Rabies resurgence: Fake vaccines, stray dogs fuel the crisis

A dog getting a rabies vaccine. [Courtesy/GettyImages] In recent years, the country has witnessed a surge in rabies cases. During the 1970s and 1980s, rabies was largely brought under control in most parts of the country. However, this is no longer the case, largely due to the government's withdrawal from key areas of veterinary disease control. The resurgence of rabies in some regions over the past two years is a growing concern, directly linked to this reduced government involvement. Kenyans are urged to report any stray dogs exhibiting unusual behaviour. A rabid dog typically foams at the mouth and shows no fear of biting people or other animals. This aggressive behavior is a common sign of rabies. In humans, the disease may also cause disturbing symptoms, including an intense, almost comical fear of water-a sign of severe nervous system involvement. According to doctors, rabies can infect almost all animals, though susceptibility varies. Some animals are more likely to succumb to the disease than others. Public health officials in Nairobi are urging residents to report any dogs showing signs of rabies so they can be captured and vaccinated. One of the most effective ways to prevent rabies from dog or wild animal bites is to avoid high-risk areas such as national parks, wildlife game reserves and sugar belt regions, which are more prone to disease outbreaks. Rabies is one of the most dangerous diseases globally and remains common in many countries. Once symptoms appear, the disease is almost always fatal. This means that if someone is bitten by a rabid dog and does not receive treatment, death is almost certain within a short time. However, rabies is preventable. With prompt medical attention and post-exposure vaccination, the virus can be effectively neutralised before symptoms develop. Unfortunately, many cases of rabies and dog bites go unreported. Dogs are responsible for over 95 percent of rabies cases worldwide. Other animals known to spread the disease include squirrels, bats, raccoons, skunks, foxes, wolves and mongooses, among others. According to the World Health Organization (WHO), rabies virus attacks the brain, leading to severe behavioural changes in infected individuals. When someone is bitten by a dog or cat, it is recommended that the animal be placed under observation for 10 days. This helps determine whether it was infected with rabies. A rabid dog typically dies within five days if left untreated. The risk of death from rabies is nearly 100 percent once symptoms appear. An infected person can die within 20 to 60 days if not treated in time. Rabies typically begins with non-specific symptoms, called the prodrome phase, lasting 2 to 10 days. These include fever, irritability, fatigue, insomnia, loss of appetite, headache, sore throat and general malaise. As the illness progresses, symptoms may include burning pain throughout the body, swollen tissues, nervous system malfunction and eventually, coma and death-usually within 2 to 12 days. "Death is inevitable due to complications from cardiorespiratory failure," says vaccination specialist Dr Mercy Njuguna. She advises that after a dog bite, the first step is to immediately wash the wound with clean water and soap, apply an antiseptic or a spirit with at least 70 percent alcohol content and then seek post-exposure vaccination withoutdelay. "And since rabies vaccines are administered after exposure, it becomes a race against time to save the patient-with little chance for a second opportunity," explains Dr Njuguna. Research shows that Kenya has several registered anti-rabies vaccines. According to doctors, the standard vaccination schedule involves five doses: on day 0, day 3, day 7, day 14, and the final dose on day 28. Dr Mwangi emphasises that the injections must be given in the deltoid muscle (upper arm), not the buttock. "For children," he adds, "the vaccine should be administered in the anterolateral area of the thigh muscle. Under no circumstances should it be injected into the gluteal region." Medical experts stress that these guidelines must be followed strictly to ensure the vaccine works effectively and to prevent complications. However, concerns have emerged over counterfeit vaccines. "There are unscrupulous importers who bring in fake products that mimic the name, logo, and appearance of genuine vaccines," says pharmaceutical distributor John Otieno. He warns that these fakes often enter the market under the guise of 'parallel importation,' bypassing proper regulatory checks. He urges media houses to regularly highlight the dangers of counterfeit medical products. The presence of fake anti-rabies vaccines, often distributed without adhering to proper storage guidelines, is particularly dangerous. "These products put lives at risk," warns Otieno, "as most people cannot tell the difference between genuine and counterfeit vaccines." Experts explain that vaccines are made from live organisms and must be stored under strict cold-chain conditions-refrigerated around the clock-to remain effective. If not properly stored, these vaccines degrade, lose their potency and become useless. Worse still, using degraded or inactive vaccines can be more dangerous than the diseases they are meant to prevent. Experts caution that treatment with such compromised vaccines may lead to severe complications or death. Price is another red flag. Fake vaccines are often sold at significantly lower prices than genuine ones. Doctors also point out that managing rabies or snakebites pharmacologically is far more expensive than dealing with other vaccine-preventable diseases-making prevention through genuine vaccination critical.

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