Zoonosis, Live and let live, and Man’s Best Friend
Myanmar being a predominantly Buddhist country, the lay public is largely ingrained with the idea that pest control brings “akusala” (bad kamma). Some healthcare workers are reluctant even to administer antibiotics because they consider bacteria living beings. (This concept is refuted by the religious leaders, but the idea is still widespread.) Thus, it is not surprising that zoonotic infections is rife in Myanmar, alongside vector-borne disease. The less-than-satisfactory disposal of garbage, abundance of ground rats near garbage containers, presence of mosquito-breeding grounds, scarcity of water, poor hygiene all contribute to the spread of infection.
Of particular concern is rabies, especially at this time of year (the dog breeding season; dogs are the main sources of human rabies). This concern has been increasing in recent years and rightly so. According to reports, the incidence of rabies is now double that of malaria and the disease incidence is among the highest in the world. The practice of feeding leftovers to stray animals, the lack of mechanisms for sterilizing stray dogs and vaccinating them, the dearth of dog sanctuaries provide a fertile background for rabies to develop into a major health problem. Particularly distressing is the fact that there is no cure. Although thorough washing of the bite for 15 minutes and post exposure prophylaxis (PEP) are of help, 99% of cases are fatal once clinical symptoms set in. The Editorial Board was thus contemplating on making “Rabies” the theme for this issue when we opportunely received an article on “Rabies Control in Myanmar” by Prof.A.Warrell who has a very high regard for Sayagyi Aung Than Batu, one of the Founders of the MJCMP and the person responsible for its reactivation in 2018. In fact, he sent it to ‘the ATBT Journal”. Although we abandoned the idea of making “Rabies” the theme for this volume, it gives us great pleasure to feature Prof.Warrell’s article as the leading article; a fitting tribute to commemorate the third anniversary of Sayagyi ATBT’s passing on 7th October.
Equally interesting are the cases and articles presented for the benefit of our readers. We are grateful to the authors for their contribution towards the propagation of knowledge geared towards better healthcare. Hopefully, more GPs will overcome their inertia and share their experiences on this forum.
– The Editors
