THINK ON THESE: Best Implementer vs rabies

THINK ON THESE by Henrylito D. Tacio“Davao awarded as ‘best LGU rabies program implementer,’” the headline said.

“The National Rabies Prevention and Control Program of the Department of Agriculture-Bureau of Animal Industry awarded the City Government of Davao as one of the ‘Best LGU (Local Government Unit) Rabies Program Implementer’ in the Philippines,” wrote Ralph Lawrence Llemit in one of the recent issues of EDGE Davao.

Aside from Davao City, there were several other LGUs that were given such recognition during the 12th World Rabies Day celebration that was held at Brentwood Suites Hotel in Quezon City last September 28.

The award was given as a way “to produce and encourage champions in the rabies program to achieve the country’s target of a rabies-free Philippines by 2020,” Llemit wrote in his news report.

Recent statistics showed rabies is responsible for the deaths of an average of around 200 to 250 Filipinos per year.  In Asia, the country ranks third when it comes to rabies deaths – after India and China.  Below the Philippines are Indonesia, Sri Lanka, Thailand, and Vietnam.

It’s no wonder why rabies remains a public health problem in the country despite the enactment of Republic Act 9482, otherwise known as the Rabies Act of 2007 which seeks to eradicate rabies in the Philippines two years from now.

Among Filipinos, rabies is a highly misunderstood disease.  Many, especially those in rural areas, still believe that garlic and a few drops of vinegar can cure rabies.  Others believe that a quack doctor – called “tandok” – have the power to eliminate the virus from the body with the use of a stone or by sucking with the use of a carabao horn.

“Rabies is an acute and deadly viral infection of the brain that causes irritation and inflammation of the brain and spinal cord,” informs The Merck Manual of Medical Information.  It is one of the most terrifying diseases known to man.

“Usually, rabies is eventually fatal once the rabies virus reaches the spinal cord and brain, but the virus takes at least 10 days – usually 30 to 50 days – to reach the brain (depending on where the bite is),” the Merck manual notes.  “During that interval, measures can be taken to eradicate the virus and help prevent death.”

The virus that causes rabies belongs to the group of viruses with a distinct “bullet” shape.  It is usually introduced into humans through the bites of infected animals but other means of transmission are possible.

Oftentimes, rabies is transmitted by dogs.  Other animals which can transmit rabies are cats, bats, and foxes.  Rabies rarely affects rodents (such as mice and rats), rabbits, or hares.  Birds and reptiles do not develop rabies.

“The domestic dog is the most important reservoir of the virus,” says Dr. Mary Elizabeth Miranda, leader of the rabies research program of the Research Institute for Tropical Medicine.

According to the health department, rabies is usually transmitted from a dog’s saliva and enters the body through breaks in the skin. It can also enter the body through a person’s eyes and mouth.

Medical books say the incubation period of rabies – from the introduction of the virus to the moment it reaches the spinal column or brain – is variable.  “The nearer the site of the bite to the brain, the faster the movement of the virus,” Dr. Silvius Jude Alon, a veterinarian who used to work with the Mindanao Baptist Rural Life Center, points out.

During the incubation period, no signs of illness are evident.  The virus may be traveling silently through the nerves from the wound to the brain.  Once it reaches the brain, it multiplies rapidly then travels from the brain to the salivary glands and other nerves.

Health experts say rabies develops with three main phases: the early period followed by excitation phase and finally coma.   During the early period, the symptoms are mild and non-specific.  They include:  a slight fever, chills, uneasiness, headache, loss of appetite, vomiting, sore throat, abnormal reaction to light, and a persistent loose cough.  A specific early symptom is local or radiating pain, burning, or itching, a sensation of cold, and/or tingling at the inoculation bite.

During the excitation phase, patients experience nervousness, anxiety, agitation, marked restlessness, apprehension, irritability, sensitivity to loud noises, fear of water, excessive salivation (one to one-and-a-half liters in 24 hours), secretion of tears, and perspiration.  Systemic symptoms are severe, and they include:  heart beating greater than 100 beats per minute, cyclic respirations, urinary retention, and a higher temperature.

Death is inevitable once the symptoms appear.  “Though a small number of people have survived rabies, the disease is usually fatal,” says the Minnesota-based Mayo Foundation for Medical Education and Research.

As such, if you think you are bitten by a rabid animal, “you must get a series of shots to prevent the infection from taking hold,” the Mayo suggests.  But before doing, you must know if the animal really has rabies.  But if you can’t find the animal, “it may be safest to assume that the animal has rabies.” However, some factors should be considered like the type of animal and the situation in which the bite occurred.

Generally, rabies vaccine – which is made from killed rabies virus – as a pre-exposure treatment is given to people who are at high risk of exposure which include veterinarians, animal handlers, rabies laboratory workers, spelunkers, and travelers who are going to areas where rabies is common.

The reason why rabies still thrives in the country is that most Filipinos don’t know the dangers of rabies.  In fact, some people even refused to have their animals, particularly dogs, to be injected by rabies vaccine.

Most people think that dogs will be less aggressive once vaccinated.  There are also those who don’t want their dogs to be vaccinated because these are to be butchered for some special events like fiesta and birthdays.

Other reasons on why rabies still exist in the country include the following: ineffective ordinance in the province, city, and town of the implementation of the rabies prevention and control program, poor vaccination coverage by the province, numerous stray dogs, lack of funding, limited/lack of personnel, and lack of vaccinators and dog catchers.

 

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