Published Date: 2009-10-28 22:00:06
Subject: PRO/AH/EDR> Rabies, human, canine - Ghana
Archive Number: 20091028.3738

RABIES, HUMAN, CANINE - GHANA
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Date: 27 Oct 2009
Source: allAfrica.com [edited]
<http://allafrica.com/stories/200910271144.html>


Residents of the Bongo district and of communities within the
Bolgatanga Municipal area in the Upper East Region are trembling in
fear as rabies infested dogs have bitten and killed 6 people, with 2
others currently in critical condition.

The horrific death of an 11-year-old boy on 19 Oct 2009 in Zorko, a
suburb of the Bongo, brought the total number of deaths related to
rabies to 6 within 5 days. According to an eyewitness, when the boy
was brought to the hospital, he was literarily barking like a dog and
behaving aggressively. He said that because the case had advanced,
the medical personnel could not offer any help except to dose him
with sedatives just to ease the pains. His parents, out of
frustration however, took the child home, where he died later the
same day.

When Public Agenda visited the Bongo District Hospital, a Senior
Nursing Officer confirmed the cases but said all the 6 people died
out of hospital, since "they were brought in too late for admission
and treatment." The official lamented the absence of anti-rabies
vaccines in the hospital. She said that even cases that were reported
in a timely manner could not be treated because of lack of the
anti-rabies vaccine in the hospital.

According to her, 2 people from Namoo, a border community in the
district, reported with cases of rabies on 20 Oct 2009 but were asked
to go and buy the drug [vaccine] at Bolga for treatment. The victims
could not afford the drug [vaccine] and so had to return home to
await their painful death. According to the official, anti-rabies
drug [vaccine] sold in the open market costs around GHS 100.00 [USD
70.00], an amount too costly for most people living in deprived
communities such as Bongo. An official at the hospital who pleaded
anonymity alleged that because the drug [vaccine] is expensive, some
officials are hoarding the drug as a way of making money for
themselves. She wondered why an anti-rabies drug [vaccine] which is
not regularly dispensed can suddenly run short of supply.

Another official, speaking on anonymity, was of the view that as a
matter of urgency, all dogs and cats within the district should be
vaccinated free of charge. Another option, according to the official,
was to kill all dogs, as was done to pigs at the time of the swine
fever, since the situation was reaching an alarming state. "As I
speak to you now, we don't know how many dogs are getting infected
out there and how many people will be bitten by these dogs," she
stated.

When this reporter visited the veterinary offices in the district, no
official was available for comment. When contacted by telephone, the
District Chief Executive of Bongo, Hon. Akugre Clement, said that he
was not aware of the matter. He, however, said that he would liaise
with the Ministry of Health and the Ghana Service to find a solution
to the menace.

The people of Bongo are living in fear now with every passing moment
and demand the immediate supply of anti-rabies vaccines for the
treatment of infected persons. They are also calling on the
veterinary division of the Ministry of Agriculture to, as a matter of
urgency, take steps to vaccinate all dogs and possibly cats to
prevent further spread of the disease.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[Rabies causes over 24 000 deaths a year in Africa, mostly children
in poor rural communities. Rabies prevention and treatment are costly
and the necessary resources often scarce or inadequate. Controlling
rabies in dogs, the main agents of rabies spread, is, therefore, an
important part of any rabies eradication programme.

To investigate the evolutionary dynamics of rabies virus in western
and central Africa, 92 isolates sampled from 27 African countries
over 29 years were collected and sequenced. This revealed that rabies
virus currently circulating in dogs in this region fell into a single
lineage designated "Africa 2." A detailed analysis of the
phylo-geographical structure of this Africa 2 lineage revealed strong
population subdivision at the country level, with only limited
movement of virus among localities, including a possible east-to-west
spread across Africa.

In addition, Bayesian coalescent analysis suggested that the Africa 2
lineage was introduced into this region of Africa only recently
(probably less than 200 years ago), in accordance with the timescale
of expanding European colonial influence and urbanization, and then
spread relatively slowly, perhaps occupying the entire region in a
100-year period. (See Evolutionary history and dynamics of dog rabies
virus in western and central Africa. Talbi C, Holmes EC, de
Benedictis P, Faye O, Nakoune E, Gamatie D, Diarra A, Elmamy BO, Sow
A, Adjogoua EV, Sangare O, Dundon WG, Capua I, Sall AA, Bourhy H.
National Reference Centre for Rabies, WHO Collaborating Centre for
Reference and Research on Rabies, 75724 Paris Cedex 15, France. In
The Journal of General Virology, 90 (Pt 4): 783-791, 2009: open
access paper:
<http://vir.sgmjournals.org/cgi/content/full/90/4/783>).

The HealthMap/ProMED-mail interactive map of Ghana is available at:
<http://healthmap.org/r/00IG>. Bolgatanga, colloquially known as
Bolga, is the capital of both the Bolgatanga Municipal District and
the Upper East Region of Ghana and has a population of about 50 000
(2000 census). Bolga is the major town between Tamale, 161 km (about
100 miles) to the south, and the border with Burkina Faso. The
location of Bolga is indicated on the map at:
<http://en.wikipedia.org/wiki/Bolgatanga>. - Mod.CP]

[According to Ghana's information to the OIE, 19 human cases of
rabies were recorded during 2008; a rate of 0.0903 per 100 000
population. This was significantly higher than the records of the
previous 3 years, 2005, 2006 and 2007, when 1, 3 and 1 humans,
respectively, reportedly died of rabies. The background to this
increase is not disclosed but may reflect an increased number of
stray, unvaccinated animals (particularly dogs). The number of animal
rabies outbreaks (each of them including one or multiple cases) were,
for the 4 years 2005-2008, respectively 38, 37, 23 and 57.
Vaccination of domestic animals should be accompanied by immediate
steps to control the size of the virus reservoir, mainly the stray
dog population. - Mod.AS]

See Also

Rabies, animal - Ukraine (02): oral vaccination 20091018.3587
Rabies, animal - Israel: (central) human exposure 20091018.3583
Rabies, canine, human - Indonesia (15): Bali 20091016.3564
Eastern equine encephalitis, equine - Canada (02): (NS) 20091004.3451
Rabies, canine - USA (02): (AL) 20091002.3438
Rabies, bovine, feline - USA (02): (CO) 20091001.3415
Rabies, canine, human - Angola (07): (UI) 20090607.2106
.....................................................mpp/cp/arn/msp/lm

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