ROJoson PEP Talk: RABIES AWARENESS

1. RABIES
Awareness
March 18, 2023
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have a
basic understanding
of RABIES in their
health management.

2. RABIES
Awareness
March 18, 2023
1400H - 1500H
Via Zoom
Empowerment
objective - for
laypeople to have a
basic understanding
of RABIES in their
health management.
Welcome all!
MUTE yourself but always
show your video picture.
Sign in your name, FB
account, or email address in
the Chat Box! Include names
of companions attending.
Use the Chat Box to ask
questions and make
comments while the PEP TALK
is on.
Group pictures at start and
end of PEP TALK – show your
face in video.

3. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

4. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

5. RABIES
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of RABIES in their
health management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

6. RABIES
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of RABIES in their
health management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START PEP TALK
PROPER IN 2
MINUTES!
Pls. turn on your
video!
Show your face!

8. RABIES
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of RABIES in their
health management.
ROJoson PEP Talk
I have a Patient
Empowerment
Program in which I
like to empower the
lay people or
patients to take
control in the
management of
their health.

9. I started the PEP Talk
on May 15, 2021.
There are 3 courses
in the PEP Talk.
I completed the Core
Course on October 9,
2021.

10. From October 23,
2021 onwards, I have
been tackling Health
Disorder and Health
Issue Courses. This
may take 3 years or
longer depending on
our enthusiasm and
perseverance.

11. RABIES
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of RABIES in their
health management.
My PEP TALK today is
entitled:
RABIES
AWARENESS
In consonance with
DOH Health
Awareness Calendar
- RABIES
AWARENESS MONTH
(March)

12. RABIES
Awareness
Contents
• Why the RABIES Awareness Month?
• What is the Philippine government program
against RABIES?
• What is a RABIES?
• What is the prognosis of RABIES?
• What are the preventive measures against
RABIES?
• How can one contribute to ZERO RABIES
DEATH in PH by 2030?
• What are ROJoson’s health advice on
prevention of RABIES on a personal level?

13. RABIES
Awareness
Why the RABIES Awareness Month?
To raise awareness on RABIES as a health
problem in the community and in our personal
life.
To highlight the importance of managing RABIES
in the community because it is
• common
• causing a lot of deaths
• preventable and beatable (if only every
citizen is empowered and cooperates)

14. RABIES
Awareness
More than one (1)
million cases of
animal bites
reported to DOH
2016 up to
present

15. RABIES
Awareness
Why the RABIES Awareness Month? Majority are bites
are from DOGS and
CATS
Rabies cases mostly
from DOGS

16. RABIES
Awareness
Why the RABIES Awareness Month?
Rabies is a viral zoonotic disease (transmitted
from animals to humans) that cause 59,000
deaths every year worldwide with 56% of the
cases occurring in Asia.
In the Philippines, there are 250-300 deaths
every year mostly among children below 15
years of age and those who are poor.

17. RABIES
Awareness
RABIES - fatal
disease (99% to
100% FATAL) once
symptoms are
present
- NO specific
treatment available
anywhere in the
world YET.

18. RABIES
Awareness
RABIES
PREVENTABLE –
100%
BEATABLE – ZERO BY
2030

19. RABIES
Awareness
Why the RABIES Awareness Month?
Challenges:
• Even though such deaths are preventable, there is no
treatment or cure for rabies once the clinical manifestations of
rabies set in.
• The high cost of anti-rabies vaccine and immunoglobulin,
expenditure for medical consultations and the loss of income
are an additional burden to a regular Filipino family
confronted with a potential rabies exposure.
• In addition, victims of potentially rabid bites suffer anxiety
resulting from the uncertainty on the consequence of a rabies
exposure.

20. RABIES
Awareness
Why the RABIES Awareness Month?
What the government is doing?
• The enactment of the Anti-Rabies Act of 2007 (Republic Act
9482)
• The creation and implementation of the National Rabies
Prevention and Control Program (NRPCP) from the national to
the local level.
• Establishment of 613 Animal Bite Treatment Centers (ABTCs)
as of 2018 under the Department of Health (DOH) and Local
Government Units (LGUs) all over the country has resulted to
increased access to rabies Post Exposure Prophylaxis (PEP).

21. RABIES
Awareness
Why the RABIES Awareness Month?
What the government is doing?
National program include:
• mass vaccination of dogs
• dog population management
• health promotion
• advocacy on responsible pet ownership
• establishment of central database system for dogs
• provision of pre-exposure prophylaxis (PrEP) for high-risk
individuals
• provision of post-exposure prophylaxis (PEP) after an exposure
from potentially rabid animals

22. RABIES
Awareness
Why the RABIES Awareness Month?
What the government is doing?
The Department of Health (DOH) was mandated to ensure the
availability and adequate supply of WHO pre-qualified human
anti-rabies vaccines (ARV) in Animal Bite Treatment Centers
(ABTC) at all times.

23. RABIES
Awareness
Why the RABIES Awareness Month?
What the government is doing?
There is a strategic plan by the NRPCP
(2020 to 2025)
with the overall and ultimate goal of
declaring the Philippines rabies-free by
year 2030
To end human deaths
from dog-mediated
rabies by 2027

24. RABIES
Awareness
STRENGTHENING the NATIONAL PROGRAM:
• mass vaccination of dogs
• dog population management
• health promotion
• advocacy on responsible pet ownership
• establishment of central database system for dogs
• provision of pre-exposure prophylaxis (PrEP) for high-risk
individuals
• provision of post-exposure prophylaxis (PEP) after an exposure
from potentially rabid animals
HOW CAN YOU HELP?

25. RABIES
Awareness
HEALTH PROMOTION
• Celebration of Rabies Awareness Month under Executive
Order No. 84, March is Rabies Awareness Month
• Celebration of World Rabies Day - September 28 has
been declared as World Rabies Day.
• Development of IEC (info, education, communication)
Materials
• Massive Health Information Campaign using tri-media
• Integration of Rabies Program into the School
Curriculum
HOW CAN YOU HELP?
Be empowered
with the 4 Ks -
Kaalaman
Kakayanan
Karapatan
Kapangyarihan
Empower other
people!
Especially
CHILDREN and
the POOR!

26. RABIES
Awareness
DOG VACCINATION
This is the most effective measure to control
canine rabies.
The Department of Agriculture – Bureau of
Animal Industry takes the lead in mass dog
vaccination campaigns and provision of animal
rabies vaccine.
HOW CAN YOU HELP?
Be empowered with
the 4 Ks - Kaalaman
Kakayanan Karapatan
Kapangyarihan
Empower other
people!
• Vaccinate your dogs and cats!
• Help in the dog vaccination
program!

27. RABIES
Awareness
DOG POPULATION MANAGEMENT
This includes stray dog management through
impounding, field control and disposal, surgical
and non-surgical sterilization and habitat control.
HOW CAN YOU HELP?
Be empowered with
the 4 Ks - Kaalaman
Kakayanan Karapatan
Kapangyarihan
Empower other
people!
• Report to community leaders on
stray dog!
• Assist in stray dog management!

28. RABIES
Awareness
RESPONSIBLE PET OWNERSHIP
The program adopts the strategy of promoting
Responsible Pet Ownership to prevent spread of
rabies.
The public is advised to bring their pet dogs for
antirabies vaccination when they reach 3 months
of age and yearly thereafter, provide proper
nutrition, exercise and shelter to their pet dogs
and not to allow their pet dogs to roam around
to prevent contact with infected animals.
Note: there is a law that penalizes owners of stray dogs.
HOW CAN YOU HELP?
Be empowered with
the 4 Ks - Kaalaman
Kakayanan Karapatan
Kapangyarihan
Empower other
people!

29. RABIES
Awareness
Animal Bite Treatment Centers / Animal
Bite Clinics (Centers)
ABTC by DOH started in 1997.
ABTC – government (DOH and LGU)
ABC – private
There are a lot now – government and
private (hospital based / clinic based).

30. RABIES
Awareness
In the Philippines,
there are 250-300
deaths every year
mostly among
children below 15
years of age and
those who are poor.

31. RABIES
Awareness
Rabies is a dangerous viral animal infection and a
fatal disease (99% to 100% FATAL) with no
specific treatment available anywhere in the
world.
Once RABIES develops, there is nothing that can
be done.
Signs and symptoms of RABIES (FURIOUS TYPE):
• Hydrophobia (fear of water)
• Fever, malaise, headache
• Intolerance to noise, bright light or air
• Irritability, hyperactivity
PREVENT RABIES
AT ALL COST!

32. RABIES
Awareness
PERSONAL PREVENTION
Have your pets (particularly dogs and cats)
vaccinated against rabies.
Be vigilant against getting licked, scratched or
bitten by dogs and cats whose vaccination status
is not known. PREVENT RABIES
AT ALL COST!

33. RABIES
Awareness
PERSONAL PREVENTION
Once exposed (licked, scratched or bitten) to
dogs and cats particularly whose anti-rabies
vaccination is not known:
• Wash wound immediately and thoroughly
with soap and water for at least 15 minutes.
• Go to an Animal Bite Center or emergency
room as soon as possible!
• Observe involved animals for 14 days. If
presence of signs or illness or death –
immediately report to authority --> lab exam
for rabies.
PREVENT RABIES
AT ALL COST!

34. RABIES
Awareness
PREVENT RABIES
AT ALL COST!

35. RABIES
Awareness
What is an Animal Bite Treatment Center /
Animal Bite Center?
ABC or Animal Bite Center is a facility where you
can avail of services about animal bites. These
clinics may be attached into hospitals or as
separate centers.
The centers have available vaccines and injection
shots especially made to prevent rabies
symptoms and infections.

36. RABIES
Awareness
World Health Organization (WHO)
Post-exposure prophylaxis (PEP)
Post-exposure prophylaxis (PEP) is the
emergency response to a rabies exposure.
This prevents the virus from entering the
central nervous system, which would
invariably result in death.
Pre-exposure
Prophylaxis (PrPEP)
• Before exposure
• Given to people
with high-risk of
exposure to rabies
such as
veterinarians

37. RABIES
Awareness
WHO
Post-exposure prophylaxis (PEP)
PEP consists of:
•extensive washing with water and soap for at
least 15 minutes and local treatment of the
wound as soon as possible after a suspected
exposure;
•a course of potent and effective rabies vaccine
that meets WHO standards; and
•the administration of rabies immunoglobulin
into the wound, if indicated.

38. RABIES
Awareness
Categories of contact with suspect rabid animal
• Category I - touching or feeding animals,
animal licks on intact skin (no exposure)
• Category II - nibbling of uncovered skin, minor
scratches or abrasions without bleeding
(exposure)
• Category III - single or multiple transdermal
bites or scratches, contamination of mucous
membrane or broken skin with saliva from
animal licks, exposures due to direct contact
with bats (severe exposure)
Risk assessment of
exposure to rabies

39. RABIES
Awareness
Categories of contact
with suspect rabid
animal
Post-exposure prophylaxis
measures
Category I
Washing of exposed skin
surfaces, no PEP
Category II
Wound washing and
immediate vaccination
Category III
Wound washing, immediate
vaccination and
administration of rabies
immunoglobulin/monoclona
l antibodies
Exposure risk and
indications for PEP
Depending on the
severity of the
contact with the
suspected rabid
animal,
administration of a
full PEP course is
recommended as
follows:

40. RABIES
Awareness
Schedule of Vaccine Shots
The anti rabies vaccine schedule depends on the
recommendation of the doctor. In most cases,
the counting includes 0, 3, 7, 14, 28 days.
Need to complete the number of shots to make
the vaccine effective.
Number of Shots Required
A minimum of three shots may be given by the
doctor depending on the patient’s condition. If
you had a vaccine before, the doctor may decide
to give you a shorter course.

41. RABIES
Awareness
Vaccinations usually used in patients with animal
bites
Against RABIES
• Cell culture vaccines
• Purified Vero Cell Rabies Vaccine (PVRV)
• Purified chick embryo cell vaccine (PCEC)
• Equine Rabies Immunoglobulin (ERIG)
• Human Rabies Immunoglobulin (HRIG)
Against TETANUS
• Tetanus toxoid
• Immunoglobulin (Human or Equine)
Take note:
Human sources –
more expensive
Different brands
Different costs
WHO / BFAD certified
- acceptable

42. RABIES
Awareness

43. RABIES
Awareness
Intramuscular
Intradermal

44. RABIES
Awareness
Injection of immunoglobulin around the wound

45. RABIES
Awareness
Costs of anti-rabies vaccinations
Government institutions: FREE
Private institutions:
As high as P10,000 per session
As high as P50,000 complete set of vaccinations
(Day 0, 3, 7, 14, 28)
Stand-alone clinics (Animal Bite Centers) –
cheaper
Hospital-based Animal Bite Centers – more
expensive
Whilst ABTCs use
intradermal
administration, ABCs
usually use
intramuscular
administration for
anti-rabies
vaccination.

46. RABIES
Awareness
Some quotations from private Animal Bite
Centers
Anti rabies Vaccine
Intradermal -
Php700/dose x 4 doses
Antirabies Vaccine
Intramuscular -
Php1,400/dose x 5 doses
Tetanus toxoid:
Php150/dose x 3 doses
ERIG: Php1,550 base
price
Abhayrab(PVRV) 2k per session. need 4 session.
Verorab – 2292; ERIG – 2661
Toxoids – 176; HTIG – 1158
ABC - 3474
Anti Rabies - Php 700 per session x 4 sessions
Anti Tetanus - Php 150 per session x 3 sessions
ERIG (by schedule)- Php 1,700 base price (once only for
patients assessed under Category 3)

47. RABIES
Awareness
How long are you immune to rabies after
vaccination?
The rabies vaccine does not provide lifelong
protection.
Should I take rabies vaccine again after 3
months?
"within 3 months" of vaccination, if again a
dog/any animal bite happens, you need not to
take any anti rabies vaccine. Only wound
treatment. If "after 3 months" of vaccination,
animal bite happens, you need to take 2 booster
dose on day 0 and 3.
Frequently Asked
Questions

48. RABIES
Awareness
Is there a single dose of rabies vaccine that is
available?
No.
Series or a course (Day 0, 3, 7, 14, 28) (Day 0, 3,
7, 14) (Day 0, 3)
You must be sure to complete the full course of
vaccinations. This means that you will need to
return to the health facility to receive additional
vaccinations. This is critical as only one
vaccination is not enough to ensure your safety.
Frequently Asked
Questions

49. RABIES
Awareness
How many doses of vaccine will I need to get for
PEP?
PEP can be administered in one of two ways,
either intramuscularly or intradermally.
— The WHO-recommended option is the
intradermal regimen that involves two doses of
vaccine administered on each of days 0, 3 and 7.
This is the most cost-, dose- and time-sparing
option.
Frequently Asked
Questions

50. RABIES
Awareness
How many doses of vaccine will I need to get for
PEP?
Two intramuscular PEP regimens are also still
considered valid options by WHO.
These are
— One dose of vaccine administered on days 0,
3, 7 and a fourth dose between days 14 to 28;
— OR Two doses of vaccine administered on day
0, followed by 1 dose on days 7 and 21.
Frequently Asked
Questions

51. Contents
• Why the RABIES Awareness Month?
• What is the Philippine government program
against RABIES?
• What is a RABIES?
• What is the prognosis of RABIES?
• What are the preventive measures against
RABIES?
• How can one contribute to ZERO RABIES
DEATH in PH by 2030?
• What are ROJoson’s health advice on
prevention of RABIES on a personal level?
RABIES
Awareness
Summary
Take Away

52. Be always in touch with reliable medical
information on RABIES.
Knowledge is power; it gives power.
Use the 4Ks of Patient Empowerment:
Kaalaman, Kakayanan, Karapatan and
Kapangyarihan
to gain greater control over decisions in
the prevention of RABIES in one’s health
management.
Take Away in
relation to
Patient
Empowerment
RABIES
Awareness

53. RABIES
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of RABIES in their
health management.

54. Reminder after the PEP
Talk:
Take the Online Learning
cum Evaluation Test
Exercise (OLETE) for
mastery of learning and
have a perfect score to get
a Certificate.
Link is in Chat Box.

55. Reminder:
50 OLETE Certificates = 1
Voucher for ROJoson
Telemedical Consultation

56. RABIES
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of RABIES in their
health management.
ROJOSON’S REQUEST:
FEEDBACK TO THIS
PEP TALK!
Pls. type in your
feedback in the chat
box during the open
forum and before we
adjourn!
Thank you!

57. RABIES
Awareness
Empowerment
objective - for
laypeople to have a
basic understanding
of RABIES in their
health management.
LET’S NOW HAVE A
GROUP PICTURE
TAKING BEFORE WE
START Q&A AND
INTERACTIONS!
Pls. turn on your
video!
Show your face!