Rabies kills thousands in Kenya as vaccination and surveillance gaps persist

WHO says rabies kills an estimated 59,000 people globally every year. [Courtesy]

For many Kenyan families, dogs are more than animals. They guard homes, protect livestock and grow up alongside children.

Cats, cows, donkeys and horses are also part of everyday life and livelihoods.

Yet behind the wagging tails, purrs and familiar routines may lurk a deadly threat: rabies.

“Rabies is a viral disease caused by the rabies virus. It can affect all warm-blooded animals,” says Maurice Murungi, a research manager at World Veterinary Service and an epidemiologist.

Dogs, cats, cows and donkeys can all contract zoonotic diseases, which can be transmitted between animals and humans.

But dogs remain the biggest threat to people.

“About 99 per cent of cases transmitted to humans come from dogs,” Murungi says.

The disease kills an estimated 59,000 people globally every year, according to the World Health Organisation (WHO), with about 95 per cent of deaths occurring in Africa and Asia. Nearly 40 per cent of those affected are children under 15, while dogs are responsible for up to 99 per cent of human rabies infections.

In Kenya, rabies is among the top five prioritised zoonotic diseases. It remains endemic, with an estimated 2,000 human deaths annually, primarily from dog bites.

Health experts say the neglected tropical disease is almost entirely preventable through vaccination, yet gaps in dog vaccination, surveillance, veterinary services and access to post-exposure treatment continue to put lives at risk.

“Children are particularly vulnerable because they often play with dogs and may not recognise the danger posed by an infected animal,” says Murungi.

Murungi notes that, once a dog contracts rabies, it typically dies within 10 days. Before death, however, it can transmit the virus to other animals or people through its saliva, usually through a bite.

Lian Thomas, a senior scientist at the working on neglected zoonotic diseases at the International Livestock Research Institute (ILRI), says even a scratch from an infected animal can transmit the virus.

The virus travels along the nerves to the brain and once clinical signs appear, the disease is fatal.

“In dogs and cats, rabies commonly presents as the “furious” form. The animal may become aggressive, its bark or vocalisations may change, and it may salivate excessively because it can no longer swallow,” says Thomas.

Donkeys, horses and cows more often develop the “dumb” form. They may become depressed and withdrawn, stand still with saliva dripping from their mouths and move less.

“These signs can be mistaken for conditions such as bloat or choke, prompting handlers to intervene and expose themselves to infected saliva,” she adds.

Thomas advises anyone who notices a dramatic change in an animal’s behaviour to contact a veterinarian immediately.

“After an infected animal bites a person, the virus enters the body through the wound. It multiplies at the site before entering the nerves and travelling towards the brain,” she says.

The person may appear well during this period, but it is the critical window in which treatment can prevent the disease.

“The virus travels along the nervous system towards the brain at roughly a centimetre a day,” Murungi says.

The incubation period typically ranges from about a week to a few months, although rare cases have been recorded after as long as two years. How quickly the disease progresses depend on factors including the location and severity of the bite and the amount of virus deposited.

Anyone bitten should immediately wash the wound with plenty of soap and running water for about 15 minutes before going to hospital for post-exposure prophylaxis (PEP).

“Before the virus reaches the brain, something can be done. You can get a vaccine that can protect you from rabies. It is called post-exposure prophylaxis,” Murungi says.

The regimen typically involves five vaccine doses on days zero, three, seven, 14 and 28. Depending on the exposure, rabies immunoglobulin may also be administered around the wound.

Once symptoms appear, however, rabies is almost invariably fatal.

Experts warn against throwing stones at, chasing or trying to kill a suspected rabid dog. A cornered or provoked animal is more likely to bite.

“You must protect yourself, and you must ring the vet to come and capture that dog safely,” Thomas says.

A safely captured animal can be humanely killed and its brain sent to a laboratory for diagnosis. The same applies to suspected rabid livestock.

Thomas also cautions against eating meat from animals slaughtered at home, particularly sick or dead animals.

Meat inspectors are trained to assess animals before slaughter and determine whether their carcasses are safe for human consumption.

“It's not about making it more expensive. It's about protecting everybody's health,” she says.

Backyard slaughter can expose people to rabies and other zoonotic diseases, including anthrax and tapeworm.

Vaccinating dogs remains the single most effective tool for preventing human rabies, Thomas says.

An effective vaccine exists, but at least 70 per cent of dogs in an area need to be vaccinated to achieve herd immunity and interrupt transmission.

Yet Kenya does not have a reliable national figure for its dog population.

Research by Murungi, based on his PhD work, estimated roughly 400,000 dogs in Machakos County alone. Neither the national census nor livestock census counts dogs.

“We really struggle to know the number of dogs,” Thomas says.

Without reliable population data, counties cannot accurately budget for vaccination campaigns or determine where resources are most needed.

Private veterinarians, county governments and organisations including ANAW, VSF Germany, Mission Rabies and the Kenya Society for the Protection and Care of Animals are helping fill the gap, but planning remains difficult without knowing the size of the population.

Thomas also distinguishes between stray and roaming dogs. Many dogs seen on Kenyan streets are owned and return home for food and shelter.

But roaming exposes them to injury, road accidents and greater involvement in the rabies transmission chain.

The true human toll of rabies in Kenya is difficult to establish because of weak surveillance.

Murungi says he was aware of at least seven human rabies deaths so far this year in Ruai, Meru, Makueni and Siaya, including three children, but these had not been captured in a systematic national count.

“It would be nice for you in the media to be able to say, today, this year, we have lost 300 lives, or 400 lives, or 1,000 lives to rabies. But I'm sorry, we can't give you that number,” he says.

“Not because people are not dying, but because nobody knows about them.”

A review of surveillance data by researcher Sam Kariuki of the Department of Veterinary Services, using the Kenya Animal Bite Surveillance system and Kenya Health Information System, found the data too poor to reveal reliable patterns.

“Animal bites are also rarely confirmed through laboratory testing or post-mortem examination, while some facilities record bite cases as rabies without distinguishing confirmed infections,” Thomas says.

Poor data affects more than statistics. It also makes it harder to ensure that post-exposure vaccines are available where they are needed.

Published research has documented shortages of PEP. A 2019 study found health facilities experienced vaccine stock-outs lasting between three and 36 weeks a year.

A 2022 study of 42 facilities in Makueni and Kibwezi West found only five facilities, or 12 per cent, had rabies vaccines in stock during the survey, while none had rabies immunoglobulin.

Kenya’s Strategic Plan for the Elimination of Human Rabies in Kenya 2014–2030 aims to eradicate dog mediated human rabies by 2030.

Its key pillars include sustained mass dog vaccination to achieve at least 70 per cent coverage, prompt PEP for bite victims, public education and stronger surveillance linking human and animal health systems.

The national strategy aligns with the global “Zero by 30” goal of eliminating dog-mediated human rabies deaths by 2030.

Kenya’s efforts come as the world marks World Rabies Day on September 28.

The 2026 theme, “Stronger Together,” set by the Global Alliance for Rabies Control, highlights the need for a coordinated One Health response involving communities, veterinarians, healthcare workers and governments.

For Thomas, rabies control is a shared responsibility. “Responsible dog ownership means keeping animals within the compound, feeding them, vaccinating and deworming them, and having them spayed or neutered,” she says.

But individual responsibility cannot replace functioning public veterinary services.

Thomas calls for greater government investment in veterinary services, particularly in underserved rural areas, alongside support for private vets and subsidised vaccination.

“There is a living to be made because there's animals everywhere,” she says, arguing that investment in rural veterinary care is both a public health and economic opportunity.