According to the National Directorate of Public Health of Colombia, there is no evidence of rabies spread by dog bites in the country since 2000. People get rabies from the bite of an animal with rabies (including bats and other wild animals). Unfortunately, 14 (2004) and 3 (2005) cases of rabies in humans have been recorded in Choco Department. These cases were associated with transmission by bats. The Ministry of Social Security announced the presence of rabies virus in Santander de Quilichao Municipality, located on Valle del Cauca department, in April 2008. Two children out of six exposed died owing to cat bites. The microbiological results showed that four samples of six were positive by immunofluorescence (1).
What can be concluded about rabies and preventive actions from the public health point of view?
Rabies is an infectious viral disease that affects the nervous system of humans and other mammals, a typical zoonosis with high case fatality. Rabies is prevalent in Europe, Asia, Africa, North America and South America. Nearly 40,000 to 70,000 people die from rabies each year, mainly in Asia and India. Approximately 10 million people are vaccinated against the disease worldwide each year. The vast majority of human rabies cases that occur without a history of an exposure are thought to be due to unrecognized or forgotten bites (2).
The goal of public health must be to prevent human exposure to rabies by education and to prevent the disease by post-exposure prophylaxis with currently available effective vaccines. There are only special situations and risk groups that require pre-exposure prophylaxis with vaccines, owing to the generally low and very focal risk of infections. There is no effective treatment for rabies once symptoms of this fatal disease have appeared. Consequently, the recommendations for public health action include strengthening rabies surveillance system as well as pre- and post exposure vaccination as elaborated above. The rabies post-exposure prophylaxis entails combining the administration of a rabies vaccine and rabies immunoglobulin (RIG) (3). In addition and depending on the specific epidemiological situation, mass vaccination campaigns of dogs have been most effective measure for control in certain areas. The success of rabies control in Latin America since the 1980s has been based on annual national mass vaccination of dogs and cats with high coverage over –0% achieved in a short period of time (less than one week).
1. Brote de rabia en Santander de Quilichao. Ministro de Salud. 2008. Bogota, Colombia. Available on http://www.minproteccionsocial.gov.co/VBeContent/NewsDetail.asp?ID=17235&IDCompany=3.