After a spike in demand for foreign trips as travel restrictions ease, and the scrapping of the amber list from October 4 in England that will see 71 of the world’s canine rabies endemic countries added to the green list, UK-based charity Mission Rabies is urging animal lovers travelling overseas to know how to protect themselves against rabies. The caution falls on World Rabies Day, September 28, and comes after the charity has seen an increase in transmission at project sites due to the pandemic.
Founder and CEO for the Mission, Dr Luke Gamble, explains that rabies is endemic (still prevalent and a major issue) in many of the world’s top tourist destinations. Whilst the chance of being bitten by an infected dog in countries like India, Cambodia, and Sri Lanka is extremely low, his concern is that the uninformed – children, families in rural areas, and unsuspecting tourists – are most at risk of a deadly but 100% preventable disease.
“Great Britain is an island full of animal lovers, and when travelling abroad the temptation to pat, feed, or play with stray animals is there,” explains Dr Gamble. “In rabies hotspots, one bite from an infected animal – or even a lick to broken skin – can lead to an unimaginable death. It’s a horrifying fact, and one that still leads to an estimated 59,000 deaths every year, often in poor and remote communities.”
Dr Luke Gamble and the Mission Rabies charity want holiday goers to know:
- Rabies is serious. 99% of all human rabies are caused by an infected dog bite. The virus is carried through the animal’s saliva and enters the body of another animal or human through broken skin or the eyes, nose, or mouth, before travelling through nerves to the brain. Once an animal or person shows symptoms of rabies, there is no treatment – rabies is fatal.
- How to be safe around stray dogs.Never disturb a dog that is eating, sleeping, or feeding its puppies. If you’re approached by dogs, please do not scream, run, or chase the dogs away. It is better to stay calm and still, and to avoid eye contact.
- The critical steps to take if bitten. Please wash the wound with soap and running water for 15 minutes, apply liquid antiseptic, and then go to the hospital for the full course of anti-rabies injections.
- Always consult your doctor or a travel doctor before heading overseas.Travelling abroad can impact public health. The best way to protect yourself and others is to discuss preventative measures with your doctor as many of the most widespread travel-related illnesses are vaccine-preventable.
While the pandemic stilled human activity worldwide, it didn’t halt the spread of diseases. In fact, in India – one of the world’s worst-hit countries by COVID-19 – the lockdown, curfews, and travel restrictions heightened the risk of transmission. The closure of the restaurants and food vendors forced free-roaming dogs to travel further and into new territories in search of food, causing fights with other dogs and conflicts with people, increasing the number of dog bites and subsequently, the risk of disease transmission.
“It has been tough, but we’ve adapted to the new reality on the ground,” said Dr Gamble. “As an essential service, we were issued with travel permits from the start, allowing us to respond to suspected rabies cases and keep vaccinating dogs in the areas of most concern. As the pandemic evolved, we did as well. We also provided the strays on the empty streets with food, water, and human interaction, to help them survive in their local area, and keep them from migrating.”
One major tourist destination that has not seen an increase in human rabies cases is Goa. Despite facing the same issues created by the pandemic, no human rabies deaths have been reported in the Indian state since 2018. The milestone is a result an eight-year partnership between Mission Rabies and the Government of Goa and led to the state being declared a Rabies Controlled Area in June this year – the first in India’s history.
“This year alone, amid the ongoing pandemic, my team has administered over 46,000 rabies vaccinations to dogs across the Goa state. If we had stopped work, people would have died and rabies would have started to re-emerge in places where it has been banished to the history books,” explains Dr Gamble.
British volunteers from various veterinary and non-veterinary backgrounds have joined Mission Rabies on the frontline since 2013. Working alongside the specially trained dog catchers, the volunteers help vaccinate at least 70% of targeted canine populations to create herd immunity and slash the R number of the disease from 2 to below 1.
While no humans have contracted rabies in the UK from animals – other than bats – for over 100 years, there is still a risk of contracting rabies from animals abroad. The most recent rabies death was in 2018 after a Briton was bitten by a cat in Morocco, at which time, health chiefs issued the same warning to residents, urging them to be aware of the risks when traveling abroad.
Local Surrey veterinary nurse Natasha Horne was thankful to be part of a programme in Goa, India before the pandemic, and says she’s been urging friends and family in the UK to learn about rabies ever since.
“The lack of rabies awareness amongst the British people is understandable as the threat level is very low,” said Miss Horne. “But that certainly doesn’t mean it’s not something we need to be aware of, particularly when heading overseas. In the short two weeks that I volunteered with Mission Rabies, it opened my eyes to the impact that this disease is having on people in these areas, but to the same degree, how easily it can be prevented.”
The charity’s work expands beyond India with projects sites in other rabies hotspots, including Malawi, Thailand, Ghana, Uganda, Tanzania, Sri Lanka, Zambia, Mozambique, and Cambodia, where they have delivered over 1.7 million canine vaccinations since 2013.
Readers who are interested in volunteering abroad when it is safe to do are encouraged to apply for Mission Rabies’ programmes starting in 2022.
Education is also key to rabies elimination. The charity delivers education programmes to students and teachers in schools, frontline workers such as bus drivers, lifeguards, police officers, and railway workers, and the general public through community events, local advertising, and online platforms, to ensure they know how to identify the disease and prevent transmission.
Rabies awareness can be a matter of life and death. Only last month in Malawi, a 27-year-old man Fanuel C lost his life to rabies after taking in a stray puppy.
Mr C was bitten on his thumb by the puppy when he tried to put a lead around its neck. Unaware of rabies and how it is transmitted, the man from a village in Thyolo didn’t seek medical attention. Three days later, the puppy had passed away.
The father of the now-deceased man explained to an Integrated Bite Case Management (IBCM) Officer for Mission Rabies Lyson Kanchotseni that in the weeks following, Mr C began experiencing rabies symptoms, including numbness of his thumb, arm, and up to his neck, as well as confusion and difficulty swallowing water, before sadly dying at home.
As soon as Mr Kanchotseni was notified of the case, he began investigating. He managed to find the body of the deceased dog, which had been buried next to the house, and confirmed that the animal was rabid by testing a brain tissue sample.
The charity’s team conducted a thorough search of the community for other dog bite cases which been had not reported to the local hospital, whilst at the same time, educating those they spoke to on the signs and symptoms of rabies, the importance of getting their pets vaccinated, and how to report a suspected animal to the Mission Rabies local emergency hotline.
Mr Kanchotseni explained that villagers were in disbelief over Mr C’s death. “Some of the villagers think that it was magic for someone to sick and die after being bitten by a dog.”
Mr C’s younger brother James C was also bitten by the rabid dog, but thanks to the efforts of Mr Kanchotseni, was able to receive his anti-rabies vaccinations.
Rabies is one of the world’s oldest and deadliest diseases that is still endemic in areas with large dynamic dog populations. Awareness in prevention is not only vital for those that live in these areas, but for those who travel there.
In 2015, the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), and the World Organisation for Animal Health (OIE) set a target of no human deaths from rabies by 2030. That’s less than nine years to end the suffering caused by rabies and forever write this generation into the history books for all the right reasons. Mission Rabies is working alongside its global supporters to reach this shared goal and create a rabies-free future for both people and dogs.