Epidemiology of Rabies in Thailand

Abstract

Control of rabies in Thailand was first carried out in selected areas in 1967. At present, vaccination of dogs is charged at an acceptable and affordable cost. Imported inactivated rabies vaccine for use in animals is being used. However, attempts to produce inactivated tissue culture rabies vaccine for use in animals locally is undertaken. In addition to poison-baits and imported capture-guns, domestically produced poison-rods have been used for stray dog elimination with satisfactory results. Impounding of strays is at present considered not feasible except within Bangkok Metropolitan. Medroxyprogesterone acetate has become more interesting for birth control of female dogs. Both Semple and Suckling Mouse Brain (SMB) vaccines are produced locally and are given free of charge. Attempts to replace Semple vaccine with SMB vaccine is under way. Antirabies hyperimmune (horse) serum is rarely used due to its relatively high cost and high risk of vaccine reactions. However, each province is advised to reserve antirabies serum for at least at its provincial hospital. Research on the use of small doses of Human diploid cell (HDC) vaccine given intradermally showed highly satisfactory results. Furthermore, a project on the use of small dosage of SMB vaccine has been planned. So far, 4 rabies diagnostic labs are found in Bangkok and 13 labs are decentralized; all are equipped with fluorescent microscopes. Revision of the Rabies Act is nearly completed. Control activities are demonstrated by 10 mobile rabies control teams from the department of CDC and will later on be taken over by local health authorities. Approximately 300 human rabies cases and 60,000 individuals receive post-exposure antirabies treatment each year. It is noted that there is a tendency of noticeable declining in human rabies cases. However, control of rabies in Thailand has still been hampered by: a) lack of knowledge to the danger of rabies and cultural obstacles against killing of semi-owned dogs among the public b) limited funds and c) existence of large and scattered rabies areas.