Rabies in Southeast Asia: Veterinarian Sciences and Medical Vaccines 1
Rabies in Southeast Asia
Francesca Fung and Sam Therrien
Northeastern University
Rabies in Southeast Asia: Veterinarian Sciences and Medical Vaccines 2
Abstract
Rabies is a disease of public health and economic importance in Southeast Asia, affecting many
lives of the general population. Dog bites account for a large percentage of rabies cases in the Southeast
Asia region. This article explains what steps need to be taken to prevent rabies and eventually eliminate it.
Innovative tools and techniques including vaccinations, population management, and education are used
to control the disease in dogs.
Rabies in Southeast Asia: Veterinarian Sciences and Medical Vaccines 3
Rabies is a virus that has long been recognized throughout history. It is present in many animal
species such as dogs and bats. There are two forms of rabies, furious and paralytic rabies, both of these
forms are fatal. The disease is commonly spread to humans through the bite of an infected animal. The
virus infects the central nervous system and can progress quickly causing neurological disorders and
eventually death in all mammals, including humans. Canine rabies is the cause of the majority of human
rabies deaths globally, especially in developing countries like those in Southeast Asia.
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Recent studies show, more than 1.4 billion people are at risk of contracting rabies infections in
Southeast Asia. The outbreak of rabies in this region has started to increase and the epidemic has claimed
many human lives this past year. Each year 23,000 to 25,000 people die from rabies in Southeast Asia,
this accounts for over 45% of the world's deaths from rabies.
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The majority of the rabies cases are in children in the 5 to 15 year old age group. These children
make up 40% of the people exposed and infected to dog bites in Southeast Asia. More likely than not,
these bites go unreported and the exposed children do not get the proper post exposure treatment in a
timely manner. Thus, there is the possibility of a disproportionately high number of young children
contracting and dying of undiagnosed rabies.
1
There is no certain cure for rabies as of right now but the virus can be prevented by vaccinations.
Rabies vaccine is given to both canine and human as preventive measures. It is also given to victims who
have been exposed to the infection as soon as possible. Most countries in the world require domestic
puppies to be vaccinated against rabies by law. However many developing countries lack the education of
and financial resources for rabies control, and therefore do not prioritize the importance of obtaining these
vaccinations. This is one main reason to why rabies is known as a disease of poverty.
2
Due to the absence of successful medical treatment for rabies and because of the severity of the
disease, most rabies victims die at home instead of being admitted to a hospital. The lack of reported
hospitalizations creates image that rabies is a rare disease resulting from the bite of a neglected dogs and
Rabies in Southeast Asia: Veterinarian Sciences and Medical Vaccines 4
does not receive the priority or attention it deserves. There is no national rabies control program as such
in most countries and the ever-increasing dog population is a big challenge to prevent human exposure
and to achieve the desired level of dog vaccination coverage. The only way the rabies outbreak in
Southeast Asia is going to decrease is if people are educated about proper medical procedure and get their
vaccinations. This is not a case of people in Southeast Asia choosing not to get vaccinated but a case of
people either not being educated or not having the means to get vaccinated. There is a lack of
organizations like the World health Organization (WHO) and local government programs in place in
Southeast Asia. These programs need to communicate and share resources in order to spread awareness
and eliminate rabies from the region.
3
Cost of rabies vaccine may be a huge factor to why population in developing countries such as
South East Asia is neglecting to have their dogs or themselves vaccinated. Vaccinations for dogs can
range from $20 to $150 USD and vaccinations for human is much more expensive. However many
organizations such as the World Health Organization have started to administer low-cost vaccinations for
impoverished regions in Southeast Asia like Sri Lanka and Thailand to encourage the population to take
precaution. Massive decreases in rabies related deaths through mass dog vaccination movements,
improved accessibility of vaccines and more effective vaccine delivery systems have been seen in both
countries since they have adopted cost-effective intradermal rabies vaccination to control human rabies.
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In India, intradermal rabies vaccination schedule has been supported at the individual state level.
Animal welfare and non-government organizations (NGOs), like The Rabies in Asia Foundation and the
Animal Welfare Board of India, carry out animal birth control and anti-rabies vaccinations for dogs.
Unfortunately, the rest of Southeast Asia does not have access to these resources due to the fact they
cannot financial support local or national programs to control and prevent rabies. That is why, larger
world organizations need to supplement Southeast Asia’s programs already in place.
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Rabies in Southeast Asia: Veterinarian Sciences and Medical Vaccines 5
A huge issue that has been persisting in Southeast Asia is the lack of dog population
management. This has led to an increase in the number of stray dogs in the region. Stray dogs have pose
human health and animal welfare problems throughout the years. Studies have shown that rate of rabies
infection is directly proportional to the increase in the number of strays; and controlling this population
has successfully minimized the spread of the virus. Monitoring dog populations is currently one of the
most effective tools for the prevention of rabies in man and animals. Use of cruel methods of dog
population such as poisoning and drowning are practiced in some underdeveloped countries, therefore
organizations such as the World Organization for Animal Health (OIE) has provided ways to combat
stray dogs by humane means. This includes reproductive control through the promotion of sterilization of
dogs, animal birth control, and the control of trade and movement of dogs.
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Another issue with the increase in rabies transmission is that the responsibility of dog ownership
at the community level is not promoted in Southeast Asia. Legislation for responsible ownership could
also help reduce the number of stray dogs. Registered dogs are often linked to animal health societies
which encourage mandatory rabies vaccination. However, many dogs in the region are not treated as part
of the family like how we treat our beloved companion here in the United States. The concept of spending
money on registering a dog and providing preventative care for their domestic pet is not a priority, which
is also a reason to why many dogs do not get vaccinated. This problem may be tackled by lowering costs
and educating the community on health care not only for their dogs but for themselves as well.
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On the topic of education, public health education on rabies in the region is one strategy that
could absolutely reduce the spread of the virus. It could be as simple as promoting proper care of dog bite
wounds or educate children to take caution while handling domestic or stray dogs. The Global Alliance
for Rabies Control have started a global movement called World Rabies Day to spread awareness on
rabies prevention and reduce transmission. It promotes education in classrooms, teaching children how to
be safe around animals and the importance of taking care of them as well. This knowledge is encouraged
Rabies in Southeast Asia: Veterinarian Sciences and Medical Vaccines 6
to be reinforced and passed on to the community. Making sure people understand this information helps
save many lives lost to the disease every year.
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Rabies has created a major problem in Southeast Asia due to the numerous stray dogs and the
lack of human education and government program regarding rabies. Plans to control and eventually
eliminate this epidemic need to be put in place in this region. Southeast Asian countries must establish
national programs to control rabies, so they can develop a strategic plan of action. This plan should
include a vaccination schedule for humans and dogs, and emergency medical procedures for infected
patients. In order to complete these tasks there must be improved rabies surveillance and data collection.
This will provide better records to that better treatment can be administered. This information can be used
to promote rational use of TCVs for PEP and encourage the introduction of cost-effective intradermal
(I/D) human rabies vaccination schedule in major rabies vaccination centers. This is only part of the
solution. The dog population has to be controlled. There must be the appropriate measures for the
regulation of dog movements around the region. The biggest part of the control and eventual elimination
of rabies in Southeast Asia is the community participation. The people of the region need to be educated
and need to make a conscience effort to get medical attention if bitten, get their dogs vaccinated and get
themselves vaccinated. This is the only way to eliminate the risk of rabies from billions of people.
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Unfortunately the majority of cases for rabies in Southeast Asia is in children, and goes
unreported and untreated until it is too late, and over 10,000 children between the ages of 5 and 15 years
old die from it. Overall, rabies can be easily prevented and eliminated throughout the world, if individual
countries perform the correct preventive measures, educate their people about rabies, and take swift action
when people are infected.
Rabies in Southeast Asia: Veterinarian Sciences and Medical Vaccines 7
**Sam Therrien Reflective Note: Seeing as I am not a medical sciences major, I have to relate this
to supply chain, specifically global supply chain. Seeing is most supply chains are global, many raw
materials are produced or manufactured in Southeast Asia. This rabies epidemic and restrictions on
transportation of livestock and good between Southeast Asian countries could be affected. This drives
costs up on the financial side of the supply chain with in turn drives costs up for the consumers. Having a
good understanding of how epidemics affect the supply chain is key to understanding my concentration.
Rabies in Southeast Asia: Veterinarian Sciences and Medical Vaccines 8
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