Rabies dispatch from Malaysia

Just a few days ago, I arrived here in the heart of Malaysia. 

The capital, Kuala Lumpur, is a clean, orderly and modern city. KL, as it is affectionately known, is a thriving gateway to Southeast Asia. 

Shiny sky scrapers are clustered about the city center, motorcycles and cars pulse through the streets, banyan trees and thickets of bamboo offer oases of shade, while thick humid air enshrouds everything in unbearable heat.  At night, the Petronas towers shine like crystal. Wow!

I came here for the 13th annual International Congress on Infectious Diseases.  Doctors and scientists from all of the world met to review the latest drugs, emerging diseases, HIV/AIDS, parasitic infections and tropical medicines - it was an exciting time. 

Luckily, there is no rabies here.  Decades ago, the government resolved to eliminate that threat.  Dog control with vaccination and round-up of street animals was authoritarian but effective.  Rabies had no place to hide.  The WHO officially recognizes Malaysia as rabies-free.   Occasional rabies cases may cross over from border countries, but are quickly stamped out.

Many countries in Asia still struggle with rabies. Depending on resources and commitment, the situation varies. In Thailand, for example, the government curbed human rabies by providing free anti-rabies vaccines to anyone exposed. Expensive, but effective, human rabies cases number only a dozen or so per year. In the Philippines, reductions in rabies suffering are anticipated with the passage of the “Anti-Rabies Act of 2007″ (Republic Act No. 9482).  This law commits to wiping out rabies by 2020 from those islands.  Hopefully it will occur sooner, and with more resources it certainly could. 

RFW is gearing up to support more dog vaccination projects in the Philippines through our click2vaccinate program.  Dispatching rabies from the Philippines remains our primary goal.  We have alot of work ahead of us!

Travelers to Malaysia should check out the CDC website and confer with a travel medicine specialist before their trip.

RW

HIV needlestick!

A good friend of mine who works as a nephrologist was putting in a dialysis catheter. She had done many ‘lines’ before and this one was just routine. The catheter looked like a very large needle with tubing attached. The catheter or dialysis line provides access to the blood stream to provide the patient with life saving hemodialysis. When the kidneys fail, a patient will die in a very short time without dialysis, as toxic levels of metabolites build up.

She accessed the neck veins and got a good flow of blood, indicating the line was in position. She finished up the placement and was preparing to give some fluids to flush the line clean. Now that the ‘hard’ part of placing the line was done, her attention lapsed ever so slightly. While preparing the fluids, she inadvertently stabbed the needle through her glove and into her finger. A lancinating pain ran up her arm – it was a bad ‘stick’ or injury. The needle had penetrated through and through her finger.