Why rabies kills thousands in Africa despite being a preventable disease

Kenyan sprint coach Dennis Mwanzo bent down to fix the starting blocks for his ward during morning training on October 3 when he felt something grip his right calf.

Alarmed, he turned around to discover that he had been bitten by a stray dog that sneaked up on him while he was engrossed in his work.

Mwanzo had just become one of several victims of stray dog attacks at the World Para Athletics Championships at New Delhi's Jawaharlal Nehru Stadium.

For Mwanzo, who was helping 200m sprinter Stacey Obonyo prepare for training, the immediate concern went beyond the pain. Like anyone bitten by an unknown animal, he feared contracting rabies.

Mwanzo rushed to Safdarjung Hospital for treatment and put out a video later to share his trauma.

"I am feeling much better now. I have been given several vaccines, including for tetanus and rabies," he says.

While India's National Capital Region is home to nearly a million strays, the risk of dog bites transmitting rabies isn't restricted to one country.

Africa is just as susceptible, with a growing population of stray dogs in many parts of the continent posing challenges to public health, animal welfare, and urban management.

"The mere mention of rabies is cause for alarm," Dr Traore Tiebe, technical officer for animal health and wildlife diseases at the World Health Organisation (WHO), tells TRT Afrika.

"Despite being one of the oldest known diseases, it is still a silent killer in parts of Africa, claiming thousands of lives every year. These deaths are preventable."

Understanding rabies

Rabies is a serious, potentially fatal disease caused by a virus of the Rhabdoviridae family and transmitted to humans through contact – especially bites and scratches – with infected domestic or wild animals.

Although rabies is found on every continent, its prevalence in many African countries far exceeds the average. In both urban and rural areas, dogs are responsible for up to 99% of human infections.

Experts say the extent of rabies prevalence in African countries is difficult to measure because many cases go unreported, especially in rural communities where access to healthcare facilities and testing tools is limited.

"Rabies infections are often under-reported and even misdiagnosed, which is why we don't have complete data," says Dr Traore.

Growing global toll

Worldwide, rabies kills an estimated 59,000 people each year, with about 95% of these deaths occurring in Africa and Asia.

The disease disproportionately affects the poor, who often cannot afford or access post-exposure prophylaxis (PEP), a vaccine that can prevent infection after a bite.

Children are at the highest risk. "Around 40% of people bitten by animals suspected of having rabies are children under the age of 15," says Dr Traore. "Their natural curiosity and playful nature with animals put them at high risk."

The rabies virus enters the body through a bite or scratch and travels silently along the nerves to the brain. Once in the brain, it causes inflammation that leads to confusion, fear of water, paralysis, and eventually death.

"Once symptoms appear, the disease is almost always fatal," warns Dr Traore.

Two types of rabies manifest in humans infected by dog bites. "Furious rabies", which is more common, is known to cause rage, disorientation, and a fear of water.

"Paralytic rabies" progresses slowly, starting with muscle weakness before leading to coma and death. Because it mimics other neurological symptoms, this type of rabies is often misdiagnosed, contributing to underreporting.

Prevention as cure

The good news is that rabies is 100% preventable in both animals and humans, with mass vaccination of dogs being the best possible solution.

"Vaccination of dogs, including puppies, stops the virus at its source. Killing stray dogs on the streets is not an effective solution," Dr Traore tells TRT Afrika.

If someone gets bitten by a dog, even if the animal is not a stray, prompt wound care and vaccination can make the difference between life and death.

"Washing the wound thoroughly with soap and water after contact with a suspected rabid animal is essential," says Dr Traore. However, medical attention should be promptly sought.