Community Rabies Awareness and

Mobilization Manual

Photo by Sarah Pryke

LET’S WORK TOGETHER TO MAKE RABIES HISTORY

1 Community Rabies Awareness and Mobilization Manual

Training Manual

Purpose

To teach community health workers about rabies and the serious threat their

communities face from rabies every day.

• Why should community health workers create awareness and distribute

information about rabies within their communities?

1. To encourage people to have their dogs vaccinated.

2. To teach children how to avoid being bitten.

3. To ensure that people report suspect dogs.

4. To ensure that community members who are bitten get immediate

treatment.

• How can trainees use their influence to mobilize communities when dog

vaccinations are planned and carried out to achieve control?

1. Engage with community leaders to support campaigns.

2. Inform communities of coming campaigns.

Community Rabies Awareness and Mobilization Manual 2

Contents
1. Our dogs.......................................................................................................................................................3

2. Rabies ...........................................................................................................................................................4

History............................................................................................................................................................... 4
What is rabies? ................................................................................................................................................. 4
What kind of animal can get rabies? ................................................................................................................ 5
3. How does the rabies virus enter the body? ..............................................................................6

Symptoms in animals ........................................................................................................................................ 7

4. Rabies and children ...............................................................................................................................8

5. What can we do about this disease?............................................................................................9

6. How do we vaccinate dogs when we come to the community? .................................10

7. How can you help – why we need you ...................................................................................................11

Talk to school children ....................................................................................................................................11

Build a good relationship with all community members, especially community leaders ..............................13
8. To whom should the community report rabies problems? .............................................13

What should you do until help arrives?..........................................................................................................14

3 Community Rabies Awareness and Mobilization Manual

1. Our dogs

Dogs are an important part of our communities and our history. They will always be with us,
so a disease like rabies that can spread from dogs to people must be prevented. (Pictures
supplied by Sarah Pryke)

However, dogs play a far more important role in our lives and if we are good to them they
will always be loyal and protect us, our homes and livestock. Dogs can also be companions
to children and need to be treated with kindness. They can transmit other diseases besides
rabies to people, such as worm diseases, and so a healthy happy dog is very important.

Animals need to be ensured the following five freedoms (basic needs):

• Healthy food and clean water (diet) – puppies must

be fed 2-3 times a day and adults 1-2 times per day;
• Shelter from wind, rain and sun (environment) –
warm and dry;
• Treatment when sick or hurt (health) –vaccinations,
and deworming at least twice a year;
• Other animal friends to play with (companionship);
• Freedom to express normal behaviour (behaviour).
Community Rabies Awareness and Mobilization Manual 4

2. Rabies

History
Only since 1976 has rabies been present in dogs in KwaZulu-Natal (KZN) and the disease
been killing people across the province.

In 2018, KZN experienced a large outbreak of rabies in animals and as a result eight people
died in eight months of rabies, six of whom were children aged 2-12 years. Most of these
deaths resulted from dog bites, but one was due to a cat scratch. As the wounds were minor,
people did not think that they needed help. All these deaths could have been avoided with
correct, free treatment; however, victims died a terrible, painful death.

What is rabies?
Rabies is a deadly disease and is caused by a virus. A virus is a tiny organism and can only be
seen with a powerful microscope. Many diseases are caused by viruses. All viruses have
different shapes, as you can see in the picture below.

The rabies virus is bullet shaped, which is fitting due to

its deadly nature – it is 100% fatal if untreated.

The virus is transmitted by the bite of a rabid animal,

with virus-laden saliva entering the wound.

As soon as the virus attaches itself to a nerve, there is

no cure and the animal or person will die of rabies.
5 Community Rabies Awareness and Mobilization Manual

What kind of animal can get rabies?

All mammals can get rabies. Mammals are warm-blooded animals with hair and they
produce milk to feed their babies.

Animals like snakes, frogs and birds (cold-blooded

animals) do not get rabies.

Rabies in KZN is mostly spread by dogs. Jackals are

the only other host of the disease in KZN but play a
small role in the Midlands area. Where rabies
occurs, that is, most parts of KZN, 85-90% of rabies
cases are rabies in dogs.

Cattle have the next most cases, with a few cases

in goats and sheep.

Cats also get rabies and are very dangerous to

people because they get very aggressive.

No rats or monkeys with rabies have been

found in KZN.
"100% of animals that get rabies will die."

Many other animals also get rabies, especially

mongooses, wildcats and antelope. Bats also get
rabies from a slightly different virus; they are
then considered very dangerous.

Most importantly, humans can also

get rabies, and because of this
danger we want to raise awareness
and educate people on how to avoid
this terrible disease.
Community Rabies Awareness and Mobilization Manual 6

3. How does the rabies virus enter the body?

The virus is found in the saliva of a dog or animal with rabies. When it bites a victim the
saliva enters the body (see picture).
The virus will multiply at the site
of the bite (this is the most
important stage in treatment).
When it reaches a nerve cell it is
too late for treatment. It
normally takes about two-six
weeks from the time a
dog/human is bitten to the time
they start showing signs of the
disease; however, this period can
become very long, ranging from
six months to more than a year.

When the virus enters a nerve cell it starts to multiply quickly and move toward the brain.
It attacks nerve tissue. Nothing can be done to save a person once the virus enters the
nerve cells – the person will die.

Once in the brain, the virus multiplies and starts causing symptoms that we see as it
affects different parts of the brain.
The virus then moves to the salivary glands where
it is secreted, and so it can be seen that the
secretion of the virus and the onset of symptoms
happen at about the same time. The symptoms are
terrible and very scary for both the victim and the
people around them. The virus quickly affects
important functions in the body by paralysing
muscles, which always leads to death, most
commonly as the respiratory system shuts down.
Death normally occurs three to five days after
symptoms start.

NO ANIMALS OR HUMANS SURVIVE RABIES.

7 Community Rabies Awareness and Mobilization Manual

Symptoms in animals
It is not always clear from symptoms that an animal has rabies. That is why it is important
not to touch unknown animals.

The symptoms can be varied and occur at different stages in the three-five-day clinical
period. There are two main forms of rabies, namely the dumb and furious forms; however,
these forms are also misleading.

Important symptoms:

- Change in behaviour
- Attacking and biting anything
- Exaggerated response to light and sound
- Restlessness
- Nervousness IMPORTANT!
- Snapping at imaginary flying insects Rabies symptoms
- Disorientation can be varied as the
- Wandering aimlessly virus affects the
- Fixed stare animal’s brain, so be
- Drooling saliva aware of any change
- Hoarse howling in behaviour.
- Choking sounds
- Uncoordinated actions
- Progressive paralysis
- Dilated pupils
- Biting itself
- Convulsions and spasms
- Coma
- Death

Symptoms in humans can be similar to those in animals.

Community Rabies Awareness and Mobilization Manual 8

4. Rabies and children

Most people who die of rabies are children

who have been bitten by dogs but do not go
to a clinic for treatment.

If you are treated properly and quickly after

being bitten, the treatment is 100% effective.

Rabies is 100% fatal but also 100% preventable.

NOBODY HAS TO DIE FROM THIS DISEASE!!!

That is why we need to raise awareness.

If someone is bitten, the wound must be washed immediately with soap and water and they
must to go to the nearest hospital or clinic for treatment. If the wound is bleeding the
patient will receive a special injection of immunoglobulin, that is pure antibodies are
injected into the wound. The patient receives four injections of the vaccine, the first on the
day of the bite and the others three, seven and 14 days after.

Most deaths result from lack of community awareness, incorrect treatment or patients not
receiving all their injections. Children do not go to a clinic as they do not understand the
dangers of this disease. Insist on treatment if someone is bitten.

The symptoms of rabies in humans are horrific and in KZN they are often confused with
demonic possession. All victims who do not receive immediate treatment die.

Most bites that spread rabies are small bites or scratches that children and parents do not
worry about. The size of the wound does not matter; go to the nearest hospital for
treatment!
9 Community Rabies Awareness and Mobilization Manual

5. What can we do about this disease?

RABIES CAN BE ELIMINATED THROUGH THE VACCINATION OF DOGS.

If 70% of dogs are vaccinated against rabies the disease will be wiped out.

If people who are bitten by dogs or cats go for treatment – THEY WILL NOT DIE.

If everybody helps by looking after their dogs, feeding them and keeping them in their yard,
it would stop dogs from wandering and getting rabies.

If children understand how dogs behave and when and how to avoid them, they can avoid
being bitten.

Rabies can appear anywhere and anytime

Dogs with rabies sometimes run for many kilometres. A dog can have the virus in its body
for months without showing symptoms or being dangerous. Therefore, someone buying
puppies from another area can bring rabies into their area. These puppies or dogs can
suddenly get sick and spread the disease in your community. It is very important that new
puppies are vaccinated. When buying a new puppy first check if the bitch was vaccinated
before moving the puppy; otherwise, have the puppy vaccinated immediately.

We need to vaccinate as many dogs (and cats) as possible.

Vaccinating dogs and cats is safe

Rabies vaccines are safe and will not affect your dog in any way.
It won’t make your dog sick, aggressive or a worse hunter.
Vaccinate regardless of the age or size of your animal.
Community Rabies Awareness and Mobilization Manual 10

6. How do we vaccinate dogs when we come to

the community?

• We inform the community one to two weeks before

we are coming.
• We send a message through the Department of
Health/Red Cross.
• Schools – Inform principles and ask them to put up
information about vaccination day.
• Loudhailers – Advertise using loudhailers two days
before and on the day of vaccination.
• Put up posters at tuck shops, churches etc.
• Radio

On the day of vaccination:

• We arrive with a group of vehicles (see below).
• Vehicles go up and down the roads, and people are called with loudhailers to bring
their dogs to the road to be vaccinated.
• Certificates are issued to all owners by the vaccinators.

Static

clinics – For this we would ask a school or shop owner if

we could use their premises for a clinic. Advertising a
static clinic is done the same way as advertising a mobile
clinic. With a static clinic, we stay in one place and people
come to us. A clinic is only static if the people can bring
their dogs to a central point easily. It works best in
isolated villages.
11 Community Rabies Awareness and Mobilization Manual

7. How can you help – why we need you

Talk to school children

Talking to school children is one of the main ways to raise
awareness. Ask schools to allow you 10 minutes in assembly or
maybe even one lesson during school time.

• Booklets – You can use the booklets as teaching aid to

teach the children about rabies, and to teach them to look
after their pets and to avoid being bitten by a dog. These
booklets should preferably be used to teach a class and
not just be given out to all the kids. (Copies of the
certificate can be made to reward kids for completing the
workbook tasks.)

• Comics – These are stories that the kids can read and even act
out in class. After each story you can go through the questions, and
also educate through role-play. Again, comics should be used as a
resource by the teachers and not given to the children, unless more
are supplied. (One can be left in each library.)

Also use the other material we will supply you with – PowerPoint
presentations, video clips (give copies to schools, so they can show them in their own time),
colouring pages, etc. Be creative and make this education as interesting as possible.

Key message:

Stay away from any dog or cat that you do not

know personally, especially stray or sick or
injured animals. Do not touch them and do not
play with them.

Get your dogs and cats vaccinated. IT IS THE LAW.

Community Rabies Awareness and Mobilization Manual 12

If you are bitten by a dog or cat:

1. Wash the wound thoroughly under

running water for at least 15 minutes.

2. Put a disinfectant on the wound.

3. Go straight to a clinic or hospital.

4. Do not wait, act immediately.

It is important to teach kids how to avoid being bitten by dogs.

Children need to read a dog’s body language, and

understand that dogs need to be treated with kindness
and respect. Use the booklets, information sheets,
posters and the PowerPoint presentations which include
video clips.

Learn to read a
dog's body
language yourself,
and study it
further. (See
websites/flyers
from the Global
Alliance for Rabies Control (GARC) at the end of this
booklet.)

Use as much of the educational material as you can

to make the lessons as interesting as possible for the
children.
13 Community Rabies Awareness and Mobilization Manual

Build a good relationship with all community members, especially community

leaders
By building a good relationship with all the community members, especially community
leaders, you can influence the community on a much bigger and wider scale and maybe
even get help from the community leaders. So, one of the first things you should do is to
contact the community and community leaders to let them know who you are and what
you/we want to achieve.

KEY to success: relationships

If possible, get written approval from your community leader.
Then go to schools, churches, and other institutions to let them
know who you are and what you would like to do.
Raising awareness about rabies through education!

8. To whom should the community report rabies

problems?

Clinics – all people who are bitten by animals must go to a clinic the same day.

Get to know the nurses and sisters at local clinics so that they understand you are trying to
help with rabies. You can also put up flyers at clinics and information about the next rabies
vaccination drive for dogs. It all depends on the relationship you build up with the staff at
clinics.

South African Police Service (SAPS) – if dogs are vicious and biting people it can be reported
to the SAPS.

State animal health officials (state veterinarian) – suspect dogs and other animals must be
reported to the state vet. (See list attached.)

KZN Department of Health – the KZN Department of Health can be contacted toll free on
0800 005 133
Community Rabies Awareness and Mobilization Manual 14

The Society for the Prevention of Cruelty to Animals (SPCA) or tribal authorities – the SPCA
or tribal authorities can also be contacted.

What should you do until help arrives?

First of all, stay calm. Warn the people about the animal and tell them to stay away from it.
If you can safely confine the animal without risk, do so and alert the authorities. It is
important to know where the animal is so that it can be taken away when help arrives.

Let’s work together to make rabies history!

Contact details of state veterinarian officials

District State veterinarian/Supervisor Number
Illembe 032 437 7504
Uthukela 036 634 6300
Ugu 039 682 2020
Umzinyathi 034 299 9662
King Cetshwayo 035 474 2163
Ethekweni 031 328 9300
Hluhluwe 035 562 0207
Jozini 035 572 5303
Nongoma 035 874 9018
Harry Gwala 039 834 2974
Umgungundlovu 033 347 6247
Amajuba 034 315 3936
Vryheid 034 981 4416/7

Contact details of the KwaZulu-Natal Department of Health

Toll free number – 0800 005 133