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June 17, 2019

The rabies problem is a menace to humans

Giving food to stray dogs seen in Yangon.  Photo: Phoe Khwar
Giving food to stray dogs seen in Yangon.  Photo: Phoe Khwar

Today the spread of rabies through dog bites are becoming menaces to the humans. Most people would agree that the stray dogs are nuisances, even if they are not rabid or do not bite anyone. In our country they can be found almost everywhere in the urban, the suburban and the rural areas. They are abundant in towns and cities, especially in the market places, on the roads and streets, inside some tea shops and roadside eateries. Most of them are infested with lice and one kind of skin infection or the other and thus they are very disgusting that no health-conscious person would like to get in contact with them.
According to a World Health Organization (WHO) fact sheet, just a contact with them could cause the rabies virus to be transmitted to humans. Rabies is an infectious viral disease that is almost always fatal following the onset of clinical symptoms. In up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans. It spread to people through bites or scratches, usually via saliva. The rabies can also affect both domestic and wild animals.
The worst case scenario would be to be bitten by a rabid dog, whether a stray or a house pet. The victim of a dog bite must try to get immediate treatment with a preventive injection as soon as possible. The injections are sometimes not readily available and are quite expensive too. One would be lucky if that dog didn’t die in a few days after biting, otherwise one would be headed for big trouble, which could cost him his life.
Our roads and streets, especially in the crowded residential areas, are swarming with stray dogs and hence dogs’ poo or feces are littered everywhere. Thus, their presence among the humans, especially at the markets and eateries are undesirable and unacceptable, as they can cause health problems.
According to one WHO report some years ago, a very high per-centage about seventy or so of the stray dogs in Yangon were rabid. Thus Myanmar is classified as a high rabies endemic country. Although there are other animals such as, rodents, bats and cats, etc, which also carry rabies viruses, the causes of deaths due to rabies were mostly caused by dog bites. Rabies is a vaccine-preventable viral disease which occurs in more than 150 countries and territories.
Thus the following preventive measures should be taken in our country to minimize and eventually eradicate human rabies deaths altogether to be in line with the global “United Against Rabies” strategy. This is a common strategy formulated by the collaboration between the WHO, the World Organization for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO) and the Global Alliance for Rabies Control (GARC) to achieve “Zero human rabies deaths by 2030”

Eliminating rabies in dogs
Rabies is a vaccine-preventable disease. Vaccinating dogs is the most cost-effective strategy for preventing rabies in people. Dog vaccination reduces deaths attributable to rabies and the (PEP) is needed as a part of dog bite patient care.
The PEP or post-exposure prophylaxis is the immediate treatment of a bite victim after rabies exposure. This prevents virus entry into the central nervous system, which results in imminent death. It consists of extensive washing and local treatment of the wound as soon as possible after exposure and a course of potent and effective rabies vaccine that meets WHO standards administered immediately. Effective treatment soon after exposure to rabies can prevent the onset of symptoms and death.
Awareness on rabies and preventing dog bites
Education on dog behaviour and bite prevention for both children and adults is an essential extension of a rabies vaccination programme and can decrease both the incidence of human rabies and the financial burden of treating dog bites. Increasing awareness of rabies prevention and control in communities includes education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite.

Veterinarians vaccinate and neuter stray dogs in Yangon. Photo: AFP
Veterinarians vaccinate and neuter stray dogs in Yangon. Photo: AFP

Preventive immunization in people
Human rabies vaccines exist for pre-exposure immunization. These are recommended for people in certain high-risk occupations such as laboratory workers handling live rabies and rabies-related viruses; and people (such as animal disease control staff and wildlife rangers) whose professional or personal activities might bring them into direct contact with bats, carnivores, or other mammals that may be infected.
Pre-exposure immunization is also recommended for travellers to rabies-affected, remote areas who plan to spend a lot of time outdoors involved in activities. Immunization should also be considered for children living in, or visiting, remote, high-risk areas. As they play with animals, they may receive more severe bites, or may not report bite. Precaution is the best preventive measure.

Eradicating the stray dogs
In the past, the Yangon Municipal periodically culled the stray dogs by poisoning them. However, as the times had changed and many dog lovers opposed such actions they are no more seen to be carried out. Recently, there are arguments on the social media concerning the eradication of the stray dogs. While the general populace want the stray dogs to be eradicated, the dog lovers are ardently against it.
In my opinion, the street dogs or stray dogs should be cleared from the roads and streets of the city for good, by one way or the other. There are many ways and means to do that without culling them. In most foreign countries they catch the stray dogs and impound them in shelters after immunizing them. Dog lovers who want to adopt them can go to those places to choose the ones they want to adopt. Those that are not adopted are sterilized to stop reproductions and have to remain in the pound until their deaths.
However, the method to offer for adoption wouldn’t be applicable to our country. As most street dogs are of multi-mix breeds and most are infected with scabies or may even be rabid, no one would care to take them into their homes as pets. Thus, to get rid of the stray dogs from our streets, the only option is to terminate them. I’m not suggesting that they should be culled. One method is to catch them and impound them in shelters until they passed away in the natural way. However, that could impose unnecessary financial burden. Thus, the next option would be to immunize and sterilize them and just leave them to roam the streets until their deaths. This method would only partially solve the problem, because although they may not transmit rabies to humans, they would still be nuisances to the populace for quite awhile before they totally disappeared.
Although when the stray street dogs disappeared, there would still remain the pets of the dog lovers. Thus strict regulations should be in place to control the dogs and cats kept as pets. They should be properly registered and issued permits or licenses, which are subjected to renewals regularly after the pets are vaccinated to immunize them against rabies. Pets should have collars to indicate that they are properly registered and immunized. Pet owners should also be instructed as to the DOs and DON’Ts, while taking their pets out for walks. They should have leashes on at all times so that it would be easy to control their dogs. They should not let their pets to pee or poo in the streets indiscriminately. It’s their duty not to litter the neighbourhood with animal feces.
Finally, I would like to advice the public to take great care not to be bitten by dogs, whether they are pets or pests. I had came across many dog owners, who are reluctant to spend money to immunize their pets. So, if you are bitten by a dog, take proper treatment from a specialized hospital for rabies prevention, even if the dog happens to be a pet. Pet owners too, should take great care to immunize their pets regularly for the safety of their family members and others in the community. Dog owners should realize that dogs may be pets for some but they pests for others.
Reference:- The WHO fact sheet (2019)

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