RABIES AND ITS PUBLIC HEALTH IMPLICATIONS: A DESTRUCTIVE ENDEMIC ZOONOSES

Zoonotic diseases and Rabies: Zoonotic diseases are those that can be transmitted between animals and people, with
rabies being a prime example. These zoonotic diseases are broken down into five major categories: viral, fungal,
bacterial, internal or external parasites. Zoonoses are spread from animals to humans via several routes. Direct
contact with the dog and sharing the dog’s environment are the two most common means of exposure to potential
disease. Infectious agents can be in the dog’s saliva, faeces, urine and on the dog’s skin and fur. Infectious organisms
can also be in fields, streams and parks shared for recreational purposes with the dog. Serious public health concerns
arise from this issue and dog bites result in significant numbers of hospitalizations each year while rabies and other
zoonoses establish reservoirs in uncontrolled stray dog populations. Due to its seriousness, rabies control has
overshadowed the other zoonoses transmitted by dogs; thus in many countries the health sector is focusing on this
disease.

Rabies is preventable through timely vaccination. However, once the disease occurs, death is inevitable. The primary
means of transmission is through a bite from an infected animal, as saliva carries large numbers of the viral agent.
Other less common means of transmission include infected saliva coming in contact with an open wound or
abrasion. There have been a few cases of Rabies being spread by the inhalation of aerosolized virus.

More than 1.4 billion people are at potential risk of rabies infection in South-East Asia (SEA) and each year there
are 23000 – 25000 human rabies deaths. Sri Lanka is a small island in the Indian Ocean, 66,000 Km2 in area, with a
population of almost 21 million. In Sri Lanka, according to the World Health Organization (WHO), between 1987
and 2007, with the total number of human fatalities reaching 2042, the country ranks number three in the region and
seven in the world in disease fatalities. In the year 1973 the country had the highest number of human rabies deaths
of 377 (20 per million population) and the lowest of 55 (3 per million population) in 2005. Rabies is currently
endemic in Sri Lanka. Of the human rabies deaths that occurred between 1992 and 2000, diagnosed clinically at
Medical Research Institute (MRI), 60% occurred in adults and 34% in children with a male to female ratio of 3:1.
The dog is the main reservoir for transmission of rabies to human, accounting for 96% of cases; cats account for 2%
and other animals for 2%.

Cost for rabies control: Rabies continues to be a major public health issue in Sri Lanka and the cost to the
Government for rabies treatment and management is very high. Immunization against rabies is a vital component in
reducing human and dog rabies cases. Currently the number of dog bites reported per day is 2000. The government
spends Rupees 500 million (about US$ 4.31 million) each year to treat dog bite victims at an average of Rs. 39,000
(about US $336.2) per person. Meanwhile, the government has allocated Rupees 200 million (about US$ 1.74
million) to the Health Ministry’s sterilization program to control the growth of dog population in Sri Lanka. 20,740
surgical sterilizations and 13,557 chemical sterilizations were carried out in the first half of 2011. This is a very
small percentage (approximately 1.3%) relative to the estimated dog population of 25 million (though accuracy is
uncertain). It should also be noted that a cumulative figure over several years, based on dog lifespan under local
conditions, should be considered; as surgical sterilization is permanent. Also for the purposes of population control
the percentage of female-dog sterilizations is the more pertinent figure. The Public Health Veterinary Services of
Health Ministry has carried out 955,953 dog vaccinations in 2010.

Controlling Rabies in Roaming Dogs: Since Rabies is a significant health hazard throughout most of the developing
world; countries use diverse strategies for its control and management. Until 2006 Sri Lanka had practiced
vaccination of owned dogs combined with mass culling of roaming dogs in order to control rabies. However, these
programs were unsuccessful in providing effective sustainable control of rabies. Now the government policy for
rabies control has shifted to sterilization and vaccination of both owned and roaming dogs.

BPT was granted honorary membership of the World Society for the Protection of Animals (WSPA) in 2004.
Subsequent to the tsunami of December 2004, the fear of rabies outbreaks spread throughout the affected coastal
areas. BPT, in collaboration with WSPA, operated two mobile veterinary clinics to sterilize and vaccinate dogs in
these regions. Due to the success of this 2 year project, in 2007 WSPA invited BPT to carry out a 5 year dog
population management and rabies control program within the city of Colombo under the ICAM coalition
guidelines.

ACHIEVEMENTS OF COLOMBO CITY PROJECT:

Vaccination by BPT of roaming dogs > 80 % of roaming dog population. – Photos

Sterilization of roaming female dogs > 70 % of roaming female dog population – Photos

Dog rabies cases from an average of 35 (1992-2007) to 10 at end of 2010 and 8 detected as at end 2011.

Education of school children and adults on bite prevention, rabies awareness and responsible dog ownership –
Photos

63102 primary school children (almost 90% of schools covered) – Photos

19836 secondary school children (35 schools) – Photos

4615 community members (42 programs) – Photos

Dog Managed Zones – 6 (2 hospitals, 1 school and 3 Government offices). An innovative program providing
tailored solutions to minimize conflict between the public and dogs in high risk public locations. – Photos

Reduction in number of lactating bitches and pups (from 25 % in 2007 to almost 0 % in 2011) – Photos

Training of CMC staff in humane dog handling, catching, and veterinary techniques
This project has been well accepted and received by the CMC and the local communities. Due to the success of this
project, WSPA is beginning to invest in the replication of this model to other locations in South East Asia. Delegates
from the ASEAN countries and Nepal have visited BPT with a view to replicating the Colombo City Project in their
own countries.

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VETERINARY TRAINING – INTERNATIONAL AND LOCAL

BPT’s mobile veterinary clinic is of particular interest to veterinary students who have ample opportunity to practice
their skills under the guidance of a qualified veterinarian; especially due to the large scale of the project. It is a
hands-on experience and each student can learn and experience as much as he/she wants to. In this way knowledge
and skills will be shared and multiplied so that animal welfare can be improved throughout Sri Lanka and abroad.

TRAINING AREAS

Students can select both areas and either one catergory of training areas
Holistic approach of Rabies management project.
Surgery – Female OHE, Male castration, Cat male and female sterilization
Currently we do female sterlization only. But we can arrange cat and dog male sterilization for student training. We
can train 2 students at a time.

INSIDE BPT SURGERY

VETERINARY TRAINING - INTERNATIONAL AND LOCAL

DOG CATCHING AND HANDLING

Most of the roaming dogs are friendly, but often do not like to be touched as there is no interaction with people other
than feeding. Therefore hand catching is not always successful and we have to catch them using special nets. This is
considered one of the most humane of the currently accepted methods of catching dogs.

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