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Archive Number 20100208.0422
Published Date 08-FEB-2010
Subject PRO/AH/EDR> Rabies, canine, human - Philippines (03): update
RABIES, CANINE, HUMAN - PHILIPPINES (02): UPDATE
************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sat 6 Feb 2010
Source: market4everything.info [summ., edited]
<http://www.market4everything.info/rabies-persists-as-public-health-headache-in-philippines>


The Department of Health (DOH) reported that rabies continues to be a 
public heath problem in the Philippines wherein dogs [are responsible 
for 90 percent of cases of rabies]. Rabies is the 10th most frequent 
cause of death globally due to infection in humans, predominantly 
affecting poor people in developing countries.

According to Dr Raffy Deray of the National Rabies Prevention and 
Control Program of the Department of Health (DOH) around 10 million 
[people] are exposed annually with some 60 000 deaths mostly in Asia 
and Africa, with 99 percent occurring in developing countries in 
which 15 percent of the population are children less than 15 years of age.

In 2005 alone, Deray reported that the [Philippines] registered 248 
human rabies cases and thee Philippines ranked 5th in Asia [after 
India, China, Pakistan, and Bangladesh].

Of the 250 cases recorded last year [2009] nationwide, 61 percent was 
recorded in Luzon, 20.5 percent in Mindanao, and 18.5 percent in 
Visayas, Deray said. The DOH regional offices with the most number of 
human rabies cases recorded last year are: CHD5 with 38 cases, 
followed by CHD2 with 37 cases, CHD4, CHD3, and CHD8 with 31, 25, and 
20 cases, respectively, Deray said. [CHD = Center for Health Development]

On the other hand, the data revealed that the top 5 provinces with 
the most number of human rabies cases recorded in 2008 were: Isabela 
(17), Camarines Sur (15), Cagayan and Nueva Ecija (14), Iloilo (10), 
and Camarines Norte (9).

The number of animal bite victims has been increasing in the past 5 
years with 189 781 cases reported in 2008. 59 percent was recorded in 
Luzon, 24 percent in Visayas, and 17 percent in Mindanao, the DOH 
official further said.

Deray stated that rabies is an acute, progressive, incurable viral 
encephalitis with a fatal outcome transmitted through injection of 
infectious saliva into a broken skin (bite exposure) and licking of 
scratches, abrasions, open wounds or intact mucous membrane; 
inhalation/aerosol transmission from bats in caves, and human to 
human (15 documented cases of fatal rabies following transplantation, 
8 corneal transplant, and solid organ transplants and a vascular 
conduit). Once clinical symptoms have occurred, he said, rabies is 
almost invariably fatal wherein mortality rate is 100 percent in 
unvaccinated patients. The risk of developing rabies is around 15-20 
percent influenced by virus content of saliva (viral shedding in 
saliva is intermittent), severity of the bite, and location of the 
bite. The average incubation period ranges from 10-90 days. 
Incubation period maybe much shorter or few days to several weeks 
especially in children with severe exposure in well innervated areas 
like face, head, and neck, or much longer in very exceptional cases 
where incubation lasts of up to 6 years which was recently reported 
in the United States of America.

Human rabies can be prevented through elimination of infection in 
animal vectors [in the case of the Philippines by vaccinating at 
least 70 percent of the dog population], and provision of timely and 
appropriate post-exposure prophylaxis (PEP) depending on the category 
of exposure, and provision of pre-exposure prophylaxis (PrEP) to high 
risk individuals

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Sadly although the problems and the remedies are well recognized, 
little progress has been achieved in the elimination of canine rabies 
in the Philippines during the past decade. Visitors to the 
Philippines should be warned that the Philippines probably still 
ranks 5th in Asia in terms of risk of exposure to rabies virus infection.

A map of the regions and provinces of the Philippines can be accessed at
<http://mapsof.net/uploads/static-maps/philippines_regions_and_provinces.png>.
The HealthMap/ProMED-mail interactive of the Philippines is available 
at <http://healthmap.org/r/00bk>. - Mod.CP]

[see also:
Rabies, canine, human - Philippines (02): (CT) 20100125.0275
Rabies, canine, human - Philippines: (CT) 20100124.0271
2007
----
Rabies, human, canine - Philippines (La Union) 20070918.3092
Rabies, human - Philippines (Iloilo) 20070209.0506
2006
----
Rabies, human - Japan (Kanagawa) ex Philippines 20061122.3322
Rabies, human - Japan (Kyoto) ex Philippines 20061118.3303
2004
----
Rabies, human - Philippines (Iloilo) 20040822.2331
Rabies, human - Philippines (Mindanao) 20040808.2182
2001
----
Rabies, human, suspected - UK ex Philippines 20010611.1139
Rabies - Philippines: background 20010519.0977
Rabies, human - UK ex Philippines (03) 20010515.0945
Rabies, human - UK ex Philippines (02) 20010513.0922
Rabies, human - UK ex Philippines 20010510.0907
2000
----
Rabies - Philippines (Bicol) 20000517.0775]
...................................sb/cp/mj/mpp

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