Rabies: A Looming Threat in Cambodia

Reviewed by Dr. Nov Tam; Date: November 23, 2024

Rabies, a viral disease that affects the central nervous system, continues to pose a significant public health threat globally, particularly in developing countries like Cambodia.1 While rabies is entirely preventable through vaccination and timely post-exposure prophylaxis (PEP), it tragically claims the lives of nearly 59,000 people each year, with 99% of these deaths occurring in Asia and Africa.

Cambodia bears a heavy rabies burden.2 Despite efforts to control the disease, it remains endemic in the country, with an estimated annual incidence of 6 cases per 100,000 people.3 This translates to a staggering 800 deaths each year, a figure that underscores the urgent need for intensified rabies control and prevention programs.

Factors Contributing to Rabies Burden in Cambodia:

Several factors contribute to the persistence of rabies in Cambodia:

• High Dog Population: Cambodia has a large population of free-roaming dogs, which act as the primary reservoir for rabies.4

• Limited Dog Vaccination Coverage: Vaccination of dogs is the most effective strategy for preventing rabies transmission to humans.5 However, dog vaccination rates in Cambodia remain suboptimal due to challenges in accessing veterinary services, particularly in rural areas.6

• Lack of Awareness: Knowledge and awareness about rabies prevention and control remain low among the general population.7 This often leads to delays in seeking medical attention after a potential exposure, further increasing the risk of developing rabies.8

• Limited Access to PEP: Access to timely and affordable PEP remains a challenge, especially for people living in remote areas.9 The cost of PEP can be prohibitive for many Cambodians, and the limited availability of rabies vaccines and immunoglobulins further compounds the problem.

Rabies Control and Prevention Efforts in Cambodia:

The Cambodian government, in collaboration with international organizations such as the World Health Organization (WHO) and non-governmental organizations (NGOs), has implemented various initiatives to combat rabies.10 These include:

• Mass Dog Vaccination Campaigns: These campaigns aim to increase dog vaccination coverage and reduce the number of rabies cases in animals.11

• Establishment of Rabies Prevention Centers: These centers provide PEP to individuals who have been bitten or scratched by animals.12

• Public Awareness Campaigns: Educational programs are conducted to raise awareness about rabies prevention and control among the general population.13

The WHO's Role in Rabies Elimination:

The WHO plays a crucial role in global rabies elimination efforts. It provides technical guidance and support to countries in developing and implementing national rabies control programs. The WHO also promotes the "Zero by 30" goal, which aims to eliminate human deaths from dog-mediated rabies by 2030.14

Key Strategies for Rabies Elimination:

• Strengthening Dog Vaccination Programs: Increasing dog vaccination coverage through sustained mass vaccination campaigns and routine immunization is essential.15

• Improving Access to PEP: Ensuring timely and affordable access to PEP for all individuals who have been exposed to rabies is critical.

• Enhancing Surveillance and Laboratory Capacity: Strengthening surveillance systems to accurately track rabies cases in both humans and animals is necessary for effective control and prevention efforts.

• Promoting Public Awareness and Education: Educating the public about rabies prevention and control measures, including responsible pet ownership and bite prevention, is crucial.16

Conclusion:

Rabies remains a significant public health challenge in Cambodia.17 However, with concerted efforts from the government, international organizations, and the community, the country can make progress towards the goal of rabies elimination. By strengthening dog vaccination programs, improving access to PEP, enhancing surveillance, and promoting public awareness, Cambodia can reduce the burden of this deadly disease and protect its people from its devastating consequences.18