Rabies is still a major public health problem in Asia. The incidence of known annual human cases in India alone has recently been revised from 20,000 to 30,000, and over 500,000 patients are given some form of postexposure rabies treatment. Only China, Peninsular Malaysia, Singapore, and Thailand are reporting a significant decrease in the prevalence of this disease in humans. Over 150,000 courses of postexposure treatment (PET) are given in Thailand every year. To determine remaining barriers to further reduction of the number of human rabies deaths, we carried out a questionnaire study of government hospitals throughout the Kingdom.
A fulminating extension of rabies-which has been enzootic in northern Malaya since 1924-occurred in Kuala Lumpur in April 1952. The outbreak was suppressed by the compulsory mass vaccination of dogs, stringent legislation, and intensive stray-dog destruction. Similar measures are being employed in the current campaign, the aim of which is the complete eradication of the disease.From an average annual incidence of 112 confirmed canine cases prior to 1952-when a total of 198 cases was reported-the incidence fell to 15 cases (all in unvaccinated dogs) for the period January-November 1953, during the last 5(1/2) months of which no case in either animals or man was reported. It is considered that the extensive publicity campaign and strict enforcement of the control measures have contributed measurably to the present improved position.Statistics relating to confirmed cases in dogs previously vaccinated with (a) phenolized 20% brain-tissue suspension vaccine (buffalo origin) and (b) chicken-embryo vaccine (Flury strain) are quoted and their probable significance in favour of the latter under Malayan conditions is discussed. The hypothesis that the development of rabies may, in many instances, have been blocked by the vaccine is advanced.The plan for a pan-Federation compulsory vaccination campaign in 1954, to consolidate the 1952-3 improvements, is outlined.
This study evaluated rabies epidemiology in Far EastAsia. Questionnaires were sent by the OIE to Far East Asian countries and eight questionnaires were returned. Data were collected from these returns, as well as from recent publications, to gather information regarding rabies epidemiology in these countries. More than 29,000 human deaths were reported in 2006 in Far East Asia, representing more than 50% of all human rabies cases around the globe. There are only a few countries or regions from which no human rabies was reported in 2006 such as Japan, Singapore, South Korea, Malaysia, Hong Kong, and Taiwan. In many of these rabies endemic countries, the number of human rabies cases has not changed much during the past decade. The only country with a steady decline is Thailand, where the number of cases has decreased from around 200 to about 20 cases per year. The most dramatic changes were observed in China. Human rabies cases declined from around 5,000 cases per year in the 1980s to about 160 in the mid-1990s. However, these trends have since been reversed. A steady increase has been reported over the past 10 years with more than 3,200 cases reported in 2006. Although there are many factors that contribute to the epidemic or endemic nature of rabies in these countries, the single most important factor is the failure to immunize domestic dogs, which transmit rabies to humans. Dog vaccination is at or below 5% in many of these countries, and cannot stop the transmission of rabies from dogs to dogs, thus to humans. It is thus most importantforthese countries to initiate mass vaccination campaigns in dog populations in order to stop the occurrence of human rabies in Far East Asia.