Tuesday, March 17, 2015

Rabies in The Philipines




One of the more interesting Pro Med posts I have seen in a while came up today, and it is concerning our bullet shaped mononegavirales friend, Rabies Virus. According to the Pro Med report, 13 people in the village of Cabatangan Village in Zamboanga, Philippines have received post exposure prophylaxis. To give you some geographical perspective on the location of this outbreak, I used my google maps skills:

























Cabatangan village is in Zamboanga, a province in the Southwest corner of the Philippines. In this village, 4 adults and 9 children were infected with RABV, a fairly large outbreak considering the normal route of transmission is animal bite. Could there be an uncontrollable, incredibly vicious, evasive canine on the loose in Cabatangan?!

Pro Med says no, and the health officials in the Philippines mounted such large post exposure prophylaxis measures after realizing that these 14 individuals had consumed Rabies tainted dog meat. Apparently this is not a novel issue throughout the country. According to the animal welfare institute, more than half a million dogs are slaughtered for consumption every year, and there is a high prevalence of the virus in dogs and humans causing 10,000 dogs and 350 people to die from Rabies in the Philippines every year.

This is an interesting cultural issue in the country, as the consumption of dog meat was actually banned nationwide in 1998. If a dog meat trader is caught in the Philippines, they can face serious penalties such as jail time and significant fines. Although this legislation is in place, the long standing cultural practice of consuming dog meat in regions of the Philippines has been difficult to stop. That being said, if the public health department is using the ingestion of dog meat as a possible means of transmission of Rabies Virus in order to argue for the cessation of this cultural practice, they may need to check their facts.

According to the WHO, Rabies cannot be transmitted through the ingestion of an infected animals tissue. So, this ProMed report may be a bunch of hogwash. Ultimately I do not fault the public health officials of the Zamboanga province for prophylactically vaccinating the individuals who may have ingested contaminated meat, as even the possibility of exposure to the fatal virus is terrifying. Additionally, that's another 13 people in your province that have been vaccinated against a fatal disease!

As a public health official, what would you do? Even if there was a remote possibility of transmission of Rabies Virus to humans via consumption of meat, I think my next step would be to launch a vaccination campaign for both dogs and humans in Rabies endemic areas throughout the Philippines. If the cultural practice is to eat dogs and it doesn't seem to be stopping, then maybe formally regulating the production and sale of dog meat wouldn't be a bad idea. This way, the animals could be checked for RABV after death, and no post exposure prophylaxis measures would be needed.

An interesting ProMed report indeed. Expect more updates from me soon fellow virologists, I have a few more blog posts to catch up on! Rabidly yours,

- Marcus Munoz







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