Rabies – the forgotten disease

Rabies is a worldwide problem. About 60,000 people die from this viral disease every year. Germany has been rabies-free since 2008, and the last infected fox was sighted in 2006. In the fight against rabies, oral vaccinations in wild animals have proven to be particularly successful. When traveling abroad, however, it is advisable to take into account the spread of rabies there and, if necessary, to carry out the necessary vaccinations.

Salivary transmission of rabies

The rabies virus is transmitted via the  saliva of  infected animals. Not even the notorious bite of the rabid animal is necessary. The smallest injuries to the skin are enough for the virus to enter the body. The pathogen multiplies there and ultimately attacks the nervous system.

There is no cure for the disease. Not everyone who is infected gets sick. But everyone who gets sick must die. It is believed that between 20 and 50 percent of people who contract the virus will also contract it. The insidious thing about rabies is the long period of time from infection to the onset of the disease (incubation period). Weeks and months can go by. Apparently healthy animals can already excrete the virus and infect other animals and humans.

But precisely this  long incubation period  also offers an opportunity: anyone who fears having come into contact with the virus can still be vaccinated to prevent the disease from breaking out. However, the  vaccination must be given shortly after the bite  .

How is the disease progressing?

The disease is insidious. The first thing that becomes visible in the animal is behavioral changes. Wild animals are initially no longer afraid of humans. Peaceful pets can suddenly become aggressive and bite. People first complain of  feverheadaches  and  problems concentrating . The bite site begins to  itch .

As the disease progresses, feelings of anxiety, fits of rage, cramps and constant drooling are added. This stage is called the  “raging rage”  . The reason for the flow of saliva is spasms in the throat that occur when the patient tries to swallow. These become so strong that just the sound and sight of water causes agony; the so-called hydrophobia (Greek: “fear of water”) arises.

Because those affected also eventually become extremely sensitive to light, it is believed that rabies also contributed to the creation of the vampire legend. Because biting,  fear  of (holy) water and fear of sunlight are part of the legend of the blood-sucking undead.

In the third and last stage of the disease, the so-called  “silent anger”  , the spasms and seizures gradually subside, paralysis sets in and the patient dies.

Oral vaccination for foxes and raccoons

Since the late 1980s, efforts have been made to combat wild rabies in Central Europe. Switzerland was the first country to carry out oral vaccinations on foxes.

In Germany, fox rabies has been combated by oral vaccinations since 1993. Initially with prepared chicken heads that were laid out by hand; later, machine-made baits made of fishmeal were dropped from airplanes using GPS navigation.

Germany is considered rabies-free

The reported cases of rabies in wild animals in Germany were reduced from 10,000 in 1983 to 43 cases in 2004. After the last fox infected with rabies was reported in 2006, Germany has been considered rabies-free since April 2008 – at least in relation to  terrestrial rabies.  Other species of rabies, such as those transmitted by bats, continue to exist but pose little risk. Since 1977 there have been five deaths across Europe attributed to bat rabies.

Finland, the Netherlands, Sweden, France, Belgium, Luxembourg and the Czech Republic achieved the status “rabies-free” before Germany.

The “problem zone” in Germany was especially Rhineland-Palatinate and the area around Frankfurt. In Hesse, the high settlement density and the fragmented landscape made it difficult to apply the rabies bait.

In Rhineland-Palatinate, which had not had any problems with rabies for a long time, there were repeated cases in 2005 because apparently infected animals had crossed the Rhine and were able to invade the long-unvaccinated fox population on the left bank of the Rhine. 

How the vaccine baits work

The so-called Tübingen baits, which were specially developed to combat rabies, are brown round objects that  smell strongly of fish  and contain liquid vaccine. Foxes and raccoons, which breed rapidly in Germany, apparently take this bait well.

The vaccine consists of live but  rendered harmless rabies viruses.  Because only living viruses survive the gastrointestinal passage and lead to a sufficient activation of the immune system.

Anyone who comes into contact with a rabies bait should always consult a doctor. Although the vaccines are subject to extremely strict regulations by the European Union and the World Health Organization (WHO), it is still safer to be vaccinated against rabies after contact with the live vaccine. The WHO also recommends this.

Rabies a problem worldwide

Rabies is still ubiquitous in Eastern Europe, Africa and Asia. Cases of rabies in raccoons and bats are also regularly reported in the USA.

The bats are a species native only to America, the vampire bat. It feeds exclusively on mammalian blood. Cattle in particular belong to the prey pattern of the vampire bat. Up to 100,000 cattle die each year from rabies as a result of a bat bite. Human deaths per year vary by region, but are at most in the double-digit range.

Tourists from low-rabies zones have apparently often lost their fear of the virus. In 2007, a tourist died of rabies after picking up a dog on a beach in Morocco. The animal was infected with the rabies virus and soon showed the typical changes in behavior: the formerly peaceful dog began to bite.

The girlfriend of the vacationer also got a bite from the sick animal. However, she did not fall ill, while her boyfriend fell into a coma and died in a French hospital after about two weeks.

Be careful when travelling!

There are numerous so-called “hot spots” around the world in which rabies is widespread. Vacationers traveling to Africa or Asia should therefore be careful not to pick up or even feed seemingly tame animals such as dogs and cats. The risk of being infected by a stray animal is simply too great.

When traveling to India, Thailand, Ethiopia or other areas with a high rate of rabies, the Bernhard Nocht Institute for Tropical Medicine even advises you to find out about a  precautionary vaccination  .

Who should be vaccinated against rabies?

In general, all people who have a lot to do with (wild) animals should be vaccinated against rabies.

Even dogs and cats can only be protected by regular vaccinations. In Poland and the Balkans, for example, cases of rabies are still common, and the open border traffic within Europe means that the disease can be brought into Germany at any time.

Abroad, you always have to be very careful with seemingly tame animals. Children in particular on holiday must be given a clear explanation that they are not allowed to touch or feed an animal unless it has been properly vaccinated against rabies.

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