Ilocos Norte: Vigilance Is Key to Remaining Rabies Free

Situated at the northernmost point of Luzon island in the Philippines, Ilocos Norte is blessed with pristine natural beauty, including 150 kilometres of coastline on the West Philippine Sea. In previous years, rabies, which is endemic to Luzon, has threatened the local population, but thanks to a number of control efforts, Ilocos Norte is on the cusp of being declared rabies free.

Historically, Ilocos Norte has had a high number of rabies cases, with human deaths recorded every year since 2003, according to Dr. Sarah Jayme, country representative for the Global Alliance for Rabies Control (GARC). At that time, public awareness about rabies and dog vaccination was very limited, and as a result, the numbers of cases continued to rise.

In May 2012, GARC launched the Communities Against Rabies Exposure (CARE) project in partnership with the Provincial Government of Ilocos Norte, with funding from the UBS Optimus Foundation, to mobilise an intersectoral response for achieving rabies elimination in the area. The Provincial Veterinary Office, with support from the Provincial Health Office, spearheads implementation of the project. Thanks to their combined efforts,  including interagency collaboration from the national, subnational and local levels such as offices of agriculture, health, education, social welfare, information, police, local government as well as rabies committees and universities, Ilocos Norte has been free from human rabies since May 2013 and from rabies in dogs since July 2013. 

Local experts, however, contend that continued vigilance is required to maintain its hard-earned rabies-free status. The primary concern, according to Dr. Loida Valenzuela, provincial veterinary officer, is dogs coming into Ilocos Norte from other provinces. “It is really hard to control and sustain rabies control in this area, as dogs are mobile and stray dogs are difficult to contain,” says Dr. Valenzuela. As a result, Ilocos Norte’s goal this year is focused on “border control.”

She points to a variety of efforts, including public education and communications, to ensure infected dogs are not brought into Ilocos Norte. “Transport, such as buses, are important because dogs are carried on board, and they need to be vaccinated against rabies. When people bring a puppy as a gift to someone in Ilocos Norte, they need to have a veterinary health certificate and permit to show it has been vaccinated.”

Dr. Dianne Licuan, field veterinarian at GARC, believes coordination is key to ensuring Ilocos Norte stays rabies free, including “continued mass dog vaccinations, rabies diagnostics, and education, working in partnership with the local government.” According to Licuan, the success that Ilocos Norte has achieved is based on the “strong collaboration between human health and veterinary experts.” Another major component is public education programmes that target young children and their families to facilitate responsible pet ownership and wound care. “Our education campaign integrates rabies prevention among young children, teaching them how to care for their pets responsibly, and what to do if bitten.”

Filling the knowledge gap and fighting common beliefs about rabies are still integral to control efforts. For example, it is common throughout the Philippines for people to seek health treatment from traditional healers, called Tandoks, and many seek to “cure” or ward off rabies.

“This is part of the culture, handed-down knowledge from the elders to younger generations,” says Jayme. “Tandoks are everywhere; they are the ‘go-to’ for everything, from snake bites to flu. People believe that, if after a dog bite they don’t die from rabies, the Tandok has cured them. It’s clear there are still barriers to rabies control, so it is important to stay vigilant.”