Rabbies, via dog/cat butchering - Viet Nam : Probable

RABIES, VIA DOG/CAT BUTCHERING - VIET NAM: PROBABLE
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A ProMED-mail post

ProMED-mail is a program of the
International Society for Infectious Diseases


[1]
Date: Tue 17 Mar 2009
Source: inthenews.co.uk [edited]


Eating dog or cat linked to rabies
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A new study has detailed how 2 people in Asia contracted rabies after
eating dog or cat meat.

A report published in the journal PLoS Medicine [see part (2) below]
describes how the 2 patients in Hanoi, Viet Nam, died from
laboratory-confirmed rabies. Health experts claim their symptoms
developed after butchering, preparing, and consuming either a dog or a cat.

The researchers were unable to test the butchered animals for rabies,
so could not be entirely certain the animals were the source of the rabies.

However, they caution that butchering of unvaccinated dogs and cats
in rabies-endemic countries should be considered a risk factor for
rabies transmission.

Communicated by:
ProMED-mail


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[2]
Date: Wed 18 Mar 2009
From: Heiman Wertheim

Rabies infections highlight dangers of processing dog meat
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Eating dog meat is common in many Asian countries, but research
conducted as part of the South East Asia Infectious Diseases Clinical
Research Network has discovered a potentially lethal risk associated
with preparing dog meat: rabies. In research published today [18 Mar
2009] in the open access journal PLoS Medicine, Dr Heiman Wertheim
and colleagues from the National Institute of Infectious and Tropical
Diseases and the National Institute of Hygiene and Epidemiology in
Hanoi, Viet Nam, report on 2 patients admitted to hospital showing
signs of rabies infection. Neither patient was thought to have been
bitten by a rabid animal in the preceding months.

Rabies is a very serious -- and in nearly all cases fatal -- disease.
It is estimated to kill more than 30 000 people each year in Asia,
and the number of cases in China and Viet Nam is increasing. Symptoms
include agitation, severe spasms, fever, fear of water and inability
to drink liquids, and eventually death. Humans are usually infected
after being bitten by an infected animal such as a dog or bat.

When the researchers investigated whether the patients had come into
contact with infected animals in the preceding months, they found
that both had been involved in preparing and eating animals that may
have been infected. In the 1st patient's case, he had prepared and
eaten a dog that had been killed in a road traffic accident; rabid
dogs were known to inhabit the neighbourhood. The 2nd patient had
butchered and eaten a cat that had been sick for a number of days.

In both cases seen by Dr Wertheim and colleagues, it is thought that
infection occurred during the slaughtering, and not by eating the
meat, as the meal was shared by others who did not become infected.
In Asia, it is believed that eating dog meat enhances health and
longevity. It is eaten throughout the year in the 2nd half of the
lunar month, particularly in the winter months, when it is believed
to increase body heat.

In Viet Nam, dogs with rabies have been detected in dog
slaughterhouses and workers at dog slaughterhouses are vaccinated
against rabies as part of the national programme for rabies control
and prevention. However, the private slaughter of dogs is relatively
common in the country.

"We need to alert both the general public and clinicians about the
risks around butchering and handling meat," says Dr Wertheim. "People
should not handle animals that may be infected with rabies. Rabies
can be prevented with a vaccine and people exposed to rabies can be
helped with post-exposure prophylaxis, but this needs to be
administered as quickly as possible following the exposure. Once a
person shows symptoms, the disease is almost invariably fatal.

"Vietnamese doctors already consider dog slaughtering a risk factor
for rabies transmission, but it is important that other health care
workers and policy makers, both inside and outside Vie Nam, are aware
of this risk factor."

The South East Asia Infectious Diseases Clinical Research Network is
funded by the Wellcome Trust and the National Institute of Allergy
and Infectious Diseases, National Institutes of Health USA.

References
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1. Wertheim, H et al: Furious Rabies after an Atypical Exposure. PLoS
Medicine. 17 March 2009 [available at
].
2. The South East Asia Infectious Diseases Clinical Research Network
[SEAICRN; ] is a multinational
clinical research network that strives to advance the scientific
knowledge and clinical management of infectious disease through
integrated, collaborative clinical research in Indonesia, Thailand
and Viet Nam. The principal sources of funding for the Network are
the US National Institutes of Health's National Institute of Allergy
and Infectious Diseases, USA and the Wellcome Trust, UK.
3. The Wellcome Trust [] is the largest
charity in the UK. It funds innovative biomedical research, in the UK
and internationally, spending over GBP 600 million [approx. USD 840
million] each year to support the brightest scientists with the best
ideas. The Wellcome Trust supports public debate about biomedical
research and its impact on health and wellbeing.

Heiman Wertheim