September 27, 2016

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The importance of Rabies in public health

Kaung Htet Thar

To revive the country and build a civilized, developed nation-state, it is necessary to have enough individual incomes, availability of food, accessibility of safe food. Nowadays, researchers reveal  that the origin of currently prevailing human infectious diseases originated from animals. Among them, some are under effective concerns for the prevention and control but some are still neglected not only in Myanmar but also in many countries. The disease which should not be on the list of neglected disease in this modern era is rabies which can cause 100% fatality despite its being 100% preventable. That is the main reason of celebrating world rabies day every year on 28th September since 2007 with the main goals of reducing risk of rabies through dog bites to zero risk by 2030.
Rabies is an infectious viral disease which occurs in all warm blooded animals with up to 6 months incubation periods in animals. After clinical signs have been developed in animal victim, it is not curable and nervous signs are the most prominent clinical features follow by death. Basically, there are two forms in clinical rabies: furious forms showing sign of salvation, aimlessly movement, unprovoked attack to all moving objectives and other susceptible animals; dumb form known as silent rabies has no clinical signs which can be overseen by the owners.
It has been reported that the major cause of rabies in human originated from the dog rabies which is threatening to at least 150 countries among 180 OIE members. The key points which have been addressed by OIE for the control and eradication of rabies are prevention, controlling stray dog population by reducing and promoting diagnosis and surveillance activities. With the ultimate goal of effective rabies eradication across the globe, it is necessary to report all outbreaks transparently and rabies control program have to be on the top priority list as one of the national needs. Even the disease is fully preventable by using vaccine but the threat of the disease risk is still huge within the community of developing countries. Myanmar people are very much aware of rabies but the number of rabies victims who take systematic treatment after post exposure with any rabies suspected animals are not in the satisfactory figure. Approaching traditional treatment, charmers and remedies cause temporary manias and believe to recover are still practicing at rural areas of Myanmar. It is strongly suggested to take more and more effective measures for the education, prevention and control at both animal and human sectors to reduce the risk of the disease.
The occurrenceof the disease is notorious among Myanmar community with a traditional saying “time of “lat pan”(Bombax Flower – Bombay buonopozense) blossoming is a time of rabies”. It means that rabies occurrence is high in summer time when “lat pan” tree blossom. The suggestion of at least 7 to 10 days watch after you suspected a dog as rabies is not reliable in this situation any more and it is strongly recommended to take appropriate post exposure treatment as soon as possible (within 24 hours) after exposed with any suspected rabies. There are some medical evidences that human victims expire earlier than the dog which bit the victim and has not developed rabies for long time. Therefore, the victims must take post exposure prophylasix treatment which has very least side effect even the dog is not stray, even dog is under close observation of an owner and vaccinated. It is crucial to see medical attendants or visit government hospital for receiving safe treatment. Killing suspected animals is not a humane manner and it is an unnecessary brutal action to an animal.
It was estimated an approximation of dog population in Myanmar in 2003 was 3.48 million by WHO survey whereas in 2016, the figure would be at double after a research study has done in a township located at central Myanmar. As a consequence, systematic depopulation of stray dog, applying mass vaccination and immediate reporting of rabies suspected animal at community areas are very much needed to combat the disease for aiming reduction of rabies risk. Even World Rabies Day campaign (talk and vaccination) has been launched for 10 years around the world, it should not be a nice performance only for show celebrating with attractive decoration. The ongoing action must be in place for the whole year round to fight against the risk of rabies. Stray dog are considered as higher risk group which is basically out of control; high probability to get and to spread the infection to other susceptible animals and no one cannot predict unprovoked attack from that group. It was best guessed that more than 6 million of victims were bitten and among them child and woman are a larger proportion. Private and government veterinarian could vaccinate approximately 10% of the dog population in Myanmar and that is not a satisfactory prevention activities. Rabies is reported not only in dogs, but also in cat, pig and horses in Myanmar. Donors and international organizations are currently focusing on the global hot issue like avian influenza which is not a crucial important disease in line with the country’s situation which has human death case like in Rabies. It is strongly suggested that relevant department must convince their primary duty and to make a priority for those neglected diseases to improve the national health as much as they can.
Finally, in the World Rabies Day which falls on 28th September of this year, all citizens must pay attention to the unnoticeably threatening neglected disease, Rabies, to be aware of the unprovoked risk of rabies. To have better prevention and control of the disease, immediate reporting on any suspected cases in time, prompt action to be taken any relevant treatment after exposed with rabies suspected or confirmed case, examining all suspected cases at veterinary department’s laboratory are duty of all citizen to prevent and control rabies in Myanmar. Therefore, with the slogan of “Educate, vaccinate and eliminate rabies” for 2016, all citizens must be aware of the risk of the disease and let’s participate in the campaign for the prevention of rabies by vaccinating to the all available dogs.


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