MANILA––Philippine, Chinese, and international public health media in mid-March 2015 warned that eating dogs can spread rabies, after at least 13 people ate meat from a rabid dog in Cabatangan village, Zamboanga, the Philippines.
Summarized Robert Herriman of Outbreak News Today on March 15, 2015, from reports published on March 14, 2015 by Philippine media and the South China Morning Post, “At least 13 people, four adults and nine children, were referred for rabies post-exposure prophylaxis and are being monitored after eating infected dog meat. Zamboanga city veterinarian Mario Arriola warned residents to take measures against eating infected meat because of the risk of the deadly virus. The rabid dog is known to have attacked a cat and two dogs in the area.”
Spokespersons for the Philippines National Meat Inspection Commission reminded the public that no government agency at any level inspects any aspect of the dog meat industry, since the entire commerce is illegal.
[See http://outbreaknewstoday.com/philippines-infected-dog-meat-results-in-rabies-pep-for-13-in-zamboanga-44019 , and http://www.scmp.com/news/asia/article/1738667/philippines-orders-13-treated-after-eating-meat-rabid-dog.]
Philippine case noted in China
That the case drew notice in China may be particularly significant, since China now has more reported human rabies deaths per year than any other nation, including India, where Central Bureau of Health Intelligence data suggests that the annual toll has dipped over the past 12 years from thousands historically to fewer than 300. Confirmed rabies deaths in China originate almost entirely from infections contracted in the regions where dogs are commonly eaten and raised for meat, though the actual deaths often occur after the victims are evacuated elsewhere for treatment.
Chinese law requires that any dogs moved across provincial borders must be vaccinated against rabies, but so-called “meat dogs” are not vaccinated, because of the belief that vaccination would make them unfit for consumption. Under pressure from opponents of dog-eating, the vaccination law has increasingly often been invoked in recent years to rescue stolen dogs from illegal commerce to supply the dog meat industry.
Chinese authorities have not yet published particulars of specific rabies cases that are definitively linked to eating dogs, though the potential risk has been acknowledged.
Previous Philippine cases
Meanwhile, potential human exposure to rabies from dog meat slaughter and preparation has repeatedly been reported in the Philippines.
Two human rabies fatalities were linked to actual dog meat consumption in 2005-2006.
“Ressia Mae Edoria, 4, of Barangay Molobolo, Cauayan, Negros Occidental died last December of rabies and encephalitis, days after neighbors gave her dog meat” at a drinking party,” reported Margaux C. Ortiz of The Philippine Inquirer in Makati City on February 1, 2006. “Renante Edoria, the girl’s father, said his daughter suffered from high fever and exhibited symptoms of rabies shortly after eating the meat.”
Hospitalized on December 13, 2005, Ressie Edoria died a few hours later. Animal Kingdom Foundation veterinarian Winston Samaniego told Ortiz that the rabies virus may have attacked her as rapidly as it did by entering her nervous system though a tooth cavity.
“I am now appealing to everyone to stop eating dogs to avoid this kind of tragedy,” said Renante Edoria.
In June 2006, the Philippines Sun Star reported, “One man died and 23 others are under observation after eating rabid dogs in Maasin, Iloilo. Rolando Carmelita, Jr. died after he cooked and ate a rabid dog. He also fed the meal to his relatives. Not contented, they cooked and ate two more rabid dogs.”
Added Greg Salido Quimpo of Animal Kingdom Foundation, “The victim’s mother is a village councilor. She passed a resolution banning the eating of dogs.”
Perspective from ProMED-Mail
Noted Program for Monitoring Emerging Diseases (ProMED-Mail) Mekong Basin disease surveillance veterinary moderator Tin Tin Myaing on March 16, 2015, “Dog meat eating was banned in Manila in 1982, and nationwide in 1998, with exemptions for dogs killed and eaten as part of indigenous rituals. More recently, the national ban was bolstered by the Rabies Act, which upgraded penalties for convicted dog meat traders to include jail time and substantially increased fines.”
However, Tin Tin Myaing continued, “Currently, the Philippines National Police and local authorities do little to enforce anti-dog meat legislation. Many police and government officials in the northern provinces eat dog meat themselves,” especially in and around Baguio, a city of about 301,000 people in the northern Luzon Island province of Benguet.
“Dog meat eating is a long-standing cultural phenomenon in some northern provinces of the Philippines,” Tin Tin Myaing acknowledged, “traditionally associated with celebratory events and rituals of mourning. Historically the practice involved a relatively small number of animals killed and consumed, but more recently dog meat eating has proliferated for commercial rather than cultural reasons.”
Myaing, a retired professor at the University of Veterinary Science in Yezin, Nay Pyi Taw, Myanmar, is also president of the Myanmar Veterinary Association.
ProMED founder comments
Elaborated Jack Woodall, who cofounded ProMED-Mail in 1994, “Such hazard [rabies risk] has been repeatedly confirmed concerning those engaged in the handling of the dogs prior and during their butchering and preparation,” but “the hazard to consumers of dog meat is yet to be confirmed. For example, in south China, where dog meat is widely consumed, the authors of a 2009 paper indicated that “up to now dog meat consumers are considered [of having] no risk of rabies infection.’ In southern Nigeria, stray dog trade fuelled by dog meat consumption was found to be a significant risk factor; human cases were described. However this did not refer to the dog meat consumers themselves.”
[See “Epidemiological investigations of human rabies in China,” http://www.biomedcentral.com/1471-2334/9/210, and “Stray dog trade fueled by dog meat consumption as a risk factor for rabies infection in Calabar, southern Nigeria,” http://www.ajol.info/index.php/ahs/article/view/100469/89693.]
Findings from Vietnam
Regardless of the extent of risk to dog meat consumers, which may vary according to how long the meat is cooked and what parts of the dog are eaten, with raw brain tissue conveying the greatest hazard, “People who prepare dog and cat meat for human consumption are at risk of contracting rabies, warned medical researcher Heiman Wertheim, M.D. in the March 18, 2009 edition of PLoS Medicine, a peer-reviewed open-access online scientific journal published by the Public Library of Science.
Wertheim and colleagues from the National Institute of Infectious & Tropical Diseases and the National Institute of Hygiene & Epidemiology in Hanoi, Vietnam, researched the association of dog meat with rabies after encountering two cases.
The first patient “had prepared and eaten a dog who was killed in a road accident; rabid dogs were known to inhabit the neighborhood. The second patient butchered and ate a cat who had been sick for a number of days,” e-mailed Wertheim to ProMED-Mail in summary of his findings.
“It is thought that infection occurred during the slaughtering [or butchering], and not by eating the meat,” Wertheim continued, “as the meals were shared by others who did not become infected.
“Rabid dogs have been found in dog slaughterhouses, where workers are vaccinated as part of the national rabies control program, Wertheim explained, but people who kill dogs for personal consumption usually are not vaccinated.
“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 concluded.
Dog meat & rabies in Nigeria
Shamsudeen Fagbo, now zoonotic disease coordinator for the Ministry of Health in Riyadh, Saudi Arabia, responded to the Wertheim posting by suggesting that rabies is also contracted through killing and butchering dogs and cats in parts of Africa.
“In Nigeria,” posted Fagbo to ProMED-Mail, “dog eating is very common in states such as Plateau, Akwa Ibom, Cross River, Kaduna, Kebbi and Ondo. Cat eating, though not as common as dog eating, can also be encountered, even in cosmopolitan places such as Lagos. While human consumption of bats is also common,” Fagbo added, “there seems to have been little or no local effort (as per the limited information available) to evaluate the risk of rabies transmission.
“Rabies is no doubt underreported and probably misdiagnosed in Nigeria and elsewhere in Africa,” Fagbo continued. “Cultural and religious beliefs will also contribute to the underreporting of human rabies that may arise from the consumption of infected but apparently healthy dogs and cats. The [rabies-related] Lagos bat and Mokola lyssaviruses remain under-diagnosed in the human populace.”
Fagbo pointed out that a little-noticed paper entitled “Rabies in apparently healthy dogs: histological and immunohistochemical studies,” published in 2006 in The Nigerian Postgraduate Medical Journal, identified dog-eating as a high-risk practice in restaurants near two military barracks in Maiduguri, an overwhelmingly Muslim city where eating dogs is otherwise culturally forbidden. The researchers found evidence of rabies in the heads of 16 of 52 dogs who had been butchered.
“If the observations [of authors B.B. Ajayi, J.S. Rabo JS, and S.S. Baba] are confirmed,” wrote Fagbo, “this, in their words, ‘signifies a new dimension in the epidemiology of the disease.’”
Fagbo’s 2009 warning was confirmed by the 2014 study “Stray dog trade fueled by dog meat consumption as a risk factor for rabies infection in Calabar, southern Nigeria” [referenced above], which used fluoroscopy to detect rabies negribodies in the saliva and brain tissues of five out of 100 slaughtered dogs whose remains were offered for sale in southeastern Nigeria.
Other health hazards from eating dogs
Malaysian Society of Parasitology & Tropical Medicine president S. Vellayan, M.D. warned in July 2008 via Marjorie Chiew of The Star of Malaysia that rabies is only one of the health hazards of eating dogs, after politicians objecting to the presence of street dogs suggested that the dog should be eaten.
“Eating stray dogs is not encouraged,” Vellayan said, “because some of them may have viruses, bacteria and parasites and can bring about parasitic problems such as cysts and tapeworm infection. These can be transmitted from animals to humans if the meat is not cooked thoroughly. People can also be infected with tapeworms and rabies when slaughtering the infected animals with their bare hands,” Vellayan cautioned.
Vellayan suggested that rabies might be more common in dogs from northern and border states. He also cited risk of dog-eaters contracting tuberculosis, salmonellosis and leptospirosis.
“Protozoan diseases such as toxoplasmosis can be transmitted via the oral route to humans,” summarized Chiew. “In the congenital form, transplacental infection can take place in the early months of a woman’s pregnancy, resulting in abortion or stillbirth.”