The Truth About Rabies – A Much-Needed Wakeup Call

http://www.theborneopost.com/2018/09/28/the-truth-about-rabies-a-much-needed-wakeup-call/

IT HAS been over a year since the outbreak of rabies in Sarawak, and our situation has only worsened as the deadly virus continues to spread wider and wider into our state.

Since the official declaration of a rabies epidemic on July 1, 2017, Sarawak has identified and declared a total of 41 areas in the state to be rabies infected areas.

The rabies virus, spread predominantly through dogs, is currently one of the worst epidemics our state has ever faced and has officially claimed 12 lives so far.

To mark World Rabies Awareness Day, The Borneo Post has teamed up with Sarawak Health Department and members of the local Dog Bite clinic in Sarawak General Hospital (SGH) to help deliver a message to the public in hopes of raising awareness of the deadly virus – how to protect ourselves against it and the appropriate steps to take in an event of a dog bite.

What do I do in the event of a dog bite?

Already one year down the road in the rabies outbreak, you would think most of us know the appropriate steps to take in the event of an animal bite.

This does not seem to be the case as Dr Chua Hock Hin and Dr Ooi Mong How who both head the dog bite clinic in Sarawak General Hospital shared that many cases during this trying time, indicate many Sarawakians are still very ignorant on how they should manage and look after themselves after an animal bite.

“From our side, we often see poor wound washing by our patients or delayed treatment as they do not come to the hospital to seek treatment.

“During this critical time, it is imperative that anyone who is bitten by a dog or cat should properly wash their wound immediately before heading to the nearest healthcare facility for further washing and treatment,” Dr Chua advises.

Adding to this, Dr Ooi who is a paediatrician, advises that parents or adults, tasked with washing the bite wounds of a child, not to be swayed by the crying of the child.

“At one point, we picked up that our children patients were not receiving proper wound washing right after a bite because the parents could not bear to wash the wound properly due to their child’s crying.

“Washing a fresh wound is bound to be very painful for anyone, so parents tend to compromise and perform a ‘half-hearted’ washing as they are afraid of causing more pain to the child. This is not a very good idea because it places the child’s life at risk.”

Explaining the importance of a thorough wound washing, Dr Chua, who specialises in infectious diseases, explains the rabies virus is found in the saliva of infected animals, hence immediate and thorough washing of the wound is extremely important to reduce the number of virus particles at the wound site.

“After washing one round, they should head to a healthcare facility immediately to have the wound washed once more to ensure that thorough washing of at least 15 minutes has been performed and to assess whether further treatment is needed.

“Considering how serious the current outbreak of rabies is, I recommend heading to public healthcare facilities as they are more geared towards treating dog bites and have designated clinics for it,” Dr Chua adds.

These designated areas are dog bite clinics, quickly put together over the past year, to cope with increasing dog bite victims in Sarawak.

Right now, there are a total of six clinics in Sarawak, located at SGH, Serian Hospital, Bau Hospital, Klinik Kesihatan (KK) Sri Aman, Sarikei Hospital and KK Midlayar which is near the Betong.

Finite supply of medication and what we can do to help

All of these clinics are supplied with rabies vaccines to treat animal bite victims but only the clinic at SGH is equipped with Rabies Immunoglobin (RIG), reserved for only high-risk patients.

“RIG’s function is to help bridge the gap between rabies vaccination and the onset of an adequate antibody response from the human body and is only reserved for high-risk patients because it is in very short supply.

“It is not a synthetic thing that can be mass-produced, so the World Health Organisation’s (WHO) recommendation is we reserve it only for specific high-risk cases. Otherwise we would end up with zero supply and have to rely solely on vaccines for all cases,” Dr Ooi explains.

As rabies vaccines and RIG are in limited supply, both Dr Chua and Ooi advise everyone to avoid preventable bites for their own safety while helping the state maintain enough medication to treat all animal bite victims.

“Many cases we see are caused by preventable bites. For example, we have patients who were bitten because they provoked the animal by petting it while it was eating or they tried to separate animal fights, feed a pack of hungry dogs, handle the animals roughly or place themselves in precarious situations with suspected rabid animals.

“These patients are treated like everyone else and it places a strain on our medication stocks as we are also treating patients with non-preventable wounds – victims who are randomly attacked because a dog or a cat has gone rabid.

“So, to ensure these precious resources are used judiciously, everyone should make sure they do not place themselves or their families at risk unnecessarily by avoiding areas with large number of free-roaming dogs and watching children closely as they may provoke animals by hitting or playing roughly with them.

“Additionally, never adopt dogs or cats without a clear idea of their backgrounds as they might already be harbouring the virus. Even new-born animals could have the virus as they may obtain it from their mother,” Dr Ooi elaborates.

What can we do to curb the outbreak of rabies?

With so much said and done, the reality remains that the rabies outbreak is still raging and we need to start taking drastic steps to help curb the outbreak and prevent it from spreading further in the state.

According to Dr Ooi, the path to a rabies-free Sarawak is a multi-pronged approach where everyone has a part to play in changing our mindsets and methods in dealing with dogs.

“As citizens of the state, we need to change our mindsets as responsible pet owners. If we continue to let our dogs roam freely, then there will always be a chance the dogs might get infected and harbour the rabies virus. Owners should make sure their dogs are kept inside their gates and leashed when taken out for walks and exercise.

“Owners should also be encouraged to start neutering their pets if they do not want to breed them as we often see some irresponsible owners abandoning their unwanted pets on the streets rather than surrendering them, hence adding to the growing number of strays.

“We need to start educating everyone,especially our children,on the consequences of such callous action so that the young can grow up to be responsible and good pet owners.”

To the relevant authorities, Dr Chua advocates stricter guidelines and enforcement for dog ownership.

“Right now, we do not enforce very strict licensing of dogs, so it is hard to even tell if a dog has been vaccinated or neutered. With stricter licensing, we can help ensure dogs with owners are protected.With stricter enforcement, we can help encourage responsible pet ownership throughout the state.

“For the sake of our children, every Sarawakian should put aside their differences and work together towards the common goal of making Sarawak a rabies-free state again,” Dr Chua stresses.



IT HAS been over a year since the outbreak of rabies in Sarawak, and our situation has only worsened as the deadly virus continues to spread wider and wider into our state. Since the official decla…

Source: http://www.theborneopost.com/2018/09/28/the-truth-about-rabi..

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The Sarawak Society for the Prevention of Cruelty to Animals believes that animals, as living creatures, have value beyond economic measurement, and are entitled to legal, moral and ethical consideration and protection. The Sarawak SPCA's mission is to act as an advocate on behalf of animals and as an enforcer of their rights; to provide for the well-being of the animals of the State of Sarawak who are abandoned, injured, subjected to unfair or cruel treatment, or otherwise in need; to cultivate in the people of our community an awareness of the animals whose world we share; to promote a bond of mutual assistance between people and animals; and to instill respect for and appreciation of all living things.

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