MANILA, Philippines—For tomorrow’s celebration of World Rabies Day, the country’s leading pediatric infectious disease experts have begun a nationwide campaign to promote preventive rabies vaccination among children aged 5 to 14.

“The implementation could save the lives of many Filipino children, who are most prone to get bitten by their own dog or the dog of someone they knew,” said Dr. May Book-Montellano, president of Pediatric Infectious Diseases Society of the Philippines.

Here in the Philippines, 98 percent of rabies cases are due to dog bites or licks to an open wound or skin breaks (cats and other animals such as monkeys are also sources of rabies infection).

She explained that children often don’t know how to act around dogs and lead them into aggressive behavior.

Disadvantage

A child’s height could also be a disadvantage since two-thirds of injuries among children are to the head or neck region, which is a high-risk site to get bitten by a dog with rabies.

“Their size makes them less intimidating to an attacking dog. Moreover, these children are more likely to move or react much slower when escaping or fending off the bite,” she added.

Rabies ranks 11th among the world’s major deadly diseases killing about 60,000 people every year (the Philippines ranks sixth in Asia for the most number of cases of rabies).

While there are a reported 200 to 300 individuals who die from rabies every year here in the country, these statistics, however, are an underestimate as rabies is often not reportable where the majority of human deaths occur.

1 to 2

In fact, the World Health Organization revealed that one to two children die from rabies every 30 minutes.

“Rabies is the most deadly, and yet ironically, one of the most preventable diseases,” explained Dr. Beatriz Quiambao, Clinical Research Division head of the Research Institute for Tropical Medicine in Muntinlupa City.

Aside from prompt and proper wound care as well as administration of postexposure prophylaxis (vaccine and rabies immunoglobulin), death from rabies could be prevented if one is immunized against it.

“Since one cannot predict when he or she will get bitten, the best protection is for an individual to get rabies vaccination before they are bitten (otherwise known as preexposure prophylaxis). Before, veterinarians, animal shelter staff or healthcare workers are required to receive this but it’s good news that children are now included in the list,” Quaimbao said.

Law

“It’s now the law. The Anti-Rabies Act passed in May last year provides for free routine immunization, among others, in areas where there is a high incidence of rabies,” Quiambao added.

The PIDSP campaign, Montellano explained, is private initiative of the group to remind more parents and guardians why they need to have their children immunized against rabies.

“Our campaign would take us to communities in highly affected areas where we will be in touch with various leaders who will then communicate to their constituents the importance of immunization as well as how to be a responsible dog owner,” Montellano said.

Vaccines, like the inactivated, purified rabies vaccine prepared on vero cell line, will not only protect one from inadvertent exposure as this will also mean the shots needed after being bitten is much less (the need for passive immunization with rabies immune globulin is eliminated).

Overall cost is also reduced.

Vaccination

Quaimbao reiterated that rabies is extremely contagious from animal to human, usually through a scratch or bite, transmitted through saliva.

“Early diagnosis is crucial to the survival of the patient, especially a child. If left untreated, death is almost always 100 percent, so if you suspect contamination, rush your child to the hospital or the nearest Animal Bite Treatment Center for care immediately,” she said.

The virus that causes rabies has affinity for the nervous system, and once symptoms of the disease develop, rabies is fatal to both animals and the human victim.

The first symptoms are usually nonspecific and involve the respiratory, gastrointestinal and central nervous systems. In the acute stage, signs of hyperactivity or paralysis may predominate, but the disease eventually progresses to complete paralysis followed by coma and death in all cases, usually due to respiratory failure.

“Without intensive care, death occurs after approximately seven days from the onset of symptoms,” Quaimbao explained.

Prevention

Aside from advocating pre-exposure prophylaxis, PIDSP will also assist in education to help prevent children from being exposed to rabies including:

• Keep pets and other domesticated animals up-to-date with regular animal rabies shots.

• Report stray dogs or any animals that act strangely or sick to your barangay or community leaders.

• Keep the phone number of nearby hospital, doctor or health worker.

• Teach children to never run away from or past a dog (this can make them aggressive and want to chase).

• Tell children to never go up to a dog they don’t know and try to get friendly or to stay away from a mother dog tending to her puppies.

• Remind children that if an unfamiliar dog comes up to them, just stand still (most of the time, the dog will sniff and then walk away).

• Tell them not to bother a dog that is eating or sleeping.