New Delhi: A combination of large human and dog populations in congested habitable areas combined with widespread poverty has led to more deaths due to rabies in WHO’s South-East Asia Region than in any other part of the world. More than 1.4 billion people are potentially at risk of rabies in this Region. Children aged 5-15 years represent 40% of people exposed to dog-bites in rabies-endemic areas.
Dog bites are the primary source of human infection in all rabies-endemic countries in the Region and account for 96% of human rabies cases. On World Rabies Day (28 September) , WHO is urging Member States to ensure access to modern tissue-culture rabies vaccine, promote cost-effective intradermal vaccination and control rabies at the source through mass dog vaccination and animal birth control. The WHO Regional Office for South East Asia has developed a regional strategic framework for elimination of human rabies transmitted by dogs. The strategic framework will provide technical leadership, encourage national health authorities in Member States to develop consensus among major stakeholders for a comprehensive rabies elimination programme and implement national strategies for elimination of human rabies considering the epidemiological situation, technical feasibility and socio-cultural context.
“Rabies is a fatal disease, but it can and must be prevented,” says Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia Region. “Rabies is a serious public health problem in South-East Asia, and countries must develop and implement comprehensive national rabies control programmes through partnership in order to sustain prevention of rabies and move towards elimination of human rabies,” he adds. WHO has been providing technical support to Member States to introduce intradermal rabies vaccination.
Rabies kills 21000 – 24000 people in the Region which is approximately 45% of global deaths due to the disease. The actual number is likely to be far higher since many cases of rabies are not reported. Every year, more than 4 million people in the Region receive rabies vaccine and serum, after being bitten or exposed to animals that are suspected of rabies. Children and poor people are particularly vulnerable to the disease. Sri Lanka and Thailand have successfully brought down the number of rabies-related human deaths through mass dog vaccination campaigns, improved accessibility to human rabies vaccine and serum and an effective vaccine delivery system. Both countries have successfully adopted the intradermal rabies vaccination to ensure access, affordability and availability of modern rabies vaccine.
In India, intradermal rabies vaccination has been promoted at the state level, and antirabies vaccination and birth control of dogs have been carried out by animal welfare and nongovernmental organizations.
The elimination of human rabies in South-East Asia is feasible with intersectoral coordination, technical, political and public support. Prevention, promotion and partnership are strategic tools for elimination of human rabies;
Prevention: Introduce cost-effective public health intervention techniques to improve access, affordability and availability of rabies vaccine and serum. Develop and implement mass dog vaccination programmes.
Promotion: Improve understanding of rabies through advocacy, awareness, education and operational research. Promote responsible dog ownership.
Partnership: Provide coordinated support for the anti-rabies drive with the involvement of community, civil society, government and nongovernmental sectors and international partners.