Posted on Sep 28, 2021 | Author DR. SHEIKH MOHD SALEEM
WORLD RABIES DAY
The global COVID-19 epidemic has created numerous misconceptions and questions regarding illnesses, their transmission, and vaccination in general. As a result, there has been considerable hesitation in several countries over the roll-out of the COVID-19 vaccines, and many individuals are reluctant to get vaccinated. This is nothing new in the case of rabies, since concerns, misconceptions, and disinformation regarding the illness and its prevention stretch back hundreds of years. As a result, this year’s theme focuses on disseminating facts about rabies rather than creating fear about the disease through misinformation and misconceptions.
Facts are critical for increasing disease awareness, reducing rabies cases, vaccinating animals, and teaching people about the hazards of rabies and how to prevent it. We wouldn’t have evidence to tell decision-makers about the severity of the condition if we didn’t have facts. We would be unable to fight for its abolition, and the disease’s impact would remain undetected, resulting in tens of thousands of humans and animals dying from rabies each year. Let us utilise information to promote awareness and educate others about rabies, a disease that is 99 percent lethal yet 100 percent avoidable.
In this year’s theme, the word “fear” has three interpretations. For example, it refers to the overall dread induced by rabies, the terror humans have while encountering infected animals, and the fear people live within rabies-infested areas. The second connotation is closely related to the dread symptom that people may experience when infected with rabies. Finally, dread refers to the fear generated by ‘fake news’ or falsehoods regarding rabies — making people scared of vaccination, hesitant to have their animals sterilised or vaccinated, and believing in inadequate therapies for the illness.
Let’s get our facts right about animal bites and rabies
The disease is caused by a deadly neurotropic virus of the genus Lysa virus, which belongs to the family Rhabdoviridae. Rabies virus is most often transmitted by bites of rabid animals into wounds or cuts in the skin and mucous membrane. The Rabies virus is often found in the saliva of a rabid animal and is spread by saliva from animal to human or animal to another animal.
The majority of animal bite incidents occur in urban areas and are caused by dog bites. Rabies, which is largely transmitted by dog bites, is a terrestrial and airborne mammalian disease that affects dogs as well as wild animals such as lions, wolves, foxes, and jackals. It has also been detected in cats, monkeys and bats. Various studies have shown that dogs are still the major reservoir of rabies throughout the Asian continent, particularly in India.
Dog’s especially street dogs have always been living in harmony among the human population. Over the years, the population of street dogs has seen a sudden rise which can be attributed to the availability of more food waste due to the changing socioeconomic status, increased population, urbanization, and lack of proper measures to control their population. Dogs are said to be the earliest domesticated animals owing to their loyalty and amiable demeanour.
The other side of the tale is that these street dogs do bite when provoked or, in rare cases, without any external trigger at all. These stories do elicit public outrage and stir heated arguments. Dog bites are prevalent nowadays, and they constitute a major public health issue in India. Some bites are minor (Category I) and do not require medical treatment, but many bites are severe (Categories II & III) and require emergency medical attention. Some may additionally require hospitalisation. All these circumstances pose a burden on the health care system, economic status of the victim and usually add to morbidity rates and loss of work days.
The data in India shows that 20-25 thousand deaths are attributed to rabies with 18 million exposures to animal bites occurring every year. It has been estimated that in absence of the recommended post exposure prophylaxis, about 327,000 people would die from rabies each year in Asia and Africa alone. Apart from the threat to live and pain caused by animal bite, it may also lead to wound infections, disfigurement of body parts, incapacitation and even post-traumatic stress disorder.
Findings of the Research by the Author in the field of Rabies
The findings from the study titled “Rising pattern, Seasonal predisposition and Trend analysis of Animal bite Cases Attending the Anti-rabies Clinic of a Tertiary Care Hospital” reported that the frequency of animal bites (mostly dog bite cases) was less reported in winter season viz during the months of November, December, January and February, because mostly of the people stay indoors during the winter season. Moreover, the frequency increases with the arrival of spring i.e., month of March. Furthermore, there is reduction of animal bite cases in rainy season i.e., Month of April-May and then the frequency of animal bite cases again increases during the month of June. After that then there is a slow decline in the reported animal bite cases during the rest of the months. These results were based on 5 years data interpretation and analysis from district Srinagar.
In another study titled, “Qualitative analysis of the perception of street dog bite victims and implication for the prevention of dog bites at a teaching hospital anti rabies Clinic”. The Authors found that victims of animal’s bites have adequate knowledge that bite along with breach of the skin and oozing blood is a serious concern and calls for treatment at the hospital. Further majority victims of animal bite in the study did not blame the dog for the bite, rather unsanitary conditions of the roads, rising dog population, indiscriminately throwing household waste on streets and inefficiency of the municipality department in clearing piles of wastes from the streets as a reason for their dog bite incident.
Yet in another study, co-authored by the author titled, “Imposing COVID-19 lockdown and reported dog bite cases: An experience from a tertiary antirabies centre of North India”. The authors reported a decrease of only 28% animal bite cases during the lockdown period which was imposed from 21 March 2021 to 03 June 2020 and that too can be attributed to the fact that people’s movement was restricted during the lockdown, which led to a reduction in the number of human-dog interactions and decreased the number of dog bite cases.
• Disseminating information and education regarding human-dog interactions through mass media to reduce false beliefs and deeply seated misconceptions about the Dogs. This should be carried out at regular intervals at the health facility and public places through information, education, and communication material.
• Training of Health Care professionals on appropriate Animal bite management and Rabies Post Exposure Prophylaxis. Also, facility for washing of animal bite cases at the Anti-rabies clinics must be made available and functional for the bite victims.
• Strengthen Human Rabies Surveillance System and establishment of District Level Anti-Rabies Clinics in each district with trained manpower.
• Strengthening of Regional Laboratories under NRCP for Rabies Diagnosis.
• Creating awareness in the community through Advocacy & Communication and Social Mobilization.
• Local administrations must be geared up to reduce the stray dogs load by catching them, followed by sterilization. They must rehabilitate dogs and build dog shelters for them, so dogs live in their respective environment away from humans, which will eventually reduce dog bites and Rabies.
• Policymakers must also acknowledge problems associated with long-term sheltering of dogs in the first place. Rehabilitative in-house training of dogs must be encouraged. Activities like supervised group play and socialization help reduce kennel stress, and we must develop strategies to reduce pet overpopulation, promote adoption, and promote shorter shelter stays.
On this Rabies Day, make your facts right because facts are the only way to beat fake news, help each other to share accurate facts and ensure that decisions about rabies control in your area are based on the correct, and most up-to-date, information.
(Author is Public Health Specialist and can be reached at email@example.com)