Rabies transmitted by dogs kills 59,000 people a year around the world, according to the first-ever study of the economic toll of the disease.
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Almost all of those caught the disease from dog bites. Also, almost all the deaths are in Africa and India, and none are in Israel, where public awareness is high and preventative measures are firmly in place.
As a viral disease, rabies cannot be cured, though its development after infection can be prevented by immunization, if caught in time – yet about 160 people die of rabies each and every day, according to the multi-author study, by the Global Alliance for Rabies Control's Partners for Rabies Prevention Group.
Israel isn't on the list of countries suffering from human deaths from rabies, at least not any more.
In Israel, the incidence of rabies is closely monitored by the Health Ministry's Epidemological Department. From the establishment of the state until 1953, there were 23 deaths from rabies, the ministry told Haaretz. That year, the Veterinary Services of the Agriculture Ministry instituted mandatory immunization for dogs (a major, if far from sole, carrier of the disease), and a program to trap and put down stray animals.
The efforts were not in vain. From 1953 to 1971 there were only four deaths from rabies in Israel, the Health Ministry says. For the next 15 years, the land knew quiet – the disease does exist but there were no human deaths. Then in 1996, 1997 and 2003, the ministry says, four people died of rabies after failing to get shots after exposure – and in 2014 a woman died after catching the disease in India.
Make no mistake, the disease is around: The low death rate in Israel is a function of intense preventative work. From 2010 to year-end 2013, says the Health Ministry, more than 57,000 Israelis sought advice on preventing rabies after "exposure to animals" – one need not be bitten to the bone to be exposed to the virus, which is almost 100% deadly. About a quarter of them did receive preventative shots.
Over the last four years, on average, 7.3 Israelis per thousand went to clinics for help after exposure each year, says the Health Ministry.
Worst in Africa, but most deaths in India
Led by Dr Katie Hampson of the University of Glasgow, the study estimates that the global economic loss because of the disease runs at about $8.6 billion a year. That figure is a very rough one, comprised among other things of the cost of vaccines, lost income and premature deaths.
Economically, Israel is a member of the developed nations and can afford to monitor the disease and provide preventative care. The countries with the biggest problem are the poorest. Sub-Saharan Africa has the highest death rate from rabies, per capita, though in absolute numbers, India has the highest number of fatalities, with over 20,000 human deaths a year.
Throughout Africa and Asia, the proportion of dogs vaccinated for rabies is far below that necessary to control the disease, the study found.
In Israel, vaccinating dogs is mandatory but that's the end of the list, though pet cats can of course get the disease too. Also, there can be a problem with people putting off getting shots for their dog, whether to save money or simply because they can't be bothered, a veterinarian who preferred to remain unnamed told Haaretz.
Who's at risk?
Though the disease has been recognized since the 19th century, the particles causing it were first identified in 1931 by a government bacteriologist in Trinidad, Joseph Pawan.
Rabies is caused by a virus that infects the nervous system. Among its effects on the body is immune system depression, which helps explain its nearly 100% fatality rate.
Though many viruses are species-specific, this one is not, and can infect all mammals. Your goldfish is safe, your goat is not. The only way to protect the furry family, and yourself while about it, is to make sure that all your pets are periodically inoculated.
The viruses can be transmitted through saliva and indeed, most people who catch the disease get it from animal bites. The symptoms start with possible itching at the site of the bite, followed by flu-like signs that may include fever, fatigue, nausea, which are quickly followed by mental symptoms such as anxiety and agitation, escalating to hallucinations and insomnia.
Hydrophobia, which has become practically synonymous with rabies, is caused by pain in swallowing.
"The acute period of disease typically ends after 2 to 10 days. Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive," warns the U.S. Centers for Disease Control and Prevention.
Several vaccines for humans have been developed over the years, administered by injection. They can cause a local reaction in some people. But that's better than what would happen to them if left untreated.