Wednesday, January 16, 2008

On June 26, 2007, a dog walked into Lupiro, a small village in southern Tanzania. It bit eight people and 11 other dogs before anyone managed to kill it. It had rabies or, as the French call it, la rage.

Neither of the nearby hospitals had any vaccine. The closest place with a supply was a private clinic in Dar es Salaam — a 9-hour drive away. The clinic had enough for a full course — five doses — of vaccine for two people, or a single dose for each person. It would be $40 per dose. In Tanzania, the average income per person is just $340 a year, and Lupiro is in one of the poorest regions.

Exposure to rabies requires immediate treatment: the first dose of vaccine should be taken the day you are bitten; every hour counts. Full treatment requires the four remaining doses to be taken, on a schedule, over the course of the month. In addition, if it’s available, rabies immunoglobulin — antibodies that can attack the virus at once — should be injected at the wound. For although not all bites from a rabid animal lead to infection, you won’t know if you’ve been infected or not. If you have been, and you do not get treatment, you will die: rabies is fatal. And it is a horrible death.