YEN BAI, Vietnam––Closing the Vietnamese border to imports of dogs for human consumption as a rabies control measure may have come two years too late for Yen Bai province, high in the ethnic Hmong region of the north.
At least 1,900 Yen Bai residents were bitten by suspected rabid dogs during the first five months of 2014. Three people who failed to obtain post-exposure vaccination died. Since suspected rabid bites were reported at nearly 10 times the rate reported in 2012, when 16 people died, Yen Bai health officials braced for the worst.
Unknown or at least undocumented in Yen Bai before mid-2012, rabies arrived with a scattered series of outbreaks that also hit four other mountainous largely Hmong provinces: Son La, Lai Chau, Dien Bien, and Lao Cai.
The five provinces are contiguous, but the other four lie along the Vietnamese borders with Laos and China, and had been hit before by rabies outbreaks spreading with the dog meat trade.
Lai Chau, for example, on July 1, 2009 declared itself afflicted by a rabies epidemic, after at least four people died and 500 others sought post-exposure vaccination after being bitten by suspected rabid dogs.
“Due to the high demand for dog meat, many local people transported dogs from Phu Tho and Vinh Phuc provinces,” Lai Chau health department director Nguyen Cong Huan told the Vietnam News Service. “These dogs then infected the local dogs, leading to the rabies outbreak.”
The route from Phu Tho and Vinh Phuc to Lai Chau runs through Yen Bai.
The Vietnamese, Thai, Laotian, and Cambodian governments on February 28, 2014 agreed on plans to intercept traffic in dogs for slaughter along the Vietnamese/Laotian border and the Thai/Laotian border, two weeks after the Vietnamese Department of Animal Health on February 13, 2014 ordered provincial authorities to enforce a five-year moratorium on transborder transport of dogs. Partially implementing the Association of Southeast Asian Nations strategy for eradicating canine rabies by 2020, the moratorium was reinforced in Vietnam by a prohibiton of movements of dogs and cats across local district boundaries.
“The central authorities would like to see a more active rabies vaccination program in the districts, but are not offering support funding,” observed ProMED infectious diseases moderator Martin Hugh Jones.
Soi Dog Foundation chief executive John Dalley told ANIMALS 24-7 that he understood that the U.S. Centers for Disease Control and Prevention is “in advanced talks re arranging large supply of vaccine for the northern region of Vietnam.”
“I believe the current outbreak is not unusual,” Dalley added. “The rural northern provinces have always had high incidence of rabies, but poor reporting and health care.”
The Soi Dog Foundation has since 2011 housed and fed dogs intercepted from the clandestine Thailand-to-Vietnam dog meat traffic, and is a founding member of the Asia Canine Protection Alliance, along with the Animals Asia Foundation, Change for Animals Foundation, and Humane Society International. Formed in May 2013, ACPA has worked closely with the governments of Vietnam, Laos, Cambodia, and Thailand in their efforts to restrict the spread of rabies by constricting the dog meat traffic.
A potentially politically difficult question for ACPA and the governments involved is why the Yen Bai outbreak appeared to intensify after the international borders were closed. One answer may be that since the formerly large supply of dogs from Thailand has been cut off, dog meat traffickers are sourcing more dogs from high-risk areas, where little canine vaccination has been done.
“ACPA have recently appointed a full time officer working out of the Animals Asia Foundation office [in Vietnam] to monitor amongst other things where dogs are being sourced and if the ban is being implemented,” said Dalley.
“The Thai dogs to our knowledge were all destined for Hanoi,” Dalley added. “Recent reports indicate many dog meat restaurants have closed there. This is being investigated as to reason. Could be lack of dogs, change in public opinion or quite likely fear of bad karma.”
Said Change for Animals Foundation chief executive Lola Webber, “Based on existing research and using expert knowledge of rabies virus transmission and the workings of the trade, maintaining and/ or regulating the dog meat trade is not a viable option if the Association of South East Asian Nations’ rabies control goal is to be met. Given the dog meat trade involves the only current mass movement of known or suspected rabies-infected dogs, there is a strong argument to stop the cycle of infection by banning this trade entirely. This is in accordance with recommendations and guidelines from the World Health Organization and World Organisation for Animal Health (OIE), which clearly cite ‘controlling trade in and movement of dogs’ as key components for dog rabies control and eventual elimination.
Chinese-trained military personnel appear to have popularized dog-eating in North Vietnam during the Vietnam War years, but––while dog-eating was noted in Laos––dog-eating was rarely recorded in the memoirs of U.S. soldiers who fought in South Vietnam and Cambodia.
Dog-eating as it is now practiced in Southeast Asia appears to have spread mostly since the end of U.S. military involvement in Vietnam in 1975. This occurred partly through resettlement of ethnic Chinese refugees from Vietnam after Vietnam and China fought a border war in the late 1970s, but primarily through increasing Chinese, South Korean, and Vietnamese commerce with nearby nations.
Medical researcher Heiman Wertheim, M.D., and colleagues from the National Institute of Infectious & Tropical Diseases and the National Institute of Hygiene & Epidemiology in Hanoi, Vietnam, warned in the March 18, 2009 edition of PLoS Medicine that at least two recent human rabies fatalities had resulted from the slaughter and preparation of dog and cat meat.
“Vietnamese doctors already consider dog slaughtering a risk factor for rabies transmission, but it is important that other health care workers and policy makers, both inside and outside Vietnam, are aware of this risk factor,” Wertheim wrote.