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Rabies: 9 years and nothing gets better

 rabid dog
For about nine years now, I have been traveling to Baltimore on a semi-annual basis. I go to the Johns Hopkins Bloomberg School of Public Health and deliver, more or less, the same talk, year after year,  about rabies.
9 years, and more deaths.
It’s part of the vector-borne section of the course. While not a vector-borne disease (unless we wish to think of dogs as a vector between us and bats–a bit of a stretch, if you ask me), rabies is considered one of the Neglected Tropical Diseases (NTDs), and because it’s a preventable cause of horrific and needless suffering it needs to be somewhere.
Opening Salvo
I always preface my talk with two informal survey questions:
  1. Does anyone know what the OIE is?
  2. Does anyone know what One Health is?
Answers:
  1. OIE stands for Office International des Epizooties, or World Organisation for Animal Health (yes, they use the British spelling of “organization, which I think is a political statement, but that’s another post). It’s kind of like the WHO for animals, and it is based in Paris.
  2. One Health is a concept advanced by the American Veterinary Medical Association, the CDC, and other organizations. The CDC states “One Health recognizes that the health of people is connected to the health of animals and the environment. The goal of One Health is to encourage the collaborative efforts of multiple disciplines-working locally, nationally, and globally-to achieve the best health for people, animals, and our environment.”
I think that over the years, I’ve had maybe three ‘yes’ answers to these questions, combined. The conclusions are obvious:
  1. The OIE is failing in its mission to educate the other health professions, as well as the general public, on the importance of animal health, both as it relates to animals alone and to human health as well.
  2. The One Health concept is a failed attempt by the veterinary profession to assert its presence into discussions of public health. It represents the profession’s inability to move itself from the general world of agriculture (where it is also clearly important) and place itself among the disciplines of other health sciences.
(As a veterinarian, we are used to being the red headed stepchild of the medical professions, so this doesn’t really surprise or irk me. Sometimes, we even create brilliant concepts, like One Health, so we can pretend that it’s really a thing for those outside of our bubble.)
So, what’s the problem here, specifically regarding rabies?
Let me preface this by saying that , I don’t really trust rabies statistics. The latest updates I’m reading estimate the annual number of rabies deaths at 59,000.  Given that most of these deaths come from rural areas in Africa and Asia with poor access to treatment and prevention, I’m not sure how they come up with that number. (On my to-do list: contact a rabies epidemiologist.) What I do know is that when I first started giving the talk, the number was 25,000 – 50,000. The range itself, varying by 100% of the low number, inspires doubt in and of itself.
That noted, the trend over the past nine years is at best level, and at worst shows an increase of 18%. Rabies does not get a lot of attention. Most diseases of the poor—Chagas’ disease, cysticercosis, leishmaniasis, hydatid disease, and others—get little attention. AIDS/HIV, tuberculosis, and malaria are the exceptions, but two of those are not restricted to poor areas overseas. Rabies kills “only” 59,000 people a year, a number that pales in comparison to the other diseases listed here. But working on one disease does not preclude working on another.  Rabies is low hanging fruit. The numbers of rabies deaths are skewed towards children.  Rabies is not a medical mystery. The bottom line is that no one should die the horrible death that comes with rabies infection.

New post on PAZ blog

http://www.pazonehealth.org/single-post/2017/06/13/Hydatid-Disease-in-Ayacucho-Peru-Our-next-project-Part-I-Gross-picture-alert

New Post on the Meta-Bug

 

Click on Monica to read about parenting, divorce, baseball, politics, etc.
MONICA-VITTI

New Post on the Meta-Bug

I’ve been writing more over there lately. In this post I take up the fight against the greedy maw of MLB.

 

 

Arsenic Poisoning and Child Development

Our friends over at PAZ (Pan American Zoonotic Research and Prevention) are looking into the negative effects of heavy metals on infant and child health.

Arsenic

While arsenic levels in breast milk are low even in the face of exposure by ingestion, prenatal arsenic exposure increases the risk for spontaneous abortion and stillbirth. Surviving infants whose mothers have exposed are more susceptible to pneumonia and diarrhea in infancy. Children exposed themselves to arsenic via drinking water have 10 times greater risk of developing fatal liver cancer while young. Susceptibility to arsenic poisoning is thought to be enhanced by poor nutritional level, especially low folic acid levels.

The concern of PAZ is that in Peru–where the extraction of metals is one of the main drivers of the economy–that mining will increase the exposure of children and pregnant moms to toxic levels of arsenic.

Heavy Metal Toxicity

Heavy Metal Toxicity

 

] Arsenic dust is produced during copper and gold smelting, and coal combustion – See more at: http://www.miningfacts.org/Environment/What-is-the-role-of-arsenic-in-the-mining-industry/#sthash.ExbqmZnR.dpuf
] Arsenic dust is produced during copper and gold smelting, and coal combustion – See more at: http://www.miningfacts.org/Environment/What-is-the-role-of-arsenic-in-the-mining-industry/#sthash.ExbqmZnR.dpuf

] Arsenic dust is produced during copper and gold smelting, and coal combustion – See more at: http://www.miningfacts.org/Environment/What-is-the-role-of-arsenic-in-the-mining-industry/#sthash.ExbqmZnR.dpuf
] Arsenic dust is produced during copper and gold smelting, and coal combustion – See more at: http://www.miningfacts.org/Environment/What-is-the-role-of-arsenic-in-the-mining-industry/#sthash.ExbqmZnR.dpuf

 

 

Pan American Zoonotic Research and Prevention(PAZ) is looking for donations

Give to PAZ and Feel Warm All Winter Long, Literally.

  Posted on October 17, 2013 by PAZ

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Our COO is on her way to Lima.

Give $75 to PAZ before October 24 and we will send you a fashionable traditional Peruvian alpaca  wool hat.

Give $125 and we will send you two!

Click on the hat to donate through gofundme.comperuvian hat

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New post at PAZ (Pan American Zoonotic Resarch and Prevention.

 

 

http://pazresearch.org/2013/10/08/paz-forges-ahead-in-emerging-disease-research-looking-for-zoonoses-in-domestic-dogs-in-peru/

New Post at PAZ

http://pazresearch.org/2013/10/08/paz-forges-ahead-in-emerging-disease-research-looking-for-zoonoses-in-domestic-dogs-in-peru/

journal.pntd.0002393.g001journal.pntd.0002393.g002

Link

New Post at Pan American Zoonotic Research and Prevention

New Post at Pan American Zoonotic Research and Prevention

It’s tough work in remote locations. 

The Passing of Thistle–A Poem by Peter Davison

scotty

This is our first summer without a dog.
Fifteen years of disgraces in the night
(tattered screen doors, overtuned garbage pails,
unexpected puddles on the guestroom bed,
and other misbehaviors) have ended at last.
She had a way of posing in the landscape,
arranging herself against a screen of trees,
upon a lawn or on an outdoor deck
so as to bring out the hero in photographers
who could focus on the challenge of her darkness.
When on the move she carried less distinction:
a scottie, long in the barrel, short of leg,
she trotted country roads like city sidewalks,
so long as a glance behind her could confirm
the support of the authority that gave her hers.
Absent such authority, she panicked:
could be found, after a search, hysterically
galloping somewhere in the wrong direction
if we returned from shopping or the movies
through a region she had not known long enough to own.
On her home turf she brooked no trespassing,
at least by motorcycles, dogs, or horses,
though she’d roll over basely for human intruders.
The children who had grown up while she watched
were patient, watching her as age declined
from sleepiness to blindness, deafness and
incontinence. Before her last collapse
she lived her life entirely through the nose
and sense of touch. And as they watched her sleep
they saw their childhoods disappearing with her
and by so much ceased a little to be children.

I who had shared, in my two-legged way,
in what I could grasp of her doggy memories,
knew we had lived through all the same affections,
felt the same losses, searched through an empty house
for someone who would never be returning,
brooded on sights and voices that had vanished.
Perhaps she had a way of understanding
our loss that she could never share with me,
but now our past belongs to me alone,
now that she’s gone, and no one else remembers
the weekends that we spent in the house together
letting each other in and out of doors.

Copyright © 1989 by Peter Davison. All rights reserved. As published in The Poems of Peter Davison (Knopf, 1995). 

Originally published in The Atlantic Monthly, September 1989.