This letter is in response to the editorial, “The Fallacies of Mission Rabies” (01/10/14). Dr Rozario Menezes is rightly concerned about the risk of rabies to his patients, but he appears to have based his opinion on the work of Mission Rabies upon newspaper reports and would have had many of his concerns allayed if he had also contacted our team working in Goa. We hope to explain our approach and future plans to reduce any confusion on these matters.
Mission Rabies aims to achieve rabies elimination through mass canine vaccination of 70% of the population annually – recommended by the World Health Organization as the only effective and economical means of rabies elimination in both dogs and people, since over 99% of human rabies cases are contracted from a rabid dog bite. Mass euthanasia of dogs, as Dr Menezes supports (New York Times, ‘Where Streets Are Thronged With Strays Baring Fangs’ 06/08/2012), is not effective in controlling rabies as more than 95% of the dog population would have to be exterminated at once – impossible to achieve, inhumane and unpalatable to the public. Furthermore, killing dogs creates a vacuum which is rapidly filled by dogs from neighbouring areas, so the process is a waste of time and resources. The success of mass vaccination programmes has been demonstrated in the Nilgiris District, Tamil Nadu, which has been free of rabies for more than 10 years, and many countries worldwide. Healthy, rabies-vaccinated dogs are the best ally in the fight against rabies.
To increase the success of our vaccination programme we elected to carry out a mass sterilisation drive, to reduce the population turnover and maintain our vaccinated percentage for longer.
As there is no accurate census of the Goan dog population, a target of 20,000 sterilizations/vaccinations was decided as a realistic and achievable starting point for this programme and a step closer to the rabies free status that we intend for the State of Goa. Strategically, we decided to focus on achieving 70% in the main urban centres, where food resources are most available to dogs. Every sterilized, vaccinated dog was identified with an ear notch and surveys were conducted to calculate the percentage vaccinated, whilst also logging each dog’s GPS in a smart phone. By September, we had reached 70% coverage of all but one of the municipalities targeted. We also worked in many panchayats, where coverage of over 60% was reached, which will significantly reduce the risk of rabies here also.
Our teams responded to 107 possible rabies cases, reported by the public to the Mission Rabies hotline, and made laboratory diagnosis of rabies in 64 dogs over 6 months – the first time that an estimate of the incidence of canine rabies has been made in Goa.
This 6-month phase marks the conclusion of the first chapter in Mission Rabies Goa. The next 2.5 years’ work, if supported by the Government of Goa, will allow us to complete the vaccination coverage of the remaining areas of the State this year, followed by revaccination of 70% of the dog population across Goa annually for two further years. Thanks to our use of surveys and GPS, we now can create dog population estimates for Goa and this data will be made public in November with surveys repeated annually.
