RABIES PREVENTION AND CONTROL PROGRAM

Rabies is a human infection that occurs after a transdermal bite or scratch by an

infected animal, like dogs and cats. It can be transmitted when infectious material,
usually saliva, comes into direct contact with a victims fresh skin lesions. Rabies
may also occur, though in very rare cases, through inhalation of virus-containing
spray or through organ transplants.

Rabies is considered to be a neglected disease, which is 100% fatal though 100%

preventable. It is not among the leading causes of mortality and morbidity in the
country but it is regarded as a significant public health problem because (1) it is one
of the most acutely fatal infection and (2) it is responsible for the death of 200-300
Filipinos annually.

Vision: To Declare Philippines Rabies-Free by year 2020

Goal: To eliminate human rabies by the year 2020

Program Strategies:

To attain its goal, the program employs the following strategies:

1. Provision of Post Exposure Prophylaxis (PEP) to all Animal Bite Treatment

Centers (ABTCs)

2. Provision of Pre-Exposure Prophylaxis (PrEP) to high risk individuals and

school children in high incidence zones

3. Health Education

Public awareness will be strengthened through the Information, Education,

and Communication (IEC) campaign. The rabies program shall be integrated into the
elementary curriculum and the Responsible Pet Ownership (RPO) shall be promoted.
In coordination with the Department of Agriculture, the DOH shall intensify the
promotion of dog vaccination, dog population control, as well as the control of stray
animals.

In accordance with RA 9482 or The Rabies Act of 2007, rabies control

ordinances shall be strictly implemented. In the same manner, the public shall be
informed on the proper management of animal bites and/or rabies exposures.

4. Advocacy

The rabies awareness and advocacy campaign is a year-round activity

highlighted on two occasions March as the Rabies Awareness Month and
September 28 as the World Rabies Day.

5. Training/Capability Building

Medical doctors and Registered Nurses are to be trained on the guidelines

on managing a victim.

6. Establishment of ABTCs by Inter-Local Health Zone

7. DOH-DA joint evaluation and declaration of Rabies-free islands

Program Achievements:

The DOH, together with the partner organizations/agencies, has already developed
the guidelines for managing rabies exposures. With the implementation of the
program strategies, five islands were already declared to be rabies-free.

In 2010, 257 rabies cases and 266,200 animal bites or rabies exposures were
reported. A total of 365 ABTCs were established and strategically located all over
the country. Post Exposure Prophylaxis against rabies was provided in all the 365
ABTCs.

Partner Organizations/Agencies:

The following organizations/agencies take part in attaining the goal of the National
Rabies Prevention and Control Program:

Department of Agriculture (DA)

Department of Education (DepEd)
Department of Interior and Local Government (DILG)
World Health Organization (WHO)
Animal Welfare Coalition (AWC)
BMGF Foundation
WHO/BMGF Rabies Elimination Project
Bill and Melinda Gates Foundation
World Society for the Protection of Animals (WSPA)

Medical Research Council (MRC)

The Department of Health states that around 300 to 600 Filipinos die of rabies per
year. More than half of the victims are children between five and 14 years old.
According to the World Health Organization, the Philippines ranks among the
highest in the world in terms of rabies prevalence.

Rabies is a deadly disease caused by the rabies virus. A person gets rabies after
being bitten by an infected animal, usually a dog or a cat. It is passed on to the
victim via contact with the rabid animals saliva.

The incubation period for rabies is usually three weeks but may reach up to five
years. Symptoms include fever, headache, anxiety, confusion, difficulty swallowing,
and paralysis. Once a person develops the symptoms of rabies, the disease will be
very hard to treat. Most cases of rabies are fatal.

Fortunately, there are vaccines available that effectively prevent rabies after an
animal bite. Hence, if you see your doctor immediately after getting bitten, then
your doctor can give you a series of rabies shots that will prevent you from getting
rabies. Visit an animal bite center located in many hospitals.

Your doctor needs the following information:

1) What animal bit you?

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2) Was it a pet or a stray animal?

3) If it was someones pet, was the pet vaccinated against rabies?

4) Was the animal acting unusually, which means it could be rabid, or did you
provoke the animal?

5) Can you observe the animal for 10 days to determine if it will turn rabid?

It is best to capture the animal and observe it for 10 days. If the animal does not
turn rabid in 10 days, then it doesnt have rabies and you dont need to continue
with the anti-rabies shots. However, if the animal has escaped, then we can
presume that the animal has rabies and you should be treated accordingly.

Vaccination is especially needed in cases of bites near the head and neck areas.
These areas are more sensitive because the rabies virus can reach and infect the
victims brain in a shorter span of time.

Rabies shots usually consist of six injections given over a period of 28 days. The first
injection is best given on the day of the bite itself.

Tips on how to prevent rabies

Pet owners should vaccinate their pets regularly. For dog and cat owners, ask your
veterinarian about the vaccination schedule.

Dont let pets come in contact with other stray animals. Your pet could get bitten
by a rabid animal and develop rabies.

Dont approach and touch other peoples pet. They may seem friendly, but could
suddenly bite strangers.

Dont let your guard dog wander around. Keep your doors and gates closed at all
times. Take pity on the poor bystanders who can get bitten by your pet.

 Carry a stick or an umbrella when you go walking or jogging in the neighborhood.

Wear long pants instead of shorts.

Dont leave your child alone with someones pet. Dont bother pets when they are
eating, sleeping or nursing their babies. Keep pets on a leash.

Report stray animals to local authorities.

Stay away from bats and other wild animals. Dont let bats enter your home since
they are known to carry the rabies virus.

If you frequently work with animals, you may need to get rabies shots in advance.
Ask your doctor about it.

What the anti-rabies law says

The Anti-Rabies Act of 2007 (RA 9482) provides the guidelines for the prevention
and control of rabies in the Philippines. Several agencies and persons are tasked to
do their respective jobs in a collective effort to control rabies under a National
Rabies Prevention and Control Program.

The main goals of this Act are to give mass vaccination to dogs, establish a registry
of vaccinated dogs, and ensure proper disposition of unregistered and stray dogs.

The Department of Agriculture (DA) is tasked to ensure an adequate supply of

animal anti-rabies vaccine, to improve existing animal rabies laboratory testing, and
to give free dog vaccinations in priority areas. The DA is also required to maintain a
rabies surveillance system.

If the DAs responsibility pertains to the dog, then the Department of Healths task
is to protect the human. Hence, the DOH is directed to ensure an adequate supply

of human anti-rabies vaccine in animal bite centers nationwide. The DOH is also
obliged to provide vaccination to the victim at a minimum expense, and to keep
surveillance data on the number of animal bite victims and rabies cases.

Both agencies are urged to carry out a health information campaign on rabies and
responsible pet ownership. The Department of Education can assist in the campaign
by including rabies prevention tips in the school curriculum.

The local government units play a huge role in rabies control. The LGUs are tasked
to make sure that all dogs are immunized and registered. The LGUs should likewise
allocate the necessary funds for dog vaccines and human vaccines. They are also
responsible for field control and removal of stray dogs, and ensuring that dogs are
within the confines of the owners house. According to the law, if the impounded
dogs are not claimed in three days, they may then be put up for adoption,
preferably with the help of an animal welfare NGO.

Responsibility of pet owners

The main responsibility of pet owners is to vaccinate and register their dogs. And
should their dog bite a victim, then the owner is required to shoulder all the medical
expenses, including the cost of several vaccinations.

There are penalties for pet owners who violate the law. These sanctions include a
P2,000 fine for owners who refuse to immunize or register their dogs, and a P25,000
fine for owners who refuse to pay for the medical expense of a victim bitten by their
dog.

Lets help to keep our community safe. All of us can play an important role in
preventing dog bites and rabies.

1. Q: How do people get rabies?

A: People usually get get rabies from the bite of a rabid animal. It is also possible,
but quite rare, that people may get rabies if infectious material from a rabid animal,
such as saliva, gets directly into their eyes, nose, mouth, or a wound.

2. Q: Can I get rabies in any way other than an animal bite?

A: Non-bite exposures to rabies are very rare. Scratches, abrasions, open wounds,
or mucous membranes contaminated with saliva or other potentially infectious
material (such as brain tissue) from a rabid animal constitute non-bite exposures.
Occasionally reports of non-bite exposure are such that postexposure prophylaxis is
given.

Inhalation of aerosolized rabies virus is also a potential non-bite route of exposure,

but other than laboratory workers, most people are unlikely to encounter an aerosol
of rabies virus.

Other contact, such as petting a rabid animal or contact with the blood, urine or
feces (e.g., guano) of a rabid animal, does not constitute an exposure and is not an
indication for prophylaxis.

3. Q: How soon after an exposure should I seek medical attention?

A: Medical assistance should be obtained as soon as possible after an exposure.

There have been no vaccine failures in the United States (i.e., someone developed

rabies) when postexposure prophylaxis (PEP) was given promptly and appropriately
after an exposure.

4. Q: What medical attention do I need if I am exposed to rabies?

A: One of the most effective methods to decrease the chances for infection involves
thorough washing of the wound with soap and water. Specific medical attention for
someone exposed to rabies is called postexposure prophylaxis or PEP. In the United
States, postexposure prophylaxis consists of a regimen of one dose of immune
globulin and five doses of rabies vaccine over a 28-day period. Rabies immune
globulin and the first dose of rabies vaccine should be given by your health care
provider as soon as possible after exposure. Additional doses or rabies vaccine
should be given on days 3, 7, 14, and 28 after the first vaccination. Current vaccines
are relatively painless and are given in your arm, like a flu or tetanus vaccine.