Biting back rabies

CEBU, Philippines – March is not just Fire Prevention Month, it is also the Rabies Awareness Month, a national observance stipulated in Executive Order No. 84, of 1999, "Declaring March as the Rabies Awareness Month, Rationalizing the Control Measures for the Prevention and Eradication of Rabies and Appropriating Funds Thereof." The theme for this year is: "Bakunadong Pusa't Aso sa Rabies Protektado," meaning that proper anti-rabies vaccination protects pet cats and dogs.

There is also the government's National Rabies Prevention and Control Program (NRPCP) pursuant to Republic Act 9482 (Anti-Rabies act of 2007) and the creation of the Rabies Elimination Committee - comprised of experts from the DOH, DA, and DILG in laying out more concrete plans for achieving a rabies-free Philippines.

Rabies is a zoonotic disease. This means that it is transmitted to humans from animals, caused by a virus. The disease infects domestic and wild animals, and is spread to people through close contact with infected saliva through bites or scratches. Rabies is present on all continents with the exception of Antartica, but more than 95 percent of human deaths occur in Asia and Africa. Once symptoms of the disease develop, rabies is nearly always fatal.

The incubation stage for rabies averages one to three months, but may vary from less than a week to less than a year. The initial symptoms of rabies are fever and often pain or an unusual or unexplained tingling, pricking or burning sensation (paraesthesia) at the wound site. People with rabies exhibit signs of hyperactivity, excited behavior, hydrophobia (fear of water) and sometimes aerophobia (fear of air). After a few days, death occurs by cardio-respiratory arrest.

No tests exist that make a diagnosis on rabies infection in humans before the onset of clinical disease, and unless the rabies-specific signs of hydrophobia or aerophobia are present, the clinical diagnosis may be difficult.

Dogs are the main host and transmitter of rabies. Transmission can also occur when infectious material - usually saliva - comes into direct contact with human mucosa or fresh skin wounds. In rare cases, rabies is contracted by inhalation of virus-containing aerosol or via transplantation of an infected organ. Ingestion of raw meat or other tissues from animals infected with rabies is not known to be a source of human infection.

In the Philippines, although rabies is not among the leading causes of morbidity and mortality, it is considered a significant public health problem for two reasons: it is one of the most acutely fatal infection which causes the death of 200-300 Filipinos annually, and the Philippines ranked number six among the countries with the highest reported incidence of rabies in the world. The ranking went as high as number three in 2000. Last year, Cebu Province topped the number of cases of animal bites among other provinces in Central Visayas. The DOH recorded at least 20,796 animal bites in the entire Cebu during the period.

Rabies is considered a neglected disease that is 100 percent fatal, but 100 percent preventable too. Effective and safe vaccines to avert the disease in human and animals have been available for decades. None of these deaths would have occurred as we have all of the means necessary to prevent rabies from infecting and killing both humans and animals. However, its elimination is hampered by poverty and ignorance about the disease and its prevention.