BITE OF DEATH

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* * * ** ** * *Bite of death *

*Only effective animal birth control can stave off rabies, says

Ghosh* * * *Civic authorities confine a rabies-infected dog in an animal

pen *

 

*Every year, almost 30,000 people die of rabies in India, according to the

World Health Organisation (WHO). Exact numbers are unavailable because the

disease is not categorised as a notifiable disease by the government, and

hence it is not mandatory to report cases of rabies to the health

authorities. *

 

* " The situation is extremely grave and needs immediate attention, " says K.C.

Barui, director of health services, government of West Bengal. " The need of

the hour is the effective implementation of an animal birth control

programme to control the population of stray dogs, " he adds. *

 

*Rabies is an acute viral encephalitis. It can affect most species of

warm-blooded mammals. In urban and suburban areas the disease is usually

spread by infected street dogs. *

 

*The virus is present in the saliva of a rabid animal that tends to be

aggressive. " After a typical human infection by animal bite, the virus

enters the peripheral nervous system. It then travels along the nerves

towards the central nervous system. During this phase, the virus cannot be

easily detected within the host, and vaccination may confer cell-mediated

immunity to pre-empt symptomatic rabies, " explains Dr Tapan Kumar Ghosh,

chairman of the infectious diseases chapter of the Indian Academy of

Paediatrics and founder secretary of the Association for Prevention and

Control of Rabies in India. *

 

*Once the virus reaches the brain, it rapidly causes encephalitis. It may

also inflame the spinal cord, producing myelitis. " The period between

infection and the appearance of flu-like symptoms is normally three to 12

weeks, but it can also take as long as two years. The symptoms soon expand

to cerebral dysfunction, anxiety, insomnia, confusion, agitation,

hallucinations, progressing to delirium, " says Dr Sajol Kumar Dutta of

Pasteur Institute, Calcutta. *

 

*Fear of water*

 

*The production of large quantities of saliva and tears coupled with an

inability to speak or swallow are typical during the later stages of the

disease and this can result in hydrophobia or the fear of water. Almost

invariably, death results within two to 10 days after the first symptoms

appear. *

 

*In India, neural tissue vaccine was used to treat rabies till 2005. " But

today, modern tissue culture vaccines are being used to treat rabies, " says

Ghosh. However, even the new vaccine has not led to a decline in the number

of rabies deaths in India. " Regular immunisation of pet dogs along with

pre-exposure vaccination of persons at risk of contracting rabies can help

to address the situation. Rabies should also be made a notifiable disease so

that better surveillance can be carried out to monitor the spread of the

virus, " he adds. *

 

*One of the most important causes of rabies in our country is the unchecked

growth in the population of stray dogs. An animal birth control programme

was started in 1996 with a survey of six metropolitan cities in India to

address the issue. But even today, a decade after the programme was

launched, the problem is yet to be solved. *

 

*Dr Goutam Mukherjee, a veterinarian in south Calcutta, feels that the

proliferation of rabies is also due to the insufficient supply of government

vaccines. " Moreover, the municipal authorities should take adequate steps to

ensure that pet dogs are licensed, " he adds. *

 

*There are several shortcomings in the animal birth control programme,

according to experts. " The organisations entrusted by the government to

carry out the programme are overstretched and are working with inadequate

funds, " explains Kishore Kumar Ganguli, proprietor of Moitreyee, a

veterinary clinic in South Calcutta. Ganguly reasons that a vaccination

programme for stray dogs in one area can only temporarily address the

problem since it takes almost a fortnight for an animal to develop immunity

to the rabies virus. *

 

* " The programme has to be more systematic and regular, " he says, adding, " It

would be of enormous value if every single family in the city could

contribute towards the sterilisation of dogs in their respective areas, " he

adds. *

 

*Dr P.K. Samanta, former professor of Veterinary Science at the West Bengal

University of Animal And Fisheries Science, says, " The gravity of the

situation is illustrated by the fact that the director of the Rajya Sabha

secretariat is presently examining the Animal Birth Control programme (Dogs)

Rules, 2001, and has asked for the views of organisations connected with dog

control on the efficacy of the programme. " *

 

* " The state government is also waking up to the threat. There is a proposal

to use the state government's flexi fund for proper implementation of Animal

Birth Control in the districts in Bengal, " says Barui. *

 

* " The WHO figure of rabies deaths in India is very worrying. Making rabies a

notifiable disease would be a step in the right direction for better

surveillance and a better epidemiological understanding of the virus, " Barui

states.*

 

*Dissenting voices *

 

*However, not everyone agrees with that view. " There is no instance of human

to human transmission of rabies. So there is no need to raise a ruckus about

making it a notifiable disease, " says Soma Subhra Dutta, director of the

Pasteur Institute, Calcutta. *

 

*But whether or not rabies is made a notifiable disease, the fact remains

that controlling the population of stray dogs on India's streets will go a

long way in checking the spread of this deadly disease.*