Friday, February 15, 2008

Economic Cost of Rabies

Olivia Judson writes in NYT blog- The Wild Side;

Each year, the disease kills about 55,000 people — that’s 150 a day — almost all of them in the poorest parts of Africa and Asia, and more than 7 million people receive post-exposure treatment after being bitten by a rabid animal. Treatment is not just expensive, but time-consuming: a full course of vaccination requires five visits to a hospital or health clinic during one month. Which, if you live in rural Africa, can mean many hours of travel and time not working. Indeed, the global economic cost of rabies is estimated to be more than $583 million. And that doesn’t count the trauma that deaths from rabies inflict on families and communities. For though rabies kills many fewer people than malaria, it causes far, far more fear....

And vaccinating dogs is cheap. The vaccine costs about $1.50 per animal, and that includes the cost of delivering it. A country like Tanzania has around 5 million domestic dogs. To vaccinate 70 percent of them for one year would cost less than $6 million.

And how you'd die if you get rabies;

Often the first symptom is itching around the site of the bite. Sometimes, it’s an itching so intense that people will tear open their own skin as they scratch. The victim becomes afraid of water, to the point where drinking becomes impossible, no matter how great the thirst: the sight of a glass of water will induce spasms of terror so severe that the victim will hurl the glass away and may retch so violently as to tear the lining of the throat. The vocal cords become paralyzed, distorting the voice. Saliva may become thick and heavy. And then comes the madness.

“At the peak of excitement, the patient’s whole nervous system seems to be aroused. He is in a state of extreme agitation and has frightening hallucinations. His face is a mask of terror. He shouts incomprehensibly at the top of his distorted voice. His body is racked with tremors or spasms. He may struggle frantically and powerfully to free himself from constraints and try to escape from the room.”

Episodes of madness continue until the victim falls into a coma; this is followed by paralysis and death. Sometimes the madness includes ferocious, biting, attacks on anyone nearby. Sometimes it includes a sexual frenzy and attempted rape.

If you arrived in a Western hospital with symptoms of rabies, you’d be sedated until you died. In poor countries, where hospitals are scarce and sedatives scarcer, often nothing can be done, and the victim may be locked into a room, alone, to die. Usually, the victims are children.

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