RABIES, 120 years after Pasteur. Part 2/3





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Published on Sep 25, 2009

Dr. Rigobert:
Rabies is still a public health issue in our countries, particularly in Burkina Faso because many people are attacked. At our two rabies treatment centers in Ouagadougou and Bobo-Dioulasso combined, we count 4,000 attacks each year.
Of these 4,000 attacks, about 2,500 people are treated for rabies. But there are many more attacks in rural areas. Rabies treatment centers are too far away, so people dont come. The actual number is probably closer to 40,000.

In many countries, rabies is not a reportable disease and in fact it is misdiagnosed often because people dont think about rabies. Or perhaps its diagnosed as another encephalitic disease, like cerebral malaria, or something like that, when in fact, the person actually is infected and died of rabies.

Dr. Tordo:
Human rabies treatment is very simple. Vaccination is the only one that is truly effective. There are two types of vaccination: one is preventive and the other is given after exposure to a rabid dog. But the same mechanism works in both cases. Preventive vaccination, like post-exposure vaccination, allows the body to generate antibodies. Their purpose is to neutralize the virus before it infects the nervous system and causes death. Massive preventive vaccination in endemic countries is difficult for two reasons. The populations are large and, with three injections, the protocol is fairly complex. Scientists are working to simplify the system, but are still in the research stage.

Although they are in daily contact with dogs that may carry the virus, Daniela, like Bess and Madee, has not been vaccinated.

Across the world its really sad to think about the fact that the population that is most affected by rabies is actually our children. In fact 40-60% percent of the deaths occur in children less than 15 years old, and this is because children are often not aware of the dangers of playing with an infected animal, or if they do get bitten or scratched by a rabid animal, they fail to tell their parents about the fact and eventually they come down with rabies. And once clinical rabies is evident, there is no cure.

Jamal is a young farmer from the outskirts of Ouagadougou. He was bitten by a stray dog two months ago but made do with a band-aid. By the time his family took him to the hospital, it was too late. He died several hours after admission.

Dr. Bazie:
He hadnt been to school. I think a lack of knowledge can lead to cases like this.

Dr. Diop:
Unfortunately, health-care providers do not know how to treat bites. We see this every day.

Dr. S. Diop:
Treatment depends on the severity of the bite. Local care is very important at every stage. Immediately after a bite, the wound must be washed thoroughly with water, soap and antiseptics. The second step is to prevent the rabies risk. If the wound is not that serious (stage 1 or 2), this is done through vaccination. For a serious wound, rabies immunoglobulins are also administered.

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