‘Tremendous.” That was how Mary Divene Hilario said of the increase of rabies cases in Davao region. She knows what she’s talking about. After all, she’s the rabies program coordinator of the Department of Health (DOH) in Region 11.
Davao region is composed of Davao del Sur, Davao del Norte, Davao Oriental, Compostela Valley, and the newly created Davao Occidental. It has six cities: Davao, Digos, Tagum, Panabo, Samal, and Mati.
In a recent news conference, Hilario told reporters that in 2013 there were 20,684 rabies cases. The figure of cases went up to 33,199 last year. During the same period, deaths caused by rabies rose from 16 to 22.
“Davao City has the most recorded cases of animal bites. Almost half of the cases in the region came from Davao City,” Hilario was quoted as saying, adding that the city had 15,000 cases of animal bites in 2014.
The figure was alarming since one case of rabies can infect many people. And it’s deadly. “Usually, rabies is eventually fatal once the rabies virus reaches the spinal cord and brain,” notes The Merck Manual of Medical Information.
The virus, however, takes at least 10 days—usually 30 to 50 days—to reach the brain (depending on where the bite is). “During that interval, measures can be taken to eradicate the virus and help prevent death,” the Merck manual claims.
The Geneva-based World Health Organization (WHO) ranks the Philippines as one of the Top 10 countries with rabies problems. Although it is a preventable viral disease, it kills about 300 to 400 Filipinos every year, figures from the DOH showed. Globally, the annual loss of human lives due to rabies is estimated to be 55,000.
In the Philippines approximately one-third of deaths due to rabies are among children less than 15 years old. Schoolchildren are among the most vulnerable or most at risk for rabies infection, with almost half of rabies exposures registered for schoolchildren, the WHO said.
Despite the enactment of Republic Act 9482, otherwise known as the Rabies Act of 2007, which seeks to eradicate rabies in the Philippines by 2020, rabies remains a public-health problem in the country.
According to medical science, the virus that causes rabies belongs to the group of viruses with a distinct “bullet” shape. It is usually introduced into humans through the bites of infected animals but other means of transmission are possible.
Aside from dogs, other animals, which can transmit rabies are cats, bats and foxes. Domesticated animals like cattle, carabao, pigs, goats and horses also have rabies. Rabies rarely affects rodents (such as mice and rats), rabbits or hares. Birds and reptiles do not develop rabies.
“The domestic dog is the most important reservoir of the virus,” says Dr. Mary Elizabeth Miranda, leader of the rabies research program of the Research Institute for Tropical Medicine. In fact, 98 percent of rabies cases are attributed to dog bites.
But how can you tell if an animal is rabid? “A common clue is a sudden change of behavior, like drooling, unprovoked aggression, biting, aimless running and difficulty breathing,” informs Dr. Silvius Alon, a veterinarian who once worked with the Mindanao Baptist Rural Life Center in Kinuskusan, Bansalan, Davao del Sur. However, some infected animals may become paralyzed or die suddenly without showing signs of illness.
If possible, any dog that bites a person should be confined and observed. “If the dog remains healthy for 10 to 14 days, it’s safe to assume it’s rabies-free,” Miranda says. If the animal does show symptoms, the owner should contact the local health department or a veterinarian immediately and the dog should be humanely put down.
Contrary to common belief, puppies—upon birth—are not infected by rabies. Dr. Lester L. Quiano, a veterinarian who used to write a column for a national daily, explained: “Puppies could only acquire the disease as young as three months because at this stage, they start to lose their maternal immunity.
[At birth, the puppy sucks the first flow of milk containing colostrum, which gives protection to the puppy until three months of age. After this, the protection will start to dwindle].”A dog can be infected with rabies if bitten by a rabid animal. “When a rabid animal bites a dog, it will take 10 to 80 days for the virus to multiply in the dog’s body, after which, it will show clinical signs of rabies infection,” Quijano wrote. “During this stage, the dog shows excitement and unusual restlessness, and will bite into any moving object.
“The bite of any rabid animal is not the cause of the spread and infection of rabies,” corrects Alon. “It is the saliva of the affected animal. The bite is just an instrument so that the saliva with rabies virus can be transferred to any victim.”
According to the US Centers for Disease Control and Prevention (CDC), the rabies virus infects the central nervous system, causing disease in the brain and even death. The early symptoms of rabies in people are similar to that of many other illnesses, including fever, headache and general weakness or discomfort.
“As the disease progresses, more specific symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation [increase in saliva], difficulty swallowing and hydrophobia [fear of water]. Death usually occurs within days of the onset of these symptoms,” CDC explained.
Dr. Raffy Deray, program manager for rabies at the National Center for Disease Prevention and Control of DOH, suggests doing the following if stray animals that may have rabies bite you. First, immediately wash the bite with soap and clean water. Antiseptics may be applied. Then, consult a physician or go to your nearest animal bite center for immunization. Last, consult a veterinarian for the management of the biting dog.
By 2020 the DOH is targeting a rabies-free Philippines mainly through the vaccination of all dogs in the country.