Kenya launches ambitious rabies elimination strategy

National plan motivated by proof of concept in the United Republic of Tanzania and KwaZulu-Natal aims to make the country rabies-free by 2030

28 September 2014 | Geneva

The medical costs associated with treatment after a person has been bitten by a rabid dog is estimated at US$170.00 in Kenya. This represents considerable financial hardship to a poor household.

- James Macharia, Cabinet Secretary for Health

Kenya is currently endemic for dog-mediated human rabies. An estimated 2000 people die annually of rabies after being bitten by rabid dogs.

Despite this elevated mortality, current efforts to prevent the spread of rabies has mostly been restricted to treating individuals after a dog bite and random dog vaccinations, with little investment in sustainable prevention plans.

Furthermore, lack of facilities in rural areas means that victims have to travel to far-away places for treatment. All these add to the psychological trauma and the terrifying suffering that the disease causes.”

The World Health Organization (WHO) estimates that rabies occurs in more than 150 countries and territories. Dogs are the source of the vast majority of human rabies deaths.

Multisectoral, collaborative approach

Success in rabies elimination as achieved in many countries depends on sustained mass vaccination of dogs, which is the single most cost-effective intervention to control and eliminate canine rabies and stop its transmission to humans.

“Successful elimination of human rabies in Kenya will require a multi-sectoral and collaborative approach and a sustained vaccination campaign of the canine population,” says Director of Veterinary Services, Dr Kisa Ngeiywa. “Prevention of animal bites, effective surveillance in humans and animals, better public awareness and improved access to human rabies vaccines are essential.”

In view of its high endemicity, Kenya has ranked rabies as a priority zoonotic disease. Recent successes in rabies elimination programmes in the Philippines, Mexico, Indonesia, the south-eastern region of the United Republic of Tanzania and KwaZulu-Natal in South Africa have stimulated Kenya to develop its own national strategy to become rabies-free by 2030.

“Under the new plan, Kenya aims to achieve 70% vaccination of its canine population for at least 3 consecutive years,” says Dr Khadijah Kassachoon, Principal Secretary, Ministry of Health. “This will be followed by responsible dog-ownership practices, education and disease awareness programmes. Early and appropriate post-exposure treatment, pre-exposure vaccination and training of health personnel will also be prioritized.”

WHO lauds Kenya’s commitment and resolve to provide technical support to eliminate rabies through strengthening of laboratory capacity and the surveillance and response systems as well as the prioritization of operational research, advocacy, communication and social mobilization.

The official launch of the national plan takes place on 28 September 2014 as part of World Rabies Day celebrations in Makueni County (south-eastern Kenya).

Past Kenyan control efforts

The first recorded case of rabies in Kenya dates back to 1912. Successive dog vaccination campaigns in the 1950s and 1960s were successful, with the country achieving near elimination of the disease in 1973.

But the gradual collapse of the vaccination programme resulted in a country-wide resurgence of the disease.

Today, rabies is more widespread in Kenya than in any other time in history.

Rabies in brief

Rabies: a zoonotic disease

Rabies is a zoonotic disease (a disease that is transmitted to humans from animals) that is caused by a virus. The disease affects domestic and wild animals, and is spread to people through close contact with infectious material, usually saliva, via bites or scratches.

Dog rabies potentially threatens over 3 billion people in Asia and Africa. The majority of deaths occur in poor rural areas where access to appropriate post-exposure prophylaxis is limited or non-existent.

Although all age groups are susceptible, rabies is most common in children aged under 15 years. On average, 40 % of post-exposure prophylaxis regimens are given to children aged 5–14 years, and the majority are male.

Preventing human rabies through control of domestic dog rabies is a realistic goal for large parts of Africa and Asia, and is justified financially by the future savings of discontinuing post-exposure prophylaxis for people.

Safe, efficacious and affordable dog rabies vaccines are available, and countries embarking on rabies elimination need easy access to quality-assured dog vaccines for vaccination campaigns and for outbreak management.

Community participation, education and public awareness are important elements of successful rabies control programmes. Awareness about dog bite prevention, wound cleaning and immunization immediately after contact with a suspected rabid dog or animal can be life-saving.

With the support of the Food and Agriculture Organization of the United Nations, the World Organisation for Animal Health and the Global Alliance for Rabies Control, WHO is promoting prevention of human rabies through the elimination of rabies in dogs.