100 succumb to rabies infection annually in Nepal

By Mahima Devkota, Kathmandu, Sept.28: World Rabies day is being celebrated today with a theme, 'One Health, Zero Death' highlighting the connection of the environment with both people and animals.

Dr Chandra Dhakal, Spokesperson of the Department of Livestock Services said that every year around 100 people die of rabies infection. It is because of delay or lack of inoculation of anti-rabies vaccine timely. Therefore, timely vaccination is recommended as it prevents mortality by 100 per cent, however, if the rabies-infected person delays vaccination then the fatality rises to 100 per cent. 

Rabies is transmitted by the bite of infected warm-blooded animals. In Nepal, majority of the rabies infection is transmitted by the bite of rabies-infected dogs. In the case of humans, they get rabies when they are bitten by an infected animal, or exposed to its saliva or central nervous system tissues, through mucous membranes or breaks in the skin, however, the rabies virus is not transmitted through the intact skin.

According to Dr Dhakal, the incubation period is a few days to several years, depending on the proximity of the bite. Symptoms of the infection appear in most cases after 21 days to three months from the date of the bite. The early symptoms may include non-specific signs such as fever, headache, discomfort and pain. 

After several days, anxiety, confusion and agitation may appear, and progress to insomnia, hypersensitivity to light and sound, delirium, hallucinations, difficulty swallowing, and hydrophobia.  Death from rabies usually occurs within 2 to 10 days after the infected humans begin showing the major symptoms.  

He said, "Rabies is 100 per cent fatal and is 100 per cent preventable as well. It is important to prevent rabies in both animals and humans to prevent its further spread. We are producing 1, 50,000 doses of vaccine to infected mammals while tissue culture technology induced is administered to humans which are not produced in Nepal." 

According to Epidemiology and Disease Control Division (EDCD), a total of 295,000 vials of ARB Rabies vaccines have been administered in Nepal in the fiscal year 2077/78, 236,022 in 2076/77, 281,718 in 2075/76, and 227,639 in 2074/75.

Dr Roshika Shrestha, Veterinary Officer at the Division said there are three degrees of mammals bite, first, second and third, causing Rabies in Nepal. Irrespective of the degree of severity of the bite, or even if the dog is vaccinated with the anti-, one rabies vaccine must get the anti-rabies vaccines at the earliest.

She said, " ARB vaccine is administered for first and second-degree bites and 'Rabies immunoglobulin’ is administered for third-degree bites. So far, there is the administration of 'Rabies immunoglobulin’ in Teku Hospital only.”

Prevention of Rabies

“One must try to wash the bite of a dog, even though it is vaccinated, with warm water and soap for 15-20 minutes, and must use 70 per cent alcohol-based sanitiser. This will wash away 90 per cent of the germs,” said Dr Binay Shrestha, One-health Expert.

Saying that 90 per cent of cases of Rabies in Nepal and in South Asia are because of the dog bite, Dr Binay stressed that there is a must to vaccinate dog especially stray dogs with the anti-Rabies vaccine to control rabies cases in the country.

“Dog’s acts as an agent of rabies in Nepal, however, the reservoir hosts are Jackle, therefore, not only vaccinating dogs but also reducing the bite of Jackle to dogs must be focused upon,” he added.

Spokesperson Dhakal said that there must be a well-maintained census of dogs which will help in the identification and vaccination of dogs, management and incarceration of stray dogs, the establishment of community shelters, and inoculating dogs with the anti-rabies vaccine is a step forward to prevent rabies from the country. 

According to the World Health Organization (WHO), a country is considered to be free of rabies if there have been no indigenously acquired cases in humans or animals during the previous two years, in the presence of adequate surveillance and import regulations. 

Being part of the tripartite agreement, between the Food and Agriculture Organisation (FAO), World Health Organisation (WHO) and OIE-WAHIS, World Organisation for Animal Health Nepal also has set the target to reduce Rabies cases to zero by the year 2030.