independent

Thursday 2 October 2014

Rabies a global problem that still causes so many deaths

Published 11/02/2014 | 05:38

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Work is being done to eradicate rabies in India

It was Sam's sixth birthday, and he was playing under the kitchen table as his family gathered to celebrate.

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There was a hubbub of conversation between brothers, sisters, cousins, aunts and uncles as Sam's mother busily prepared the meal. Suddenly there was a loud snarl and a snap, and Sam let out a shriek. He had just been bitten by Ben, the family's Jack Russell Terrier, and he was bleeding from a wound on his cheek.

Dog bites are a common form of injury to humans: around half of all Irish children are bitten by a dog at some point during their life. Bites are most common in young children, particularly boys aged between five and nine: the reason for this is that children have not yet learned how to interact with dogs safely. The offending animal is nearly always the family dog (or a neighbour's dog), and most interactions are started by the child. It is rarely "the dog's fault" .

The simple answer to this problem is that children should never be left unsupervised with dogs, regardless of what type of dog it is or its previous behaviour. Children should be taught how to behave around dogs, using tools like the Kennel Club's "Safe and Sound" Scheme ( www.safetyarounddogs.org.uk).

Here in Ireland, the consequences of a dog bite are relatively straightforward. A boy like Sam may just need simple home first aid, or in more severe cases, a visit to hospital may be needed.

In many other countries around the world, it's much more complicated. A dog bite carries the risk of rabies infection, which is invariably fatal in humans.

Rabies is a global problem that causes the deaths of thousands of people and dogs. In India alone, every two seconds someone is bitten by a dog, around 24 people a day suffer an excruciating death from rabies:over half of them are children.

If Sam had been born in India, that minor dog bite could have had desperately serious consequences. If he was lucky, he might be taken to a doctor to be given post-exposure anti-rabies vaccination. However, it'd be far more likely that this level of medical intervention would be unavailable to him. Nothing would be done other than basic cleaning of the wound.

If the dog was carrying rabies, Sam would be infected, and in the following weeks, he would develop symptoms of rabies. He might have a fever or a headache at first, with an itching sensation at the site of bite. A few days later, he would develop anxiety, confusion and agitation. As the disease progressed, Sam would develop abnormal behaviour (such as fear of water), hallucinations, and insomnia. He would go on to suffer a terrifying death.

The most shocking aspect of rabies is that it is completely preventable. Vaccination of dogs in bulk programmes is inexpensive and highly effective: it can cost as little as 50c per dog. In comparison,the cost of a human being treated for rabies after a dog bite is around €40, which is over a month's salary in the regions where rabies is common.

The World Health Organisation believes that mass canine vaccination programmes are the most effective measure for controlling rabies, and that vaccinating 70% of the dogs in an area where rabies is prevalent is necessary to control the disease in both humans and dogs. Ambitious targets are in place to have rabies eliminated from the planet by 2030.

In the recent past, mass dog vaccination programmes have allowed some countries to become rabies-free: there are many examples in South America. In Sri Lanka, this type of programme has reduced rabies deaths from more than 350 in 1973 to just 50 in 2010. Yet in over 150 countries around the world, death by rabies continues to be a threat to humans and dogs. Over 55 000 people die of rabies every year, with over 95% of them in Asia and Africa.

India is the country with the biggest rabies problem, with 20000 people dying every year. So-called "street dogs" are part of the urban culture. They play an important role in the ecosystem by helping to deal with garbage: in areas where dogs have been forcibly removed, the urban rat population has become a major problem. But street dogs also carry rabies.

The answer to India's rabies crisis is well-known but difficult to implement: sterilisation and vaccination of street dogs. This has happened successfully in some areas, but the sheer size and scale of India is daunting: it's the second most populous country in the world, with over 1.2 billion people (nearly 300 times the population of Ireland), living in an area that's 40 times as big as Ireland. It's easy to be intimidated by these numbers, but the answer is still simple: vaccination of most street dogs against rabies, combined where possible, with sterilisation of dogs to prevent breeding.

Many organisations are working to achieve this goal, including the World Society for the Protection of Animals (www.wspa-international.org), and Mission Rabies (www.missionrabies.com) which is aiming to vaccinate over two million dogs in India against rabies in the next three years.

I am travelling out to India next week to play my part. I will be visiting the Mayapuri slum in Delhi, with a charity called ASHA (the Hindu word for hope). My aim is to carry out a dog census and rabies review of the area, using observation and a questionnaire.

I hope that my efforts may lead to dogs in the Mayapuri slum being vaccinated, and in due course, when a boy like Sam is bitten by a dog, he will not be infected with rabies. That one boy may seem insignificant in the statistics, but to him, the difference will be massive. And if other people take action to help to work towards the eradication of rabies in India, tens of thousands of other children like Sam will also be protected against this terrible disease.

Do you want to play your part against rabies? Visit my website at www.petethevet.com to find out more.

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