Feature: Working towards a rabies-free RP by 2020
Tacloban City (March 6) -- The rabies prevention and control program of the Philippines received its needed boost when President Gloria Macapagal-Arroyo signed into law the Republic Act No. 9482, An Act Providing for the Control and Elimination of Human and Animal Rabies, Prescribing Penalties for Violation Thereof and Appropriating Funds Therefore, on May 27, 2007.
In the next years, the Department of Health, Department of Agriculture thru the Bureau of Animal Industry, the local government units and partner agencies, will advocate for the full implementation of the law nationwide. The battlecry for this advocacy program is "Sumunod sa Batas Rabies." Meanwhile, the said agencies are also gearing up their efforts towards the goal of declaring the Philippines as Rabies-Free by the 2020.
Rabies is 100% fatal viral disease affecting the nervous system of humans and animals. It remains a serious public health problem in the country which causes the death of between 200 - 500 Filipinos annually.
The Philippines ranked No. 6 among the countries with the highest incidence of rabies in the world. A three-pronged approach, dog immunization, responsible pet ownership and dog-bite victim immunization, is still recommended for all government units to control rabies in their areas of responsibility.
Rabies kills, the Department of Health, warned the people. When bitten by dog, the Department of Health advises that the wound should be washed immediately with soap and water for at least ten minutes.Alcohol, povidone idodine or any antiseptic must be applied on the wound after thorough washing.
The victim of dog bite must be taken to the nearest animal bite center for Post Exposure Treatment. Treatment after exposure, known as post-exposure prophylaxis or "P.E.P," is highly successful in preventing the disease if administered promptly, within fourteen days after infection.
The first step is immediately washing the wound with soap and water, which is very effective at reducing the number of viral particles. Patients receive one dose of immunoglobulin and five doses of rabies vaccine over a twenty-eight day period.
One-half the dose of immunoglobulin is injected in the region of the bite, if possible, with the remainder injected intramuscularly away from the bite. This is much less painful compared with administering immunoglobulin through the abdominal wall with a large needle, which is how it was done in the past.
The first dose of rabies vaccine is given as soon as possible after exposure, with additional doses on days three, seven, fourteen, and twenty-eight after the first. Patients that have previously received pre-exposure vaccination do not receive the immunoglobulin, only the post-exposure vaccinations.
P.E.P. is effective in treating rabies because the virus must travel from the site of infection through the peripheral nervous system (nerves in the body) before infecting the central nervous system (brain and spinal cord) and glands to cause lethal damage. This travel along the nerves is usually slow enough that vaccine and immunoglobulin can be administered to protect the brain and glands from infection. The amount of time this travel requires is dependent on how far the infected area is from the brain: if the victim is bitten in the face, for example, the time between initial infection and infection of the brain is very short and P.E.P. may not be successful.
Rabies is a viral zoonotic disease that causes acute encephalitis (inflammation of the brain) in mammals. In non-vaccinated humans, rabies is almost invariably fatal after neurological symptoms have developed, but prompt post-exposure vaccination may prevent the virus from progressing. There are only six known cases of a person surviving untreated rabies.
Any mammal may become infected with the rabies virus and develop symptoms, including humans. Most animals can be infected by the virus and can transmit the disease to humans. Infected bats, monkeys, raccoons, foxes, skunks, cattle, wolves, dogs or cats provide the greatest risk to humans. Rabies may also spread through exposure to infected domestic farm animals, groundhogs, weasels and other wild carnivores. Squirrels, rodents and rabbits are seldom infected.
The virus is usually present in the nerves and saliva of a symptomatic rabid animal. The route of infection is usually, but not necessarily, by a bite. After a typical human infection by bite, the virus directly or indirectly enters the peripheral nervous system. It then travels along the nerves towards the central nervous system. During this phase, the virus cannot be easily detected within the host, and vaccination may still confer cell-mediated immunity to prevent symptomatic rabies. Once the virus reaches the brain, it rapidly causes encephalitis and symptoms appear. It may also inflame the spinal cord producing myelitis.
The period between infection and the first flu-like symptoms is normally two to twelve weeks, but can be as long as two years. Soon after, the symptoms expand to slight or partial paralysis, cerebral dysfunction, anxiety, insomnia, confusion, agitation, abnormal behavior, paranoia, hallucinations, progressing to delirium.
The production of large quantities of saliva and tears coupled with an inability to speak or swallow are typical during the later stages of the disease; this can result in "hydrophobia", where the victim has difficulty swallowing, shows panic when presented with liquids to drink, and cannot quench his or her thirst.
The disease itself was also once commonly known as hydrophobia, from these characteristic symptoms. Death almost invariably results two to ten days after the first symptoms; the few humans who are known to have survived the disease were all left with severe brain damage. (PIA 8) [top]