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Rabies Goes On As Public Health Problem In Philippines

The Department of Health (DOH) reported that rabies continues to be a public heath problem in the Philippines wherein dogs remain the principal cause of animal bites and rabies cases in the country of at least 90 percent and some 7 percent in cats affecting in more males than females. It is the 10th leading cause of death globally due to infection in humans predominantly affecting poor people in developing countries.

According to Dr. Raffy Deray of the DOH- National Rabies Prevention and Control Program, around 10 million are exposed annually with some 60,000 deaths mostly in Asia and Africa wherein 99 percent was noted in developing countries in which 15 percent are children less than 15 years old.

In 2005 alone, Deray reported that the country registered 248 human in rabies cases which the Philippines ranked 5th in Asia with India, China, Pakistan and Bangladesh in the top list.

Of the 250 cases recorded last year nationwide, 61 percent was noted in Luzon, 20.5 percent in Mindanao, and 18.5 percent in Visayas, Deray said.

DOH regional offices with the most number of human rabies cases registered last year are: CHD5 with 38 cases, followed by CHD2 with 37 cases, CHD4, CHD3, and CHD8 with 31, 25, and 20 cases, respectively, Deray said.

On the other hand, the data revealed that the top five provinces with the most number of human rabies cases recorded in 2008 are: Isabela (17), Camarines Sur (15), Cagayan and Nueva Ecija (14), Iloilo (10), and Camarines Norte (9).

The number of animal bite victims has been increasing in the past five years with 189,781 cases reported in 2008. Fifty Nine (59) percent was recorded in Luzon, 24 percent in Visayas and 17 percent in Mindanao, the DOH official further said.

Deray informed that rabies is an astute, progressive, incurable viral encephalitis with a fatal outcome transmitted through injection of infectious saliva into a broken skin (bite exposure) and licking of scratches, abrasions, open wounds or intact mucous membrane; inhalation/aerosol- bats in caves; human to human (15 documented cases of fatal rabies following transplantation, corneal transplant- 8, and solid organs and a vascular conduit).

Once clinical symptoms have occurred, he said, rabies is almost invariably destructive wherein mortality rate is 100 percent in unvaccinated patients. The risk of developing rabies is around 15-20 percent influenced by virus content of saliva (viral shedding in saliva is intermittent), severity of the bite, and location of the bite.

Average incubation period ranges from 10-90 days. Incubation period maybe much shorter or few days to several weeks especially in children with severe exposure in well innervated areas like face, head, and neck or much longer in more very exceptional cases where incubation lasts of up to six (6) years which was recently reported in the United States of America, Deray further informed.

Human rabies can be prevented through elimination of infection in animal vectors which is considered to be the most efficient and competent way to eliminate human rabies or vaccinate at least 70 percent of dog population; providing timely and appropriate Post-Exposure Prophylaxis (PEP) to all rabies exposure or treatment administered after an exposure (such as bite, scratch, lick, etc.) to potentially rabid animals which includes local wound care, administration of rabies vaccine with or without Rabies Immune Globulin (RIG) depending on category of exposure; and provision of Pre- Exposure Prophylaxis (PrEP) to high risk individuals or the administration of rabies vaccination before a person is exposed to potentially rabid animals, Deray explained.

Dubbed as Media Forum on Emerging and other Infectious Diseases,” the activity was participated in by national and local health officials, information officers in Regions VI, VII, and VIII, national media and local tri-media in the Visayas held at the Palmas Del Mar Resort, Bacolod City. (PIA-8 Neil D. Lopido)

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