A Christmas story

For Rex and Nina Tomen, the last days of 2008 suddenly went out of kilter.  Lent came early and took the place reserved for Christmas. While the rest of the world marked the joyous day of the Nativity in homes filled with the laughter of children, they passed the day at the dimly-lit mortuary of the Lubao church in Pampanga, quietly keeping vigil over the lifeless body of their youngest child, Gian Carlo, who died from the rabies virus on the night of December 23rd.  He was 5 years old.

This is not where children are supposed to be on Christmas Day.  At five, having weathered the usual illnesses of infancy, little boys are supposed to be indestructible.   A child lying inside a coffin is an incongruous image for Christmas.  The child’s father, Rex, could hardly contain the enormity of his pain.  “Gian Carlo was my tail,” he said.  “I walked him to kindergarten school every morning and waited for him after school.  He would then accompany me to work.  He made each day complete.”

Gian Carlo came into their lives unexpectedly ten years after the birth of their second child.  Nina recalls how Fr. Jaime Bulatao, the Jesuit psychologist, had told her even before she became aware of Gian Carlo’s presence in her womb: “There’s another one with you today.” The nearly blind priest sensed the little boy’s life inside Nina as he held her hands.   It clearly eases the pain somewhat for her to remember this.  Would that the psychic Fr. Bulatao had also foreseen that the little boy would be with them only for a while.

Sometime in mid-December, mother and child were in a shopping mall looking for gifts.  The little boy complained of having a headache. They went home, suspecting nothing worse than the onset of a mild flu.  Then the intense itchiness came, radiating from the superficial dog scratch on Gian Carlo’s back, which had long healed, to his nape and head.  The boy’s head began to swirl and throb as large beads of sweat formed on his handsome face.

They rushed him to the nearest hospital, but the doctors could not recognize the early symptoms of rabies infection. The scratch from the neighbor’s rabid pet occurred in early October.  The dog mysteriously vanished soon after.  The wound quickly healed after a few days.  Assured that it was not a bite but just a scratch, the boy’s parents did not immediately make the connection.  Most Filipinos would not have suspected any link precisely because of inadequate public knowledge of the sources, symptoms, and incidence of rabies in the country.  People continue to die from rabies because it is easy to confuse its early flu-like symptoms with ordinary ailments. The subsequent appearance of its distinct symptoms – delirium, hyperactivity, furious agitation, hydrophobia, foaming around the mouth, and gradual paralysis — always signals the advanced stage of the infection.

Here are some hair-raising facts:  Every year, 55,000 people die worldwide from rabies.  Ninety-five percent of such deaths are in Asia and Africa, with Asia accounting for at least 31,000 every year.  India, known for its huge population of stray dogs, has the highest incidence of deaths from rabies.  In China, in 2006, as many as 200 people died every month from rabies, outpacing deaths from tuberculosis.   More than half of all rabies deaths all over the world occur in children under 15.  Bites and scratches from unvaccinated dogs still constitute the main source of rabies infection in the poorer countries.  In the developed world, wild animals like bats account for a growing number of rabies cases.  Awareness of the potency of the rabies virus in the rich countries is such that the mere presence of a stray bat inside a home is enough reason to order a mass vaccination for everyone living in that house.

The rabies virus is typically transferred through the saliva of an infected source.  The reason for this is that the infection at its most virulent stage concentrates the virus in the lining of the mouth.  But one doesn’t have to be bitten by a rabid animal to get the virus.  A scratch from the saliva-laden paws of a rabid dog, as in Gian Carlo’s case, could transfer the virus just as easily.  So would letting an infected animal lick an open wound or a pimple.

In its early stages, the presence of the infection can hardly be detected.  The incubation period depends on how far the virus has to travel to reach the central nervous system.  Medical reports say that death from rabies usually occurs from two to twelve weeks from initial infection.  But here’s scary information: some reports say the incubation of the virus can be as short as two days or as long as five years!   Once the virus reaches the brain, all treatment becomes useless.

Nothing is more unimaginable as suffering, says the inconsolable Rex, than for a parent to watch a child slowly succumb to death from rabies.  The victim struggles against the onset of respiratory arrest.

Panic shows in his eyes.  And you can do nothing.  I believe him. Each time I watch my 8-year-old granddaughter Julia gasp for a little air when she’s having a simple asthmatic attack, I suspend my own breathing.  Little children are not supposed to die.

Gian Carlo will be laid to rest tomorrow, December 28, the Feast of the Holy Innocents – the day the Catholic calendar sets aside to remember the children who gave their lives so that the infant Jesus would have a chance at life.  I am certain it would greatly lessen the pain of his parents if awareness of Gian Carlo’s story results in one less Filipino child dying from rabies this coming year.

Comments to <public.lives@gmail.com>