Public Health

Rabies is a viral disease that affects the central nervous systems of both humans and non-human animals. Humans usually contract rabies via contact with an infected (rabid) animal. Rabies is potentially fatal, especially after symptoms develop. A health educator at a health department in a large rural community has in this case been assigned to lead a public awareness campaign to increase awareness about the problem of rabies and how to prevent its spread in the community. The role of public health in this scenario includes the public relations campaign, public outreach services including testing, the investigation of epidemiology and other health data, and the collection of resources necessary to combat the problem.

The Role of Public Health in the Scenario

A rabies outbreak in a large rural community is cause for concern. Rabies incidences are relatively low in the developed world, but are high in poor and undeveloped regions. If this large rural community is historically underserved, then it might explain why rabies has resurfaced as a problem here. A public health educator plays a multifaceted role in a situation like this.

The first step toward eliminating the problem of rabies is to educate the community about what rabies is, what animals carry or transmit the disease, who is at greatest risk and why, and how to prevent rabies. It is also important to inform the residents of the community about the symptoms of rabies, because a post-exposure prophylaxis is available and can be highly effective.

Rabies is a virus carried by carnivorous animals and bats. It is transmitted from those animals to human beings. While infected animals are a concern, the public health educator is primarily concerned with the threat of rabies on the human population. Public health organizations can help the health educator devise a plan of action. The first step would be to examine rabies prevalence surveys in the region. From there, the health educator should attempt to acquire data about local animal populations. Wild animals are often carriers of the disease, but sometimes house pets like dogs and cats will be exposed to a rabid animal and thereby be an especially deadly threat to the community. Therefore, the public health educator should conduct a thorough survey of how many wild and domestic animals are in the community.

After the tabulations of animal populations are complete, the public health educator needs information about the infected human populations in the community. Incidences of symptoms need to be recorded and the data made available to local health organizations like hospitals, clinics, and private practices. At this time, the public health educator should be preparing documents, advertisements, publications, and website materials related to rabies.

The marketing and information materials should include a broad overview of the disease, including what it is, how it is transmitted, and especially what symptoms to look out for in both humans and animals. Aware of the symptoms, the population of the community can be on the lookout for rabid animals and for symptoms in themselves or others. Instructions on how to report symptoms are essential, as the individuals will need to know proper procedures.

Steps to educate the public about rabies are part of the public health approach to dealing with the problem. Health care workers address the problem on a case-by-case basis, but ultimately, rabies is a community issue. All persons in the community must work together to ensure that the disease is eradicated as fast as possible. A public health approach depends on collaboration, cooperation, and communication between all stakeholders. This includes residents, health care organizations, schools, and public health organizations like the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).

As a public health issue, rabies requires collaboration between different stakeholders. The public health educator can serve as a community leader and a liaison. For example, knowing which animals in the region are carrying the rabies is an important first step. Armed with this knowledge, the health educator can alert the homes or farms with greatest risk of exposure to the animal in question. Farmers will need to know the risk of their livestock contracting rabies. While most livestock will not be hosts to rabies, they can be victims of the disease (WHO, 2013). Raccoons, skunks, bats, and foxes are common hosts and carriers of rabies (CDC, 2013). Because this is a matter of public health, the community will need to collaborate on methods of wild animal control such as the possible use of traps. Farmers and residents also need to be aware of methods of keeping domestic and farm animals out of contact with wild animals. The health educator takes this information and delivers it to the community in a manner consistent with public health awareness campaign methods.

Pet owners need to be especially aware of the problem, because their cats and dogs could contract the disease. The United States has implemented a mandatory vaccination program for all dogs because rabies has been recognized as a public health concern. As a public health concern, the government health organizations ensure that funding and human resources are available to all communities for education, research, prevention, and treatment. This includes funding related to animal vaccination programs. According to the County of Los Angeles Public Health (2013), the government of the United States spends about $300 million per year on domestic dog rabies vaccination programs. The vaccination of house cats is not similarly mandated by law, which is why the incidence rates of rabies is higher in cats than in dogs (County of Los Angeles Public Health, 2013).

Therefore, pet owners need to participate in vaccination programs. If rabies were not considered a public health issue, then pet owners would not be required to maintain their pets' vaccines. Similarly, veterinarians participate as members of the public health community by providing vaccines to pets, and especially by providing them to pets that belong to people who cannot afford the vaccine. Similarly, the health educator can work with local veterinary services with regards to how to provide cheap or free vaccinations to pet owners who may be struggling financially. The collaboration between veterinarians, public health organizations, and residents of the community highlights the way the rabies issue is a public health concern.

Raising awareness is a public health strategy. In a rural community, individuals do not necessarily have centralized means of information sharing. This is why the health educator may need to go door to door in the rural community to help raise awareness as part of a public health campaign. A website could be especially helpful for communicating with residents in a rural community. Other communication media including news media and radio can be used, depending on the demographics of the community. Messages should be delivered in languages that are appropriate to the community demographic. Thus, Spanish language messages might help if Spanish-speaking workers on local farms need to be aware of how to prevent the spread of rabies in the community.

The health educator also needs to find out whether members of the community have traveled abroad recently. Local wildlife is not necessarily the only carrier of the disease. Often, a traveler comes into contact with a rabid animal in a country where rabies remains relatively common. When a resident of a community contracts a disease abroad, the matter ceases to only be a matter of personal health and safety and becomes a matter of public and community health. This is especially true if the individual had traveled abroad with a pet.

As a public health matter, the rabies awareness campaign must include information about how the disease is acquired, how it is spread, and what symptoms to look for in both humans and animals. Exposure to rabies in humans is almost always via a bite from the infected animal, but residents need to know that when an infected dog licks them, they are also at risk for contracting the disease. If a person has a cut or open wound and is licked by a rabid animal, it is possible to get infected. Likewise, a scratch can be the source of infection if saliva or other fluids are involved. Washing the point of contact with soap and water is a first step, but the health educator also needs to advise residents to seek care immediately. Once symptoms of rabies start to surface, the individual is almost certain to die (CDC, 2013). Unfortunately, early symptoms might not seem out of the ordinary. Fever, headache, and general malaise are initial signs that rabies might be present. As the disease further progresses through the central nervous system and into the brain, symptoms become more characteristic of rabies such as hypersalivation, agitation, slight paralysis, confusion, difficulty swallowing, insomnia, and hydrophobia (fear of water). An alternative name for the disease of rabies is hydrophobia.

The most important thing the health educator can do for the community is to make sure that both the vaccine and the post-exposure prophylaxis are available. Health careā€¦