Beware: Rabies can strike you anywhere
By Ruwanthi Herat Gunaratne
Eighty three people died of rabies last year. Shocking statistics indeed, since this disease is preventable.

Bitten by a dog or cat: What next?
"Wash the wound with soap and water," advises Dr. Omala Wimalaratne, "and rush the victim to the nearest government hospital." The doctor will then assess the condition and vaccinate as necessary.

There are two different courses of the vaccine. One, the intra-dermal, which involves five injections over 90 days and the other, the intra-muscular, which involves four or five injections over 30 days.

In serious cases, the immunoglobin injections are administered to the wound in addition to the course of the vaccine. The immunoglobin injections are administered to every place where there is a serious bite.

"If there are ten wounds, it means ten injections," Dr. Wimalaratne said.

In cases where the dog has been given all the necessary vaccinations, the full course may not be necessary. This means the dog was first vaccinated at the age of six weeks, then at three months and for two consecutive years afterwards. If this is not the case, the course has to be administered.

"It is important to remember that even puppies can carry the virus, and puppies are actually those under the age of six weeks."

It is always advisable to tie up the dog that bites and observe it for fourteen days. I

f the dog dies, the head should be sent to the MRI for further testing.

This can help with the assessment of the animal and the nature of the bite.

However, not all people bitten by rabid animals develop rabies. The development of the disease depends upon several factors such as place of the bite, severity of exposure, species of animal involved, genetic factors and virulence of the virus.

sAs it is the nervous system that comes under attack, any bites closer to the face and head are particularly dangerous.

Rabies is an incurable disease, but prevention is possible. Sadly, awareness is almost nil.

The Health Ministry together with the Department of Animal Production and Health, various non-governmental organisations, local authorities, Police and the Medical Research Institute (MRI) has formed the National Rabies Elimination Committee, a task force dedicated to eliminating this killer disease from the country.

"As long as there remains garbage on the roads, there will be stray dogs. As long as there are stray dogs, there remains rabies," says Dr. Omala Wimalaratne, a virologist and vaccinologist attached to the Department of Rabies and Vaccines of the MRI.

But eliminating stray dogs is not enough. One-third of rabid dogs are actually domestic animals.

It is not only canines that carry the disease. They account for only 70 percent of the virus carriers. Cats, mongooses, cows and bandicoots also carry the virus.

The Health Ministry has taken an active interest in the prevention of rabies. But the battle cannot be fought by the ministry alone. Local authorities and medical professionals need to play an active role in creating public awareness. Little known for example is that there exists rabies legislation in the country, giving the Police the right to eliminate dogs carrying the virus. "This is why the Police play such a vital role in the process," Dr. Wimalaratne says.

As public health is at stake, local authorities play an important part in the elimination process. At the moment, rabies testing is conducted only at the MRI.

Any suspected carriers of the virus are brought to the MRI. As this too is a problem, the National Rabies Elimination Committee hopes to conduct testing on a provincial level with the cooperation of local councils.

Various NGOs also play an active role. Abandoned puppies are found homes. Sterilization clinics are held. Vaccines are given free at the proper time and thereby the threat to the public is lessened.

"Community participation is vital," stresses Dr. Wimalaratne, who recently delivered the Pulimood Oration on Rabies Prevention and Control in Sri Lanka.

The MRI also holds a Rabies Post Exposure Clinic every day at its premises.

"Humans are an accidental host," adds Dr. Wimalaratne. "They are also the dead-end host." The main objective of this committee is to bring the rabid dog population down to zero.

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