Rabies incurs $42m on Iran each year

October 9, 2018

TEHRAN – Rabies, an infectious viral disease spread to people through animal bites, impose health economic burden amounting to 1.8 trillion rials (about $42 million) on the country annually, head of zoonotic diseases department at the Ministry of Health has said.

Zoonotic means infectious diseases that are spread between animals and people.

“Over the past year, more than 180,000 individuals have suffered a significant animal bite throughout the country,” ISNA quoted Behzad Amiri as saying. 

Bites by the stray dogs, accounted for 90 percent of the cases reported last year, and 40 percent of individuals bitten were children under 15 years, Amiri lamented.

He went on to say that “Despite the high number of animal bites, the number of people infected by rabies or deaths related to the disease in the country is less than 10 person per year.”

“Of course, even less than 10 cases are unacceptable, and we will work along with the World Health Organization to zero the human rabies caused by dog biting by the end of the 2030,” he highlighted.

WHO, the World Organization for Animal Health (OIE), the Food and Agriculture Organization of the United Nations (FAO) and the Global Alliance for Rabies Control (GARC) have established a global “United Against Rabies” collaboration to provide a common strategy to achieve "Zero human rabies deaths by 2030".

There are more than 700 rabies treatment and prevention centers in the country, Amiri said, adding, if a person has been bitten by an animal, they will refer to these centers and undergo preventive measures, which is why the rate of rabies in the country is very low.

He further explained that plans are being implemented in the country to prevent the disease, when a person refers to a treatment center due to an animal's bite, the person will receive an anti-rabies vaccine, while in case of the animal not being available, we are obliged to complete the vaccination cycle (four doses of vaccine and anti-rabies serum) for the individual. 

“The total cost incurred for both anti-rabies vaccine and anti-rabies serum is reported about 10 million rials (nearly $240) per patient and with 180,000 people bitten by infected animals last year it cost us some 18 trillion rials (about $42 million) for treatment of the patients,” he also highlighted, adding that vaccination and equine rabies immunoglobulin are free of cost in Iran.

Amiri went on to note that to eradicate rabies in the country, stray dog’s bites must be avoided, adding, in this regard, a legislation or act to control stray dog’s population is required. 

In the past, wild or domestic animal bites were more likely to occur in rural areas, but this is already happening in the cities due to the growing population of stray dogs in urban areas, he concluded.

Rabies, causes, symptoms

According to WHO, rabies is an infectious viral disease that is almost always fatal following the onset of clinical symptoms. In up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans. 

Globally, rabies deaths are rarely reported and children between the ages of 5–14 years are frequent victims. 

As the virus spreads to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops.

People with furious rabies exhibit signs of hyperactivity, excitable behaviour, hydrophobia (fear of water) and sometimes aerophobia (fear of drafts or of fresh air). Death occurs after a few days due to cardio-respiratory arrest.

Paralytic rabies accounts for about 20% of the total number of human cases. This form of rabies runs a less dramatic and usually longer course than the furious form. Muscles gradually become paralyzed, starting at the site of the bite or scratch. A coma slowly develops, and eventually death occurs. 

Preventive measures

Rabies is a vaccine-preventable disease. Vaccinating dogs is the most cost-effective strategy for preventing rabies in people. 

Human rabies vaccines exist for pre-exposure immunization. These are recommended for people in certain high-risk occupations such as laboratory workers handling live rabies and rabies-related (lyssavirus) viruses; and people (such as animal disease control staff and wildlife rangers) whose professional or personal activities might bring them into direct contact with bats, carnivores, or other mammals that may be infected.

Pre-exposure immunization is also recommended for travelers to rabies-affected, remote areas who plan to spend a lot of time outdoors involved in activities such as caving or mountain-climbing. 

Moreover, killing the rabies virus involves first-aid of the wound that includes immediate and thorough flushing and washing of the wound for a minimum of 15 minutes with soap and water, detergent, povidone iodine or other substances.

FB/MQ/MG