Saturday, July 4

Rabies and the way to contain the disease

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The locations of rabies-infected areas in Sibu.

The death of a 62-year-old man from Sibu, who became the latest victim to succumb to rabies in Sarawak, raised red flags over the level of awareness among the public here on the dangerous disease.

Health director-general Datuk Dr Noor Hisham Abdullah confirmed in a press statement Friday that the victim died at 7pm on June 23 while receiving intensive care from medical specialists.

He said the victim was bitten by a dog that belonged to his relative on his right calf when visiting his relative in Jalan Sentosa Barat here on May 12.

The first case of rabies involving human in Sibu this year was on March 8, where a five-year-old girl at Jalan Sentosa here was attacked and bitten by a stray dog on her face, mouth and eyelids.

Dr Noor Hisham had said in a recent statement that the bite wounds were not washed with clean water and soap immediately after the incident. The Health Ministry confirmed that the girl’s death on March 26 was due to rabies.

The second human rabies case here involved a five-year-old boy bitten by a pet dog in Jalan Sanhill Barat on May 24. The boy was reported to be recovering well.

Dr Annuar Rapaee

thesundaypost sat down with Assistant Minister of Local Government and Housing Dr Annuar Rapaee to get his views and advice on containing the disease.

Q: The word rabies is not unfamiliar with folk here but what actually is this disease?

A: Well, to start with, rabies is a zoonotic disease that spreads through bites from the saliva of an infected animal. Lyssavirus causes rabies in animals and humans. This virus is more commonly found in dogs than other animals.

So, what happened here is when an infected dog bites a person, the virus is transmitted through canine’s saliva.

Q: Will the victim exhibit immediate rabies symptoms after the bite?

A: No, as it can take months for symptoms to exhibit. In fact, the symptoms only appear when this virus reached the brain because it is pre-dominantly a central nervous system infection.

Sadly, once the symptoms appeared in human, there is no cure for the disease. In other words, it is like a ‘death sentence’ and it is fatal. As you can see from all the rabies human cases in Sarawak, whenever the symptoms appeared, the patients would die except for one case. In short, it is a fatal form of infection.

So if there is no dog bite to human being, nobody will get the disease. So, no dog bite, no rabies.

Q: How do we know if a dog is a rabid dog or otherwise?

A: You see, the chances of a dog getting infected with this disease and later bite someone is rather high because the infected dog turns aggressive and will attack even when unprovoked.

Unlike normal dogs, which will only become aggressive if provoked, rabid dogs will attack at the slightest movement. In addition to this abnormal behaviour, the infected dog has lots of salivation. These are signs that the dogs are not well.

However, you must also take extra precaution if a dog is unusually quiet as rabid dogs exhibit different kinds of behaviour.

Therefore, people should know that when dogs become aggressive or unusually quiet, these are signs that the canines are not well. As this is a zoonotic disease, it cannot be transmitted from human-to-human unlike Covid-19.

Q: Should all dog bites be taken seriously?

A: A total of 261 dog bites were recorded by Sibu Hospital until May this year and 742 (bite cases) for last year. The second rabies fatality in Sibu speaks volumes that dog bites must not be taken lightly. Once bitten by a dog, had the bite wounds washed thoroughly under the running water for 15 minutes and go to hospital immediately to get medical attention, including vaccination.

Unfortunately, in the latest death case in Sibu, the patient did not return for vaccination. In other words, he was unaware of the implications of any dog bite and that vaccination must be administered.

Q: What other action should the victim take other than seeking medical treatment?

A: People should understand after being bitten by a dog, they need to get hold of the dog and immediately inform the Veterinary Services Department. This is important as the department needs to determine if it is a rabid dog where they need to run a test. If we do not know if it is a rabid dog or not, the form of treatment given, might vary.

Q: What are the forms of treatment given to a dog bite victim?

A: Treatment after a dog bite comprises three parts – the patient’s wounds is immediately cleaned, and might be given a vaccination as well as might be given rabies immunoglobulin, depending on the type of dog bite and its severity.

If a dog is confirmed rabid, the treatment will not only involve administration of vaccination as rabies immunoglobulin will also need to be given. Hence, what is most important is for people to know the importance of dog bites and its implication.

Q: What are the measures taken by the authority to remove stray dogs from the streets?

A: The total number of dogs caught by the local authorities last year was 1,079 while until June this year, the figure stood at 589, despite there being no operation during the Movement Control Order (MCO) period. In spite of this exercise, the number of stray dogs in Sibu is still very high.

For that reason, the public should cooperate with the local authorities to reduce the stray dog population. They can do so by calling the hotline – Sibu Municipal Council (SMC): 084-310808/013 807 7964; Sibu Rural District Council (SRDC): 084-336077/013 894 1205 and Kanowit District Council (KDC): 084-752093.

They can send photos to these Whatsapp contact as it is not a fixed line. However, if there is yet to be any response, they can call the hotline.

We know there were lots of complaints that councils were not acting fast enough to remove dogs from the streets.

During the last Sibu Rabies Control Team meeting, we have decided that the dog catching operation be outsourced to private sector.

Additionally, both SMC and SRDC have to work together rather than (having) too much bureaucracy on the areas of jurisdiction. They have to ensure that all stray dogs as complained by the people be removed from streets immediately.

That aside, we are also engaging community leaders in all areas together with councillors to raise the level of awareness to rid rabies.

In the meeting, we have decided to print pamphlets with all necessary information and through public cooperation, to be distributed to the hot spots in Sibu.

At the same time, we are engaging with the public to get their pets vaccinated. Therefore, I appeal to them to come to any of the locations (refer to the table attached) at the given date irrespective of where they stay. The free anti-rabies vaccination will start next month and run till September.

Alternatively, pet owners can bring their dogs for vaccination at the Sibu Veterinary Services office at Jalan Perpaduan during office hours (8am – 10.30am) from Mondays to Fridays. The number to contact is 084-330224.

Q: What will be the way forward in combating rabies?

A: Looking at the latest fatality, despite so much measures and efforts put in by the authorities, apparently, it appears that the level of awareness on the dangers posed by rabies is still low here. I can honestly tell you that if this continues, we will soon overtake Kuching in terms of the number of death cases due to rabies.

As I have mentioned before, the number of stray dogs is still high in Sibu despite the operations to round-up the free-roaming canines.

I would attribute this to possibly the breeding rate and some members of the public feeding these dogs.

The public should not feed stray dogs in public places as this will attract more strays to come.

If you really love these dogs, I suggest that you bring them home to feed and keep as pets.

That aside, pet owners need to understand the importance of confining their dogs within the house compound. Do not let them out even for a single second. This is an MCO period for all dogs.

Also, don’t let your pet dogs get into fights with dogs outside the gate, and transmit the disease among the canines. I have spoken to both chairmen of SMC and SRDC to keep a hawk eye on this matter.

To me, public awareness is most important to win the war against the deadly rabies.