Rabies Flare-Up in Georgia – A Risk Not Worth Taking

We are constantly told by non-governmental and animal welfare organizations that vaccination and sterilization of feral dog populations are the only ways to control rabies.

Recent increases in the global prevalence and incidence of rabies, e.g. in Bali, where the number of stray dogs is estimated at over 500,000, a rabies epidemic underway since 2008 has killed over 80 people (and despite vaccination the epidemic continues - a single human death in 2013, two in 2014, 12 in the first six months of 2015), seeming to be a striking and harsh condemnation of current control strategies.

Over the past 50 years many countries have worked hard to maintain sustained suppression of canine rabies yet the disease, like the feral dogs themselves, is relentlessly opportunistic and persistent. The huge advances made by Georgian, Russian and other scientists in dog and wildlife vaccination in the Caucasus region and the debt we all owe them should not be quickly forgotten and their legacy should not be elbowed aside by a resurgence of rabies in Georgia. A dozen years ago Botvinkin and Kosenko, writing for the World Organization for Animal Health, stated that “it is very probable that conditions for the next rabies outbreak are gradually forming against a background of economic crisis. History, once again, will repeat.”¹

91 cases of rabies, mostly in dogs but also in domestic animals such as cattle, horses, pigs and goats, were reported for Georgia in 2015, including 4 cases of dog rabies in Tbilisi, and no-one can forget the 4 human deaths that occurred between 2010 and 2014 (official national reporting to WHO through the vital statistics mortality database).

Any number of factors can be blamed: the explosive growth of urban areas, the throw-away society and inadequate garbage collection, limited government resources, excessive reliance on feral dog vaccination, disruption of wild mammal populations through human conflict and war, ineffectual and incorrect field methods, poor training of field personnel, the quick fix mentality, inadequate public education and overemphasis on the top-down role of prescriptive government rather than the bottom-up role of the local community, take your pick.

Where baiting for vaccination can be successful, baiting for humane lethal control can likewise be so, and in the long run is very likely to be less costly. It has to be said that irrational sentimental considerations have no place in the joined up debate and integrated approach to rabies control. The situation is too important to suffer the vanity of intolerant liberal sentiment and the attentions of the rubber gun club, particularly and pointlessly clouding the issue with their heartfelt but irrational statements, and the international rescue dog rehoming charities that continue to chew at the lunatic fringes of the debate.

The challenges that confront the global rabies eradication campaign may appear to be dwarfed by the obstacles faced today. The problem is acute and is not confined solely to urban areas. Feral dogs are ubiquitous and abundant, current estimates rank their numbers in the many hundreds of millions globally and we must accept that rising human populations have inevitably meant rising numbers of feral dogs.

Consider this: “Finding a feasible answer to humanely reduce the dog population is probably the single most important missing tool in the battle to reduce the burden of rabies across the globe,” says Professor Deborah Briggs, executive director of the Global Alliance for Rabies Control. In Indonesia this year, in North Sulawesi, the head of the Minahasa Health Agency, Yuliana Kaunang, confirmed 243 bites on humans by rabid animals, including one fatality, noting that the high rate might be due to the large feral dog population in Minahasa.

In the period 1950-2015 the world's urban populations rose from around 745 million to almost 4 billion. Much of this growth has been in the tropics; 80 percent of the populations of Latin America and the Caribbean, for example, now live in urban areas and in most of the region they share their environment with feral dogs. Southern Europe and the Caucasus are no different- just look at the growth in Tbilisi in recent years. Compared to many of their rural cousins, our urban feral dogs live in a veritable paradise of abundant food and shelter, and the obstacles to significant control would appear challenging.

Feral dogs can be hard to detect, even by the most diligent. Faced with a routine of search-and-find, field-workers inevitably miss many individuals, particularly those not in the usual categories: the nocturnal dogs, the ultra-shy, the itinerant and the migratory, and those living on closed or abandoned industrial or military sites. Considering that in Turkey the average feral dog population has been estimated in excess of 420 individuals per square kilometer, it is inconceivable that every individual can be located, vaccinated and sterilized.

The global media understandably shy away from showing you photos of the clinical effects, the end game of rabies, preferring the inevitable repeated images of dog catching, tagging, and vaccination.

Catch-and-release does nothing whatsoever to address the other problems associated with free-ranging dogs: the noise, smell, mess, traffic collisions, and completely fails to take into consideration the scourge of leptospirosis (27 human cases reported in Georgia in 2015, and 3 deaths in 2013), predation and disturbance impacts on wildlife and domestic stock, spread of wildlife diseases, hybridization with wolves and competition between dogs and sympatric carnivores.

The success and methodology of the early vaccination bait campaigns can be readily transferred to more modern and critical methods of control, where it is acceptable to local communities, community participation and local commitment in planning and execution being essential.

Although feral dogs are highly unlikely to become bait shy, baiting for control and baiting for vaccination are both very costly. Preventing the transmission of rabies through dog vaccination has a high cost per dog and in the event of having to bait for rabies control it is necessary to weigh the benefits of baiting to kill rather than baiting to vaccinate. Dog vaccines for rabies claim an immunity period of up to two years only. High turnover rates (high mortality parallel to high fecundity) clearly render single vaccination campaigns ineffectual. An annual turnover of about 25% in dog populations necessitates re-vaccination of millions of animals each year, and the reintroduction of rabies through the arrival of carrier and infected animals from outside a controlled area is an inevitable consequence in a lapse of control.

Elsewhere in the world a novel formulation feral dog bait has just been released for use, the first of its kind in 50 years. A major collaborative research and development initiative between the Australian government and industry has resulted in the first new feral dog toxin in 50 years becoming available. The new bait, launched after more than 11 years of testing within Australia and the USA, contains a chemical toxin called para-amino propiophenone (its acronym is PAPP) which causes a targeted, quick and humane death to feral dogs when consumed. Unlike other feral dog toxins, this new PAPP bait product has an effective antidote which needs to be administered by a vet. However due to the fast acting nature of the bait, normal precautions and notifications must be undertaken to protect pets, companion and working dogs, and livestock guardian dogs during baiting programs.

Here in Georgia field trials to assess the viability of lethal baiting could be completed in a matter of months. If results are favourable, the baits could be applied by landowners and licensed contractors, collaboration and coordination between stakeholders being vital. No individual landholder can fully benefit from feral dog control on their own property if their neighbors are not taking similar action. Clearly, feral dog management is the responsibility of all landowners and land managers. Training requirements would be minimal and operators would not have to cull feral dogs using firearms which may be disquieting to some members of the public, especially around hot spots such as markets, schools, hospitals and prisons.

The Achilles heel of such campaigns is, understandably, sustainability. It can be hard for a government to justify funding for a problem that appears to no longer exist and it is worth noting that the absence of human rabies cases does not prove that there is no canine rabies, merely that the incidence of canine rabies may be low.

The lesson of rabies is that after decades of dedicated control it can and will rear its ugly head when you least expect it and for this reason alone the need for effective control must continue. This year rabies infections have been confirmed in 20 provinces in Thailand, which despite decades of control has the third highest number of rabies cases in Asia. This prompted mesvaccins.net, the French holiday and travel vaccination website, to publish, on 19 May 2016, the following advice: "In Thailand, the traveller must consider every bite, scratch or lick of a wound by any warm-blooded animal (dog, cat, monkey or other mammal) as a medical emergency and must seek a medical center immediately”. In Thailand, puppies aged between 3 and 6 months are the main carriers.

Recently a well published dog watcher suggested that you may only need to vaccinate the adult dog population against rabies because the number of puppies surviving to their first year is so low², a grossly irresponsible view considering that children often become victims due to their frequent contact with dogs and their mothers not having the right knowledge about what needs to be said and done to prevent their children contracting rabies, children are often the initial adopters of 'stray' puppies, one half to two thirds of reported dog bites are to children, at least half of those bites are to the face and neck (the highest risk areas in terms of rabies infection), and children playing with cats and dogs are especially at risk even if they are not bitten. The rabies virus can enter the human body through scratch lesions on the skin.

It is timely that the long standing and incorrectly held assumption regarding rabies exposure for travellers, that a longer stay equals a higher risk, is being reconsidered. The duration of travel has little if any impact on the likelihood of having a potential rabies exposure if you can encounter feral dogs within walking distance of the airport.

Fear of rabies, and the stress it causes, is insidious and calls for a determined approach. Although rabies is 100% fatal it is 100% preventable so in the tragic event of an outbreak, pray that there is no shortage of human rabies immunoglobulin.

Rabies is a disease that is all too often under-estimated and in light of the widely acknowledged under-reporting of rabies cases internationally it would be very interesting to know how complete and consistent the numbers for Georgia are.

Are you still happy with the NGOs and animal welfare organizations telling you what to think?

Steven Simpson is a consultant invasive mammal manager and technical author. uk.linkedin.com/in/stevenjsimpson

Copyright © 2016 by Steven Simpson. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, photocopying, recording, or otherwise, without the prior written permission of the author.

Steven Simpson