brain, people may experience cerebral dysfunction, anxiety, and agitation. As it progresses even more, someone with rabies eventually may experience abnormal behavior, hallucinations, or hydrophobia (fear of water). This viral infection is almost always fatal if someone does not receive a vaccine after being bitten. There are only a few reports of people who survived without the vaccination.

⁹⁾ Animals may experience foaming at the mouth, aggression, excessive drooling, and staggering. An infected animal will typically die within seven days of being sick. While an animal can show signs of being aggressive, it may also be fearful or scared. Any animal with abnormal behavior should never be approached. Some examples of abnormal animal behavior include: wild animals that are acting more tame than normal, wild animals in an unusual habitat such as a bat on the ground, or a wild animal that has trouble moving. It is important to never approach an unknown animal.

¹⁰⁾ Figure 3. A rabid dog transmitting the rabies virus.

Most cases of rabies are from bites from a rabid animal. However, this may not always be the case. ¹¹⁾ Any direct contact with an infected animal that punctures the skin may cause rabies. There are also some documented cases of non-bite exposures like scratches. The rabies virus is transmitted through the bodily fluids of a rabid animal such as the animal's saliva. ¹²⁾ The rabies virus needs to be in fluid or it will dry out and die. Rabies also needs to be in certain temperatures to survive. Mammals are warm-blooded and have fur. This allows the rabies virus to be at the perfect temperature to survive. Animals that are cold-blooded or do not have fur can not get rabies. This is because the virus would not be able to survive within the cell. ¹³⁾ Some of these animals that can not be infected with the rabies virus include fish, snakes, frogs, and birds.

¹⁴⁾ Figure 4. Different animals that can get rabies.

Most animals with rabies are domesticated animals. ¹⁵⁾ About 99% of cases are from dogs. Dogs typically are in groups with other dogs, so it is easy for one dog to transmit rabies to another. Dogs are also a very popular pet which allows rabies to be transferred from dogs to humans. One might think that the other popular pet, the cat, would also have a high rate of infecting humans with rabies. However, cats are more solitary than dogs. This means it is less likely for a cat to obtain rabies in the first place when compared to dogs, but cats do contract the rabies virus. ¹⁶⁾ Other animals such as cattle, raccoons, and bats have been reported. Rodents can also get rabies, but this is very unlikely as they will die from a rabid animal bite and be unable to pass on the virus.

Most African mammals have been reported with rabies at some point. ^17,18) There have been cases from lions in 2019 to an elephant in 1999 that have been reported. The wild African animal that has the most reports of rabies is the African Wild Dog. While other animals have been reported, these reports tend to be more rare. There are two main reasons for this. The first reason is that a predator with rabies will typically kill its prey, so there will not be another animal that can spread the virus. The second reason is that many animals like tigers or leopards are solitary animals. If one of these animals gets infected, there is typically no other predatory animal close by to spread the virus too.

Humans can also contract the rabies virus. However, there have been no documented cases of humans spreading the rabies virus to other humans. There are numerous reasons for this. The first reason is that because humans are not solitary, they are typically isolated when sick. People are smart enough to stay away from someone who is showing early signs like the flu or late signs like being delirious. Another reason for humans not spreading rabies to other people is that humans are not built to attack others with their mouths. While it is possible, it is much easier to avoid a human bite than an animal bite.

¹⁹⁾ Figure 5. The rabies vaccine and how it is administered.

The rabies vaccine is attenuated for wildlife but inactivated for humans/pets. ²⁰⁾ Louis Pasteur and Emily Roux developed this vaccine. It was first given to an infected boy named Joseph Meister in an attempt to save him after the boy was mauled by rabid dogs. When this saved the boy's life, it was tested a little bit more, but then used to vaccinate others. What is unique about this vaccine is that it can be given after someone is infected with the rabies virus. Joseph Meister received the vaccine two weeks after getting bitten by rabid dogs. The mother had to beg Louis Pasteur for the boy to receive the vaccine. The rabies virus has long incubation periods which allows vaccination after an infection.

²¹⁾ Figure 6. (A). The reported cases of rabies. (B). A child with an informative packet on rabies.

²²⁾ Northern Namibia is known to be a rabies hotspot. Namibia is a hotspot because there are many dogs and puppies infected with the rabies virus. Children thinking these dogs are friendly are then bitten by rabid dogs. A doctor viewed one of these terrible experiences and knew that something had to change. This doctor pushed to implement a One Health approach which allows representatives to come and educate children about the danger of rabies. With education, more people started to vaccinate their dogs. There also has been a push to start vaccinating stray dogs. An oral vaccine was combined with food and left around the northern part of Namibia. This allowed many stray dogs to become vaccinated and the hope is to have zero-dog mediated rabies cases by 2030.

²³⁾ Figure 7. Old movie monsters inspired by rabies.

²⁴⁾ Cases of rabies being reported gave rise to much of the mystical folklore that we still hear today. In the 19th and early 20th Centuries, stories of mad dogs and crazed citizens scared local citizens of many towns. Symptoms like delirium, insomnia, and hydrophobia made infected people similar to that of animals. People with these symptoms who were bitten by a dog or bat were seen as transforming. Soon stories came of what we know now to be Werewolves, Vampires, and other monsters spread throughout the world. These monsters are still popular with many movies, books, and costumes representing them today.

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