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Expert says disease is 100% fatal and 100% preventable
- Friday, September 28, 2012 - From Print Edition




Like every year, World Rabies Day is being observed around the globe, including Pakistan, today (Friday). However, prevention and control of rabies has never been given due attention by the concerned authorities in Pakistan.


Rabies is one of the oldest and deadliest diseases known to mankind. It is said to be the mother of all infectious diseases. It is believed that nothing can be more painful and horrific than rabies. Known as the poor man’s disease, rabies continues to haunt people across Pakistan by claiming an estimated 2,000 to 5,000 lives annually, according to the data prepared on the basis of reported cases only.


There are safe and effective vaccines available for people who have been bitten by animals who might have the disease, but their use in developing countries like Pakistan is much low mainly because of the high cost, misconceptions and taboos.


According to estimates, more than 55,000 people die each year of rabies mostly in the areas of the world, which still have “dog-to-dog” type of rabies transmission. Of the reported cases, a large percentage of deaths (more than 60%) occur in children below 15 years of age. Overall, one person is killed by this disease every 10 minutes around the globe while an estimated 10 million people receive post-exposure treatment each year after being exposed to rabies suspect animals.


It is believed that annual number of dog bites in Pakistan is 100,000 to 150,000 of which 2,000-5,000 die of rabies every year. Once symptoms of the disease develop, rabies is 100% fatal to both animals and humans. However, rabies is easily preventable through immunisation. In the acute stage, signs of hyperactivity (furious rabies) or paralysis (dumb rabies) predominate. Paralysis eventually progresses to complete paralysis followed by coma and deaths in all cases within 2-6 days due to respiratory failure.


Rabies is a severe viral disease caused by a virus ‘Rabdo-Virus’ carried in the saliva of infected animal and is transmitted to human beings through bites, scratches or licks even. It is fatal if not treated properly. It affects the central nervous systems of most warm-blooded animals and victims of such animal bites have to be immediately vaccinated. After exposure to the disease, the victim’s survival is almost impossible. In case of a rabid animal bite case, the virus spreads from the injured part to the nerves and on to the spinal cord that damaging victim’s brain ultimately results in death. It causes convulsions, inability to move and strange behaviour developing hydrophobia (an extremely intense aversion to water, especially the fear of drinking water or other liquids) in the victim exposed to the disease.


Assistant Professor of Microbiology Dr. Humaira Zafar, while talking to ‘The News’ in connection with World Rabies Day, said that rabies is a viral disease that usually involves brain. It is transmitted from non-vaccinated animals to non-vaccinated humans. The virus enters the body through bite of an animal, via infected saliva. The infection can never be transmitted without an actual


bite of rabid animal. The virus travels from the wound to the brain, where it causes swelling, or inflammation ultimately resulting in difficulty in swallowing, muscle spasms, loss of muscle function, restlessness, seizures, coma and death, she said.


She added that the disease period from the entrance of virus into the body till the appearance of symptoms is between 3 to 12 weeks normally and in rare cases it can exceed up to six months or more. The common carriers of the disease are dogs, the commonest ones, in Pakistan while raccoons, skunks, bats, and foxes are also carriers of the disease.


“The recommendations regarding domestic animal vaccination are the core elements of animal rabies control and human rabies prevention,” said Dr. Humaira Zafar and added that the death rate can easily reach up to 100% especially in patients who do not get rabies pre-exposure vaccine after bite of a rabid animal. “The mortality from rabies infection ranks tenth among all infectious diseases worldwide.” Like other health experts, she said that majority of the rabies suspect cases remain unreported in Pakistan, therefore incidence of the disease cannot be exactly detectable.


Dr. Humaira Zafar believes that the high mortality rate of the disease in Pakistan is mainly because of the lack of awareness about vaccination of domestic animals and pre-exposure vaccination of at risk population. “Moreover, lack of diagnostic facilities regarding the specific infection adds up in making the infection with fatal outcome.”


To a query, she said that there is a need to create awareness among public that prevention from rabies is only possible through vaccination of all domestic animals. “In case of having a bite from a suspected rabid animal, one should immediately report to the nearest hospital to get immunoglobulin treatment as the delay of over one week could lead to life-threatening circumstances.” She added that the higher authorities should make policies regarding easy availability of cost-effective vaccine at least at all tertiary care hospitals and veterinary clinics in order to combat the fatal disease.