Why deadly rabies is harboured in man's trusted friend

A child plays with a dog, at Alara village in Bondo. [File, Standard] In almost every town across Kenya, from Nairobi's bustling streets to remote trading centres, stray dogs roam in search of food. Some move in packs, others play with children, while many are chased away with stones. Stray cats too, wander streets scavenging for scraps. Yet, whether strays or pets, these animals carry a hidden danger: rabies. Rabies, according to the World Health Organisation (WHO), is an infectious viral disease almost always fatal once symptoms appear. Dogs are the main hosts and account for 99 per cent of human rabies deaths. In Kenya rabies claim about 2,000 deaths each year, most among children. As the country marked World Rabies Day on September 28, it finds itself in a race against time, with just five years left to meet its ambitious target of eliminating dog-mediated rabies by 2030. The challenge begins with numbers. In Nairobi, official estimates in 2019 put stray dog populations at around 50,000, though researchers argue this vastly undercounts the reality. A recent study in Preventive Veterinary Medicine found Machakos County had 421,087 owned dogs-nearly double earlier estimates used for planning. Researchers calculated a human-to-dog ratio of 3.3 to 1, and a dog density of 126 per square kilometre. Such discrepancies undermine Kenya's 15-year elimination strategy. In Machakos, only about 40 per cent of dogs are vaccinated, far short of the WHO-recommended 70 per cent coverage required for three consecutive years to stop transmission. Dr Dennis Bahati, acting programme director at the African Network for Animal Welfare (Anaw), says "When you look at welfare, one of the key tools we use is the five freedoms framework, which highlights freedom from pain, injury and disease. That's where rabies comes in-we know how fatal it is once symptoms appear." Kenya is currently in stage three of its five-phase rabies elimination plan. Yet progress has been uneven. Kitui has reached 74 per cent coverage and Kisumu 72 per cent, but few counties sustain these levels. Only Makueni has completed the three-year consecutive vaccination cycle required for elimination. Machakos residents lines up their dogs to get vaccinated against rabies as the World marks World Rabies Day in Machakos County on September 28, 2022. [File, Standard] The decentralised system of governance complicates matters. The National Rabies Elimination Strategy was developed nationally, but county governments are responsible for implementation. "Most counties prefer to create their own plans rather than adopt a national one," notes Dr Bahati.Resource allocation is another challenge, with counties rarely budgeting adequately for rabies campaigns. The financial burden falls heavily on NGOs. Vaccinating one dog costs about Sh100, meaning Nairobi alone would require Sh5 million annually for three years. In Nairobi, the problem also lies with pet owners. Dr Dennis Maube Lumumba, a veterinary surgeon, categorises them into three groups: the compliant, the willing but economically constrained, and the "assumers" who believe indoor pets need no vaccines. Vaccination costs, ranging from Sh1,000 to Sh3,000, make routine boosters unaffordable for many households. The consequences of inadequate vaccination are devastating. Without immediate post-exposure prophylaxis (PEP), rabies is invariably fatal. The incubation period may last weeks or months, but once symptoms begin-delirium, coma, death-there is no cure. Treatment is costly and complex, requiring multiple doses and, in severe cases, expensive rabies immunoglobulins. A full course costs between Sh20,000 and Sh30,000, often unavailable outside major hospitals.

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