Rabies Prevention and Control Program

RABIES PREVENTION AND CONTROL PROGRAM

Rabies is a human infection that occurs after a transdermal bite or scratch by an infected animal, like dogs and cats. It can be transmitted when infectious material, usually saliva, comes into direct contact with a victim’s fresh skin lesions. Rabies may also occur, though in very rare cases, through inhalation of virus-containing spray or through organ transplants.

Rabies is considered to be a neglected disease, which is 100% fatal though 100% preventable. It is not among the leading causes of mortality and morbidity in the country but it is regarded as a significant public health problem because (1) it is one of the most acutely fatal infection and (2) it is responsible for the death of 200-300 Filipinos annually.

Vision: To Declare Philippines Rabies-Free by year 2020

Goal: To eliminate human rabies by the year 2020

Program Strategies:

To attain its goal, the program employs the following strategies:

1. Provision of Post Exposure Prophylaxis (PEP) to all Animal Bite Treatment Centers (ABTCs)

2. Provision of Pre-Exposure Prophylaxis (PrEP) to high risk individuals and school children in high incidence zones

3. Health Education

Public awareness will be strengthened through the Information, Education, and Communication (IEC) campaign. The rabies program shall be integrated into the elementary curriculum and the Responsible Pet Ownership (RPO) shall be promoted. In coordination with the Department of Agriculture, the DOH shall intensify the promotion of dog vaccination, dog population control, as well as the control of stray animals.

In accordance with RA 9482 or “The Rabies Act of 2007”, rabies control ordinances shall be strictly implemented. In the same manner, the public shall be informed on the proper management of animal bites and/or rabies exposures.

4. Advocacy

The rabies awareness and advocacy campaign is a year-round activity highlighted on two occasions – March as the Rabies Awareness Month and September 28 as the World Rabies Day.

5. Training/Capability Building

Medical doctors and Registered Nurses are to be trained on the guidelines on managing a victim.

6. Establishment of ABTCs by Inter-Local Health Zone

7. DOH-DA joint evaluation and declaration of Rabies-free islands

Program Achievements:

The DOH, together with the partner organizations/agencies, has already developed the guidelines for managing rabies exposures. With the implementation of the program strategies, five islands were already declared to be rabies-free.

In 2010, 257 rabies cases and 266,200 animal bites or rabies exposures were reported. A total of 365 ABTCs were established and strategically located all over the country. Post Exposure Prophylaxis against rabies was provided in all the 365 ABTCs.

Partner Organizations/Agencies:

The following organizations/agencies take part in attaining the goal of the National Rabies Prevention and Control Program:

Department of Agriculture (DA) Department of Education (DepEd) Department of Interior and Local Government (DILG) World Health Organization (WHO) Animal Welfare Coalition (AWC) BMGF Foundation WHO/BMGF Rabies Elimination Project Bill and Melinda Gates Foundation World Society for the Protection of Animals (WSPA)

Medical Research Council (MRC) The Department of Health states that around 300 to 600 Filipinos die of rabies per year. More than half of the victims are children between five and 14 years old. According to the World Health Organization, the Philippines ranks among the highest in the world in terms of rabies prevalence.

Rabies is a deadly disease caused by the rabies virus. A person gets rabies after being bitten by an infected animal, usually a dog or a cat. It is passed on to the victim via contact with the rabid animal’s saliva.

The incubation period for rabies is usually three weeks but may reach up to five years. Symptoms include fever, headache, anxiety, confusion, difficulty swallowing, and paralysis. Once a person develops the symptoms of rabies, the disease will be very hard to treat. Most cases of rabies are fatal.

Fortunately, there are vaccines available that effectively prevent rabies after an animal bite. Hence, if you see your doctor immediately after getting bitten, then your doctor can give you a series of rabies shots that will prevent you from getting rabies. Visit an animal bite center located in many hospitals.

Your doctor needs the following information:

1) What animal bit you?

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2) Was it a pet or a stray animal?

3) If it was someone’s pet, was the pet vaccinated against rabies?

4) Was the animal acting unusually, which means it could be rabid, or did you provoke the animal?

5) Can you observe the animal for 10 days to determine if it will turn rabid?

It is best to capture the animal and observe it for 10 days. If the animal does not turn rabid in 10 days, then it doesn’t have rabies and you don’t need to continue with the anti-rabies shots. However, if the animal has escaped, then we can presume that the animal has rabies and you should be treated accordingly.

Vaccination is especially needed in cases of bites near the head and neck areas. These areas are more sensitive because the rabies virus can reach and infect the victim’s brain in a shorter span of time.

Rabies shots usually consist of six injections given over a period of 28 days. The first injection is best given on the day of the bite itself.

Tips on how to prevent rabies

• Pet owners should vaccinate their pets regularly. For dog and cat owners, ask your veterinarian about the vaccination schedule.

• Don’t let pets come in contact with other stray animals. Your pet could get bitten by a rabid animal and develop rabies.

• Don’t approach and touch other people’s pet. They may seem friendly, but could suddenly bite strangers.

• Don’t let your guard dog wander around. Keep your doors and gates closed at all times. Take pity on the poor bystanders who can get bitten by your pet.

• Carry a stick or an umbrella when you go walking or jogging in the neighborhood. Wear long pants instead of shorts.

• Don’t leave your child alone with someone’s pet. Don’t bother pets when they are eating, sleeping or nursing their babies. Keep pets on a leash.

• Report stray animals to local authorities.

• Stay away from bats and other wild animals. Don’t let bats enter your home since they are known to carry the rabies virus.

• If you frequently work with animals, you may need to get rabies shots in advance. Ask your doctor about it.

What the anti-rabies law says

The Anti-Rabies Act of 2007 (RA 9482) provides the guidelines for the prevention and control of rabies in the Philippines. Several agencies and persons are tasked to do their respective jobs in a collective effort to control rabies under a National Rabies Prevention and Control Program.

The main goals of this Act are to give mass vaccination to dogs, establish a registry of vaccinated dogs, and ensure proper disposition of unregistered and stray dogs.

The Department of Agriculture (DA) is tasked to ensure an adequate supply of animal anti-rabies vaccine, to improve existing animal rabies laboratory testing, and to give free dog vaccinations in priority areas. The DA is also required to maintain a rabies surveillance system.

If the DA’s responsibility pertains to the dog, then the Department of Health’s task is to protect the human. Hence, the DOH is directed to ensure an adequate supply

of human anti-rabies vaccine in animal bite centers nationwide. The DOH is also obliged to provide vaccination to the victim at a minimum expense, and to keep surveillance data on the number of animal bite victims and rabies cases.

Both agencies are urged to carry out a health information campaign on rabies and responsible pet ownership. The Department of Education can assist in the campaign by including rabies prevention tips in the school curriculum.

The local government units play a huge role in rabies control. The LGUs are tasked to make sure that all dogs are immunized and registered. The LGUs should likewise allocate the necessary funds for dog vaccines and human vaccines. They are also responsible for field control and removal of stray dogs, and ensuring that dogs are within the confines of the owner’s house. According to the law, if the impounded dogs are not claimed in three days, they may then be put up for adoption, preferably with the help of an animal welfare NGO.

Responsibility of pet owners

The main responsibility of pet owners is to vaccinate and register their dogs. And should their dog bite a victim, then the owner is required to shoulder all the medical expenses, including the cost of several vaccinations.

There are penalties for pet owners who violate the law. These sanctions include a P2,000 fine for owners who refuse to immunize or register their dogs, and a P25,000 fine for owners who refuse to pay for the medical expense of a victim bitten by their dog.

Let’s help to keep our community safe. All of us can play an important role in preventing dog bites and rabies.

1. Q: How do people get rabies?

A: People usually get get rabies from the bite of a rabid animal. It is also possible, but quite rare, that people may get rabies if infectious material from a rabid animal, such as saliva, gets directly into their eyes, nose, mouth, or a wound.

2. Q: Can I get rabies in any way other than an animal bite?

A: Non-bite exposures to rabies are very rare. Scratches, abrasions, open wounds, or mucous membranes contaminated with saliva or other potentially infectious material (such as brain tissue) from a rabid animal constitute non-bite exposures. Occasionally reports of non-bite exposure are such that postexposure prophylaxis is given.

Inhalation of aerosolized rabies virus is also a potential non-bite route of exposure, but other than laboratory workers, most people are unlikely to encounter an aerosol of rabies virus.

Other contact, such as petting a rabid animal or contact with the blood, urine or feces (e.g., guano) of a rabid animal, does not constitute an exposure and is not an indication for prophylaxis.

3. Q: How soon after an exposure should I seek medical attention?

A: Medical assistance should be obtained as soon as possible after an exposure. There have been no vaccine failures in the United States (i.e., someone developed

rabies) when postexposure prophylaxis (PEP) was given promptly and appropriately after an exposure.

4. Q: What medical attention do I need if I am exposed to rabies?

A: One of the most effective methods to decrease the chances for infection involves thorough washing of the wound with soap and water. Specific medical attention for someone exposed to rabies is called postexposure prophylaxis or PEP. In the United States, postexposure prophylaxis consists of a regimen of one dose of immune globulin and five doses of rabies vaccine over a 28-day period. Rabies immune globulin and the first dose of rabies vaccine should be given by your health care provider as soon as possible after exposure. Additional doses or rabies vaccine should be given on days 3, 7, 14, and 28 after the first vaccination. Current vaccines are relatively painless and are given in your arm, like a flu or tetanus vaccine.