Vietnam’s ‘dramatic’ rabies surge kills 29 people in four months

Animals held at a dog farm which supplies Vietnam's meat trade
Experts warn the death toll is likely to rise as the disease flourishes in unvaccinated animals and Vietnam's dog meat trade. - HSI

Vietnam is experiencing a “dramatic” surge in rabies, with a 160 per cent jump in human fatalities recorded so far this year.

Since January, 29 people have died from the virus in 16 provinces across the southeast Asian country, compared to 11 fatalities in the first three months of 2023, according to government figures.

Experts have warned it’s a death toll which will likely mount as the disease flourishes in unvaccinated animals and Vietnam’s dog meat trade.

“Unfortunately, we can expect an increasing number of people to die of rabies in 2024, in line with the dramatic, more than two-fold rise in animal rabies in 2023,” a spokesperson for the World Health Organization’s Vietnam office told the Telegraph.

“The time lag is because the incubation period for rabies (between the bite and the appearance of symptoms) is typically two to three months but may be up to one year, so people who were infected in 2023 may only become ill this year.”

The most recent death, reported on March 27, is a case in point. The patient was bitten on their left thumb in October 2023, a wound which bled a little. The individual washed it with water and applied garlic, but didn’t seek any specialist treatment. They died five days after their symptoms first emerged.

Dog and cat meat trade transport and supply investigation in Viet Nam
Rabies predominantly jumps to people via dog bites or deep scratches - HSI

Rabies, a vaccine-preventable viral disease that predominantly jumps to people via dog bites or deep scratches, attacks the central nervous system. Early symptoms include a fever or unexplained tingling near the bite, but once these emerge the outcome is almost always fatal.

There are two main forms of disease. “Furious rabies” kills people via cardio-respiratory arrest within days, after triggering hallucinations, hyperactivity, loss of coordination and fear of water or fresh air.

By contrast “paralytic rabies,” responsible for roughly 20 per cent of cases, gradually immobilises a person’s muscles until they fall into a deadly coma.

But these are wholly preventable outcomes, with several tools available to halt the virus before it hits the central nervous system. Vaccines can be given both before and after exposure, while treatments including immunoglobulin and monoclonal antibodies are prescribed in severe cases.

Yet in Vietnam, access to these tools is limited in the worst hit regions.

“The high-risk areas for rabies are usually in remote areas where … people bitten by dogs also have difficulties getting vaccines,” said Pawin Padungtod, a senior technical coordinator at the Food and Agriculture Organisation. “They have to travel very far and cannot afford the cost for both travelling and the vaccine.”

He added that, despite government efforts, it is often in these areas where dog vaccinations – long considered the best prevention strategy – have faltered.

Dog and cat meat trade transport and supply investigation in Viet Nam
Activists have warned that dog and cat meat trade is worsening the outlook for the spread of rabies - HSI

Nationwide, rabies vaccination rates in cats and dogs stood at 58 per cent in 2023, well below the 70 per cent required for ‘herd immunity’, which prevents disease transmission. But in some places, coverage has fallen to as low as 10 per cent.

Just 19 cities and provinces have implemented vaccination drives so far this year, immunising some 550,000 dogs and cats, according to reports.

“Vaccinating dogs, including puppies, is the most cost-effective strategy for preventing rabies in people because it stops the transmission at its source,” the WHO said. “In Vietnam, low dog vaccination rates and poor dog management are responsible for the rabies outbreak.”

Yet activists have warned that dog and cat meat trade – which is prominent in Vietnam — is only worsening the outlook.

According to estimates from the anti-dog trade Humane Society International (HSI), five million dogs and one million cats are caught, stolen, trafficked and slaughtered in Vietnam each year.

“[The trade] encourages this mass production of dogs who aren’t vaccinated,” said Lola Webber, director of HSI’s Ending Dog Meat campaign.

“You have this high turnover of dogs, with low vaccination coverage and a population instability – because dogs are constantly being removed, new puppies brought into the vacuum, and dogs transferred nationwide.

“There’s a growing body of evidence that shows a higher rate of rabies positive dogs also being slaughtered and sold in public markets,” she added. “One study found it was as high as 16.4 per cent in samples in Hanoi, which is just huge.”

A dog farm involved in the trade and transport of Vietnam's meat trade
A dog farm involved in the trade and transport of Vietnam's meat trade - HSI

Dr Karanvir Kukreja, head of campaigns in southeast Asia for Four Paws International, said: “There is a real danger that we will see these spikes again and again if the trade is not addressed. The dog and cat meat trade is not the only factor in rabies in Vietnam, but must be considered as a key risk to Vietnam’s plans to eradicate rabies.”

In response to the current outbreak, the country’s prime minister last month asked localities to establish task forces to tackle the virus and expand vaccination coverage. But limited funds and supplies are hampering efforts.

“The big challenges, particularly at the local level, are to prioritise and increase resources for managing dog populations, vaccinating dogs and ensuring equitable access to post-exposure prophylaxis for people bitten by dogs, especially in underserved communities,” the WHO said.

Vietnam’s surge comes as nearby Timor-Leste – which is currently classified as rabies-free – reported its first human death from the disease. An individual in Oecusse, an enclave of the country surrounded by Indonesia, was bitten in December and died two days after going to a health centre in March.

A further 29 suspected cases are under investigation, according to a WHO situation report, which classifies the national risk as “high”.

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