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In Liberia and many other parts of the world, people live in continual fear that their dogs could become infected and that people in their family and communities could die if bitten. At that first vaccine clinic I attended in Liberia, dog owners waited patiently, braving flooding and long waits, grateful for the rabies vaccine that protects dogs and people both. The rabies certificates we provided were handled carefully as they were precious documentation that their dog had been vaccinated. If the dog bit someone, certificate in hand, perhaps the dog would not have to be killed and the loved ones of a human bite victim would not need to worry.
Normally, for aid workers, a dog bite in Africa means you’re on the next flight out to the closest place (not necessarily the U.S.) where the first post-exposure vaccine can be administered. Time is critical, as the first shot must be administered within 24 hours of the bite. Immediately after I was bitten, I aggressively disinfected the small wound. After the rabies clinic ended, our Liberian friend and partner, Craig, flew into action. He was terrified I would die of rabies and had seen his own father die after being bitten by a rabid dog. As it happened, we knew there was human rabies vaccine in Liberia, but the question was how to access it. While I started making arrangements to fly out, Craig started working with another colleague, Jackson, at the vaccine storage facility in Monrovia to find out if vaccine could be made available for me. It was gratifying to see these kind men spring into action on my behalf. Accessing vaccine in Liberia would not have been possible without the help of our in-country partners. Doing so, however, would mean that I would be able to stay and finish the projects planned for the next few weeks.
In the 1940s and 1950s, most human rabies cases in the U.S. occurred after being bitten by a rabid dog. Vaccinating pets has saved untold lives, and now exposure risk here is primarily from wildlife. Thankfully, we don’t have to live in fear that contact with the animals we love could kill us. We are very lucky. But we should not forget what a deadly disease we are dealing with.
Vaccinations save lives, and at some point, owning pets carries with it an ethical obligation to public health. Protecting our families and communities through responsible pet ownership is something we may not think of when it comes to vaccines.
In the U.S., it is easy to become complacent. While there is ongoing debate about and research around vaccination protocols for companion animals, there is no room for guessing with rabies. Rabies vaccines are very clearly labeled to provide immunity for one to three years based on specific vaccination guidelines. Rabies is not a disease we can afford to play with. It was heartening to see Liberians so understanding of the need for vaccination, to be grateful for our efforts to protect both animals and humans and to want to learn how to continue the effort after we had gone.
In our world so wonderfully enriched through our interactions with other animals and nature, there is some risk to us. Veterinarians are at the forefront of the efforts to ensure that those interactions are as safe as possible, not just in Africa, but in our own backyards. And the Veterinarian's Oath requires that veterinarians promote public health. So when your veterinarian recommends rabies vaccination, remember we care about the health of families and communities, as well as the health of your animal companions.
The Centers for Disease Control and Prevention says it best: “Your pets and other domestic animals can be infected when they are bitten by a rabid wild animal. When 'spillover' rabies occurs in domestic animals, the risk to humans is increased… Pets are vaccinated by your veterinarian to prevent them from acquiring the disease from wildlife and thereby transmitting it to humans.”
I don’t have much to add to that other than rabies does not discriminate: Vaccinate your pets.
Because of Craig and Jackson’s concern and quick action, arrangements were made for me to acquire the rabies vaccine I needed in Liberia. I received the first of my post-exposure injections from a dedicated and kind nurse at the Duport Road Free Clinic in Monrovia. She had seen three patients die of rabies in the past month and was determined that I should receive the vaccine “because you are a human being, too” and because getting the vaccine would mean I could stay in the country to continue our work. She wanted more dogs vaccinated, and after meeting her, we held another clinic to support the Duport Road community. Good outcome all the way around, and we continued our work and vaccinated many hundreds more dogs over the following three weeks.
My “souvenirs” now that I am home from my “summer vacation” are a sore arm (thanks to the rabies vaccine), memories of the work done and friendships made and a deep appreciation for the value of working together to promote health around the world.
As it happens, during the time we were in Liberia, there was a rabies outbreak. A friend, a livestock agent who works for the Ministry of Agriculture, met me “up country” where we were teaching and running more vaccine clinics. I gave him the rest of the vaccine, syringes, needles and disinfectant, some leashes, did a brief training on safe and humane dog handling, and watched as he and his team from the Ministry of Agriculture drove off to try to stop the outbreak. With a lack of refrigeration throughout much of the country, trying to keep vaccines stored properly while attempting to administer field clinics in outlying regions is a challenge. It's difficult to think about the risk these good people face daily in their work.
If you want to learn more about rabies and what you can do, check out the World Rabies Day website. This Global Alliance for Rabies Control annual educational and charitable event aims to prevent rabies wherever it occurs. It is important work. Veterinarians Without Borders is also a proactive organization that welcomes donations to help support its vaccine clinics and other efforts in the poorest areas of the world.
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