French microbiologist Louis Pasteur created the world’s first rabies vaccine in 1885, and it is fitting that, 135 years later, the institute that bears his name is leading the Kingdom’s efforts in fighting the disease.
The Rabies Prevention Center (RPC) at the Institute Pasteur du Cambodge in Phnom Penh was officially opened in 1995. For 25 years, the RPC has provided rabies prevention services to more than 500,000 people wounded by animals from all over the Kingdom.
The importance of the services the centre provides cannot be understated – from an average of 20,000 new patients per year since 2000, the number jumped to nearly 80,000 patients last year.
“In rabies prevention, we at RPC provide services both for post-exposure prophylaxis – after being wounded by animal – which is our priority service, and also pre-exposure prophylaxis – before being wounded.
“One of the main research goals is to promote better access to rabies post-exposure prophylaxis [PEP]. Major research involving the Institute Pasteur du Cambodge has led to a recommendation from the World Health Organization for a shorter intradermal rabies vaccination protocol.
“This recommendation has been very beneficial – the vaccination is complete within only one week, there is one fewer session and less vaccine volume per patient is used, promoting higher compliance. Other research studies are also being conducted,” said Dr Peng Yiksing, the head of the RPC.
The centre says rabies circulation in Cambodia is mainly related to dogs. The big dog population in the country – a ratio of one for every three or four humans – contributes to maintaining virus circulation and transmission. Another contributing factor is the absence of a rabies vaccination programme for dogs.
To further combat rabies, the RPC has implemented a range of developments, including opening two more rabies centres – in Battambang in July 2018 and Kampong Cham in July last year – to increase access to treatment across Cambodia. National Social Security Fund membership is accepted at the Kingdom’s three rabies prevention centres.
“In 2019, 15,070 people received rabies PEP at the Battambang Rabies Prevention Center, and another 11,123 people were vaccinated at the Kampong Cham centre.
“Data shows that the service is more easily reachable – with more people having access to it – and the Rabies Prevention Centers are proving incredibly useful for the regional population,” said Yiksing.
The RPC says the following action must be taken in the event of being bitten by a dog – the wound should be immediately cleaned properly for 10 to 15 minutes with running water, soap and disinfectant. Traditional remedies should be avoided.
Rabies PEP should be sought as soon as possible – immunoglobulin against rabies may be required in additional to the rabies vaccine. If possible, the head of the suspected rabies-infected animal should be sent to the laboratory for analysis.
To reduce human deaths from rabies, Yiksing says the Institut Pasteur has put in place a five-year action plan for 2018-23 in collaboration with the Ministry of Health, the Ministry of Agriculture, Forestry and Fisheries, and the Ministry of Education.
Two main objectives have been set, with the first being to raise awareness of rabies and its prevention. The second is to increase accessibility to rabies PEP.
Budget support from donors is needed for implementation of this plan, he added.
The World Health Organization, World Organization of Animal Health (OIE), the UN Food and Agriculture Organization and Global Alliance for Rabies Control have the goal of eliminating deaths from rabies by 2030, and the Institut Pasteur remains at the fore of the Kingdom’s efforts.
“Cambodia presented its commitment as part of the Asean community and as part of a global approach in the fight against rabies towards the target of elimination of dog-mediated human deaths from the disease by 2030.
“The Institut Pasteur du Cambodge will continue being involved in support of the government’s efforts towards this goal,” Yiksing said.