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View from an Internist

Shannon Palermo, VMD, University of Pennsylvania

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View from an Internist

Visiting India has always been on my bucket list. So when I learned about Mission Rabies, I realized I could combine my passion for travel with veterinary medicine—specifically in strengthening the human–animal bond and focusing on public health.

I work as an internal medicine specialist in my hometown of Rochester, New York. Fitting the typical stereotype of an internist, I performed extensive research into the rabies epidemic in India. I was shocked to learn that ≈35% of rabies deaths worldwide occur in India, which translates to over 21,000 deaths annually, the highest in the world.

Studies focusing on herd health have shown only a portion of the total dog population must be vaccinated to eliminate rabies transmission.

Rabies is universally fatal, and dog bites remain the main mode of human transmission. In addition, the postexposure vaccine series has become increasingly difficult to obtain in India. Many families are unable to afford the injections and some are unable to travel to a hospital that carries the treatment.

As with many diseases, the solution to the rabies epidemic is prevention. When I heard that we would be vaccinating dogs one by one after literally catching them on the streets of Goa, I had my doubts about the program’s efficacy. What I didn’t realize is that studies focusing on herd health have shown only a portion of the total dog population must be vaccinated to eliminate rabies transmission. The goal of Mission Rabies is to vaccinate 70% of the dog population in Goa. How likely is it that we will achieve this goal? To put things in perspective, in 2014 (just 1 year after the launch of Mission Rabies in Goa) there were 17 reported deaths caused by rabies. In 2018 (after several years of work performed by Mission Rabies) the reported number of deaths caused by rabies was zero. This is a true testament to the adage that every little bit counts.

After our first full week of vaccinating (5 days), my team and I had walked 36 miles and vaccinated 423 dogs. The combined teams reached 3,418 dogs! Our second and final week is nearly over, and I cannot wait to see the final number of vaccinated dogs.

Clinician's Brief

It has been an absolutely amazing experience working alongside so many incredible volunteers and locals, vaccinating such a large number of dogs, and knowing we are actively contributing to the end of a disease that has taken the lives of so many. I know I speak for all of us when I say that I’m extremely proud of the work we are doing and forever grateful for this experience.

Clinician's Brief

Watch for updates on social media, and be sure to check for updates at cliniciansbrief.com/mission-rabies. —Shannon Palermo

Shannon Palermo, VMD, practices at Veterinary Specialists & Emergency Services in Rochester, New York, and is a 2019 Mission Rabies volunteer.

For global readers, a calculator to convert laboratory values, dosages, and other measurements to SI units can be found here.

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