World Rabies Day September 28

Do you celebrate Thanksgiving? Memorial Day? Veterans’ Day? Do you post a flag, place flowers on a grave, spend some time reflecting?

World Rabies Day is observed globally with the goal of eradicating one of the world’s oldest recognized infectious diseases, a dreadful and violent illness that still kills thousands of people per year. If rabies doesn’t scare you, it should. About 500 American dogs and cats contract rabies each year; however, most human fatalities here are nowadays caused by wildlife, specifically bats. The bite that transmits this deadly virus needs merely to puncture the skin; some such injuries are so minor that the victim is unaware they’ve been attacked. Post-exposure inoculation must be sought immediately following the bite, because there is no reliable treatment for rabies.

The wound itself usually heals up uneventfully as the rabies virus begins its slow and silent journey to the brain. During this period, weeks to months of perfect health, the virus is absolutely undetectable by any technique of modern medicine. The initial symptom of disease is often intense itching at the site of the now-forgotten bite. Severe headaches, confusion, insomnia and personality changes follow rapidly. Hydrophobia is a genuine phenomenon caused by a “short” between the swallowing and breathing circuits, causing the patient to feel a suffocating sensation when he attempts to swallow. Eventually he can tolerate neither the sight nor mention of water. Death is virtually guaranteed and, frankly, it comes as a relief.

Over 50,000 people die each year from rabies. Just two of those fatalities occur within U.S. borders, due to an organized network for reporting animal bites, education of human victims, and investigation of potential carriers. Widespread vaccination of American cats and dogs protects both pet and owner. Here, post-bite inoculation is safe and reliable, widely available and utilized thousands of times per year. It’s here, in Milwaukee, that a treatment protocol for humans originated—highly controversial, nonetheless somehow implicated in the survival of six patients to date. In many other countries, however, such resources are either loosely organized or unavailable; reporting is haphazard, education very limited, and post-exposure inoculation too costly for bite victims. In other countries, the most common way to catch the virus is from your own unvaccinated pet, or that of a neighbor. Somewhere else, a human dies horribly and helplessly from rabies every ten minutes around the clock.

Perhaps we are observing World Rabies Day as we faithfully update our pets’ vaccines. Some will donate funding for post-exposure inoculations or the vaccination of source animals in developing countries. I’ll be observing it with a healthy measure of gratitude: how very fortunate I am to live in a nation where so many conscientious individuals are involved in the battle against this gruesome disease. From meticulous CDC scientists to resolute ER physicians down to every single pet owner and vet, they’ve each and every one made this a country where human rabies is a lightning strike instead of a day-to-day hazard.

Dr. M.S. Regan