The-impact-of-the-COVID.

Covid-19 pandemic has led a major health problem all over the world. This newly emerged animal-borne disease has almost affected all the countries in the world and infection rate in humans is very high.

By Arfa Tehreem, Haseeb Asif Abdul Mateen

Introduction:

Pakistan is also under the fire of this deadly disease. During this deadly pandemic many other disease eliminating programs are disrupted. Rabies is a neglected disease in Pakistan although the prevalence of this disease is worldwide. It is a zoonotic disease which causes viral encephalitis and it kills up to 70,000 people worldwide. The disease infects domestic and wild animals, and is spread to people through close contact with infected saliva via bites or scratches. Once the symptoms of rabies develop, it became very fatal and eventually lead to death. Dogs are the 99% of human rabies death. Rabies is one of the oldest known diseases. In past people are so scared of rabies that if any people got bitten by a rabid dog, he commits suicide. However, after the invention of rabies vaccine by Pasteur in 1885, the prophylaxis treatment leads to the decrease in rabies cases. Before the emergence of this new animal borne disease, the world was in the last mile of eliminating one of the oldest animal-borne disease- rabies.

                                                                                                                   

Rabies eliminating programs:

Rabies is one of the top priorities of health agencies with a target of reaching zero human deaths from dog mediated rabies by 2030. During the last two decades several different campaigns are being started to completely eliminate the rabies worldwide.

  • Vaccination of dog’s:

 As rabies is transmitted by rabid dogs and it is vaccine preventable disease so it is very important to vaccinate the dogs. Vaccination of dogs will lead to the reduce number of deaths due to dog mediated rabies.

 

2-Vaccination of humans:

Both pre-exposure and post exposure vaccines are available for humans to prevent rabies. Pre exposure vaccine is given before dog bite and post exposure vaccine is given after dog bite. Pre exposure vaccine is given to the people who are at the greatest risk of getting rabies i.e. veterinarians, diagnosticians, laboratory & vaccine workers etc.

      

3-Prevent dog bite & awareness about rabies:

 In order to prevent rabies, it is very important to educate people about dog behavior and bite prevention and immediate care measures after a dog bite.

Can covid-19 effect rabies re-emergence?

The answer is yes. Covid-19 has a negative impact on the rabies. Restrictions which are imposed to control covid-19 have made it more challenging to monitor rabies cases. Health workers who are supposed to vaccinate the dogs and report the bites, infections and deaths have diverted their response towards covid-19. Many of the workers faces travel issues during this pandemic. This devastating pandemic has played its role the increase of number of cases of rabies.  

How covid-19 affect rabies re-emergence?

Before this pandemic there has been a tremendous progress towards the elimination of rabies from the world. But the current corona-virus pandemic (covid-19) has led a major health crisis all over the world. The health agencies all over the world have shifted their focus towards the control and prevention of covid-19.  Different control strategies have been adopted to prevent the control of covid-19. Among many other strategies stay at home strategy has not only affected the economy of Pakistan but it also has a major impact on rabies.

Covid-19 has affected following major rabies eliminating activities:

1 – Vaccination of dogs

2 – Human vaccination against rabies.

3- Community engagement

The disruption of these activities affects several parameters. Most of the vaccination programs are affected as there is no fund to support this program due to the low economy in developing countries like Pakistan.

Also, the people have fear being infected by covid-19 so the disruption of these activities may give a chance for rabies to re-emerge.

 

Pakistan issues regarding rabies during covid-19 period:

Pakistan facing several problems related to rabies during this period some major problems are listed below:

  • Vaccine shortages:

During the COVID-19 pandemic, the most serious effect noticed has been a breakdown in the supply chain for emergency post-exposure vaccines for rabies. Unfortunately, no post-exposure vaccine is available at various Rabies Treatment Centers in Pakistan Instead, the vaccine is available only from private pharmacies, where they cost almost 10 times the price.

  • No national control plan for rabies:

Although rabies is listed among the top five priority zoonosis in the country, there is currently no national control plan for rabies in Pakistan.

Control efforts should focus on dog vaccination, community awareness and post-exposure vaccination, but are currently not enough focusing on this regard as well as COVID-19, we must not forget other diseases like rabies which may re-emerge in developing countries like Pakistan and cause problems in community. 

 

Possible solutions to control rabies re-mergence during covid-19 period:

  • In this period of covid-19, Rabies awareness programs should start and general guidelines about rabies should be given to the general public.
  • After awareness rabies control programs should start and mass vaccination procedures should be started in which keep rabies vaccination up to date for dog’s cats and other domestic pets.
  • Supervise domestic pets so they do not come in contact with domestic animals.
  • One Health Surveillance System” may be one of solution during the pandemic this system link veterinary laboratories, veterinarians and medical doctors to the general public.