Rabies on the Rise

Rabies is estimated to cause 59,000 human deaths annually in over 150 countries. Of these cases, approximately 99% are acquired from the bite of an infected dog.?If treated immediately with vaccines and medicines, death can be prevented. Once clinical symptoms appear, rabies is virtually 100% fatal.

Rabies, a viral disease transferred from animals to humans, causes progressive and fatal inflammation of the brain and spinal cord. Clinically, it has two forms:?

1. Furious Rabies – Characterized by excitable behavior and hallucinations. Death occurs after a few days due to cardio-respiratory arrest.
2. Paralytic Rabies –Muscles gradually become paralyzed, starting at the site of the bite or the scratch. A coma develops and eventually death occurs.

Although in many parts of the world, dogs are the primary vector, late last year, the U.S. Centers for Disease Control began raising awareness of the risk of rabies from bats after the death of three Americans. None of the three had received post-exposure prophylaxis (PEP) that can prevent rabies from developing if received before the onset of symptoms.?In Brazil as well, canine rabies has been brought under control, but rabies from bats is on the rise.

Post-exposure prophylaxis (PEP) is the immediate treatment for an exposed patient. It consists of:

• Extensive washing and local treatment of the bite wound or scratch as soon as possible after a suspected exposure.
• A course of rabies vaccine that meets WHO standards and prevents the virus from entering into the central nervous system.
• The administration of rabies immunoglobulin (RIG), if indicated.

Every year, more than 29 million people worldwide receive a post-bite treatment. This is estimated to prevent hundreds of thousands of rabies deaths annually. In Latin America, the area of greatest concern has been the ability to access immediate treatment. Epic Health Solutions has been successful in getting rabies-exposed patients the treatment their life depends upon.

Just several weeks ago, a gentleman in a remote Mexican village stopped to pet a dog in the street. He was bitten by the animal. Luckily for him, his insurance company partners with Epic for medical services in Mexico.

Through guidance from its extensive Latin American network, Epic knew it was more expeditious to send a rabies victim to a public hospital, rather than a private clinic.

Public hospitals in Latin America have wider access to PEP because rabies vaccines are controlled by Public Health departments. Epic found a local public hospital that could administer the life-saving post-exposure prophylaxis.

Pre-exposure immunization is indicated for outdoor travelers to remote areas, and for expatriates living in remote locations with a high rabies exposure risk and limited local access to rabies biologics. “The main factor in the management of rabies exposure is getting the patient access to PEP before the onset of any symptoms,” states Thorkild Lykke, Vice President of Strategic Partnerships for Epic Health Solutions.?“Since the vaccine may not be available everywhere, you need to have an extensive network with broad knowledge to assist members in navigating to a facility that offers the life-saving treatment.”