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Taking care


Fall
2017

Ohio State’s wide-ranging expertise is addressing rabies in Ethiopia and building relationships to control global health threats yet to come.

Eradicating infectious disease. Preventing cancer. Empowering citizens. Ohio State’s Global One Health initiative connects people across the university and around the world to accomplish these goals and more. Initiated by Wondwossen Gebreyes, a professor in veterinary preventive medicine, the program is part of an international approach to disease response and prevention that works at the intersection of human, animal and environmental wellness. And in doing so, it immerses Ohio State students in life-changing research, education and outreach. Gebreyes and Maria Belu, a graduate student in veterinary medicine, discuss the complex problem of rabies in Ethiopia and how Ohio State is working to mitigate it.

Ethiopia

This man loves the 14 dogs he cares for with a friend. An Ohio State Global One Health team vaccinated all of them against rabies, which kills 2,700 people in Ethiopia each year.

“Rabies is extremely common in Ethiopia, much more so than elsewhere. It’s not unusual to see rabid dogs as well as humans with the disease. It is children who tend to contract it most, because they are more likely to play with and get bitten by dogs. The situation is extremely dire. The CDC estimates 2,700 Ethiopians die from rabies each year. It is very difficult to see someone with this disease. Once symptoms are evident, the disease is nearly always fatal.”
— Wondwossen Gebreyes, executive director of Ohio State’s Global One Health initiative and the Hazel C. Youngberg Distinguished Professor in Veterinary Preventive Medicine in the College of Veterinary Medicine and the College of Public Health.

Ethiopia

Veterinary clinics here are sparse and ill-equipped, but they are the first point of contact for dog owners like this man, who wanted to get his dog immunized. Global One Health teams teach personnel to run campaigns that can provide up to 400 vaccinations each day.

“Rabies is an old and terrible disease, but it can be controlled. The solution has four parts. First, there is education; people have to be aware of what causes rabies and how it is transmitted. They also need to be able share information about the disease; at this point, there is not even a scientifically sound estimate of the number of cases, let alone a good way to convey data about it. Third, minimizing the risk of bites is key, and we are working to do this by controlling the population through clinics that spay and neuter dogs. And the fourth thing, which is very important, is vaccinating dogs.”
— Gebreyes

This boy was bitten by a dog earlier in the day. Frightened and suffering from a painful leg wound, he was advised to get a series of post-exposure prophylaxis, or PEP, shots to prevent rabies, which is nearly always fatal once symptoms appear.

“Why Ethiopia? The majority of infectious diseases emerge from developing countries, particularly those in sub-Saharan Africa. Ethiopia is the second-largest country in Africa and has the continent’s largest animal population. And it is home to the African Union, so you can reach out to any African country by having a presence in Ethiopia. With this project, we are building the capacity of our students — tomorrow’s professionals — and our partners in Ethiopia so that in the future, when the next Ebola-like crisis arises, we already have working relationships because we’ve been working to eradicate things like rabies. That will mean we can get on with preventing and controlling outbreaks. And in the meantime, we can make a real impact on a real problem.”
— Gebreyes

In the heart of the fight

Go on location in Ethiopia with Ohio State’s Global One Health initiative and its partners in government and nonprofit organizations as they battle rabies in dogs and humans.

Ohio State takes on canine rabies in Ethiopia

Ethiopia

An expert in dog behavior and handling, Stewart observes two dogs he encountered on the street.

“I had been to South America and China, but never to Africa. So when I first arrived in Ethiopia two years ago, I found certain things difficult to see and get used to. But this past spring, as I watched three second- and third-year Ohio State veterinary students process their new surroundings there, I thought, “Oh, I’ve gotten so used to that.” Every time I go, it feels more and more normal. You get accustomed to the chaos. Even the driving.”
— Maria Belu, ’16 DVM is a veterinary public health resident working with Jeanette O’Quin ’93 DVM, ’94, ’11 MPH, who co-leads Global One Health’s rabies eradication program. Belu is working on a master of public health degree in the College of Veterinary Medicine and is on track to finish her residency and degree in 2018.

Ethiopia

Ohio State’s Maria Belu and Emily Pieracci of the Centers for Disease Control and Prevention review test scores after teaching their trainees to identify rabies.

“I want to work internationally once I complete my degree, and rabies is a perfect example of the kind of public health concern I want to help address. It affects both animals and humans. Veterinarians and medical doctors have to work together or we’ll never get on top of it. I am looking into working with the CDC or maybe one of the nonprofits that operates in Thailand or Eastern Europe or Africa — places where there aren’t a lot of small animal clinics. I like traveling and working in places where the care delivered by a general-practice veterinarian can go such a long way. In these settings, I can help get on top of things like rabies so they don’t become a bigger problem. That’s how I envision making my greatest contribution: protecting people at home by providing a service abroad.”
— Belu

Ethiopia

Several health workers were having lunch in a café when they were alerted to a rabid dog lying in the street. Daniel Stewart of the Global Alliance for Rabies Control took the opportunity to show animal control officers some of the behaviors associated with rabies.

“The challenges and solutions are very complex, as evidenced by the fact that 14 Ohio State disciplines are at work on it. The most obvious are veterinary medicine and public health, but many others also are very important. When we focused on building a supply chain system for vaccine manufacturing, for example, Fisher College of Business was a great partner. We utilize communication expertise in the College of Arts and Sciences to create effective messages for various audiences and to help clinics reach people with vaccination campaigns. Sixteen Ethiopian organizations are involved, including universities, government ministries and the country’s equivalent to the U.S. Centers for Disease Control and Prevention. We also work with community and religious leaders. And we coordinate with government committees on policy, because everything we do involves policy.
— Gebreyes

Ethiopia

Dr. Jeanette O’Quin ’93 DVM, ’94, ’11 MPH, leads classes for animal control officers in rabies identification, medication dosing, needle safety and humane euthanasia.

“That first trip in my second year of vet school, our assignment was to spay and neuter dogs in Gondor, Ethiopia. Dr. O’Quin and a fourth-year student did the surgery, and I helped with the anesthesia. Back home you have technicians to monitor animals during surgery as well as a choice of drugs to use for anesthesia. There, my means of monitoring our canine patients was my stethoscope, my eyes and my hands. Our choice of drugs was limited, and we couldn’t do blood work or transfusions. Our surgeons worked quickly in order to keep the animals under anesthesia as briefly as possible. I learned that you don’t need top-of-the-line everything to do procedures. What you need are knowledge and the foresight to take precautions.”
— Belu

We're all in this together

In addition to eradicating rabies in Ethiopia, Ohio State’s Global One Health initiative is tackling health challenges around the world, such as tuberculosis and Epstein-Barr virus. The teams include a wide range of experts from across the university, from doctors and nurses to journalists and geographers. Areas include:

Arts and Sciences
Business
Dentistry
Distance Education and eLearning
Education and Human Ecology

Engineering
Food, Agricultural and Environmental Sciences
Medicine
Nursing

Optometry
Pharmacy
Public Health
Social Work
Veterinary Medicine

Rabies fact sheet

Through vaccination, canine rabies has been effectively eradicated in the United States. In countries like Ethiopia, however, vaccination is not yet a common practice, and the disease is a serious threat to human and animal life.

How it strikes: Rabies is transmitted through contact with the saliva of an infected animal. If a post-exposure prophylaxis (PEP) is administered soon after the bite and before the onset of symptoms, the likelihood of contracting rabies decreases greatly. Once symptoms appear, it is almost always fatal.

Vaccines are key: Distinct strains of the rabies virus affect raccoons, skunks, foxes, bats and other animals, and a dog that is not vaccinated — even in the United States — can contract a different variation. Humans can be vaccinated against rabies, but the Centers for Disease Control and Prevention recommends vaccines only for animal handlers and cave explorers.

In the United States: Every year, 40,000 people get a PEP. Thirty human deaths have been attributed to rabies since 2003, with the majority tied to the bat virus variant.

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