A Silent Killer in Southeast Asia – A Call to Action to End Rabies
Written By: Dr Jasmine Khairat
In the heart of Sarawak, a young boy named Awang was playing in his backyard when a seemingly friendly stray dog approached him, wagging its tail. Delighted, Awang reached out to pet the dog, but the dog playfully nipped at Awang’s hand, its teeth inadvertently breaking his skin. Unbeknownst to Awang, deadly viruses lurking within the dog’s saliva were now transferred to him. Days later, he began experiencing fever and muscle weakness – symptoms that were tragically misdiagnosed as a common flu. By the time rabies was suspected, it was already too late. Awang’s story is a heartbreaking reminder of the silent killer that continues to plague Southeast Asia, including Malaysia.
According to the WHO, an estimated 59,000 people die from rabies annually, with the majority of cases occurring in Asia and Africa. In Southeast Asia, the disease is endemic in several countries, including Malaysia, where an average of 10 to 15 human rabies cases are reported each year. The actual number of cases may be higher due to underreporting and misdiagnosis.
Specific areas in Malaysia, particularly in Sarawak and Perak, have witnessed a surge in rabies cases in recent years. These regions, with their large rural populations and proximity to wildlife, face unique challenges in controlling the spread of the disease. The primary reservoir of rabies in Malaysia is stray dogs, which account for over 90% of human cases. Other animals, such as cats, monkeys, and bats, can also transmit the virus, albeit less frequently.
The symptoms of rabies typically develop 2 – 3 months after exposure, but the incubation period can vary from a few weeks to several years. Initial symptoms may include fever, headache, and muscle weakness, followed by more severe neurological manifestations such as confusion, hallucinations, and hydrophobia (fear of water). Once symptoms appear, rabies is almost invariably fatal, highlighting the critical importance of preventive measures.
In Malaysia, the government has implemented various strategies to control rabies, including mass dog vaccination campaigns, stray dog control programs, and public education initiatives. However, challenges remain, particularly in ensuring adequate vaccination coverage in rural areas and addressing the issue of stray dog populations.
Protecting Ourselves and Our Communities
It is crucial to remember that rabies is a fatal disease, but it is entirely preventable through vaccination and post-exposure prophylaxis. Any animal bite, particularly from a dog or other mammal, should be considered a potential rabies exposure and requires immediate medical attention. Washing the wound thoroughly with soap and water and seeking medical advice promptly can significantly reduce the risk of infection. Pet owners have a vital role to play in rabies prevention. Ensuring their animals are vaccinated against rabies and avoiding contact with stray or wild animals are essential steps to protect both their pets and the community. Responsible pet ownership, including spaying and neutering, can help reduce the number of stray animals.
Ultimately, it is important to remember that animals infected with rabies are victims of the disease themselves. We should approach them with compassion and empathy, as well as supporting humane solutions to control the disease and protect both animals and people.
Every year on September 28th, World Rabies Day serves as a poignant reminder of the devastating impact of this disease and the urgent need for concerted action. This year’s theme, “Breaking Rabies Boundaries,” emphasizes the collaborative approach to addressing health threats at the human-animal-environment interface – is not just for scientists and policymakers. By increasing public awareness, improving access to healthcare, strengthening rabies control measures, and fostering a compassionate approach towards animals, we can work towards eliminating this deadly disease from Southeast Asia. It is our collective responsibility to protect ourselves, our families, our communities, and the animals we share our world with from the silent killer that is rabies. Let us not allow another Awang to become a victim of this preventable tragedy.
Resources:
1. Interim guideline for human rabies prevention and control in Malaysia (n.d.). https://www2.moh.gov.my/moh/resources/Penerbitan/Interim_Guideline_for_Prevention_and_Control_of_Human_Rabies_in_Malaysia.pdf
2. Rabies. World Health Organization. (2024). Retrieved from https://www.who.int/health-topics/rabies#tab=tab_1
3. Wada, Y. A., Mazlan, M., Noordin, M. M., Mohd-Lila, M. A., Fong, L. S., Ramanoon, S. Z., Zahli, N. I. U. (2024). Rabies epidemiology in Malaysia (2015–2023): A cross-sectional insights and strategies for control. Vaccine, 42(26), 126371. https://doi.org/10.1016/j.vaccine.2024.126371
Dikarang Oleh / Written By: Dr Jasmine Khairat
Pensyarah Kanan (Virologi) | Senior Lecturer (Virology)
Program Mikrobiologi & Genetik Molekul | Microbiology & Molecular Genetics Program
Institut Sains Biologi (ISB) | Institute of Biological Sciences
Fakulti Sains | Faculty of Science
Universiti Malaya