World Rabies Day 2013

Rabies continues to be a major public health problem in India killing an estimated 20 000 people annually with majority of victims coming from poorer sections of society and rural areas, largely due to ignorance, negligence and inadequate availability of primary healthcare services. About 30-60% of reported rabies cases and deaths in India occur in children under the age of 15 years.

The World Rabies Day 2013 calls for greater political support, increased awareness and enhanced country-level capacity for eliminating human rabies transmitted by dogs.

The true burden of rabies in India is not fully known as presently there is no organized national rabies control programme in the country, although multicentric survey conducted in 2005 estimate as high as 17 million dog bites per annum.

Due to lack of awareness among the general public of how to prevent this disease after an exposure, patients with limited financial resources seek ineffective treatments from traditional healers depriving themselves of available post-exposure prophylaxis.

Given that rabies is an almost fatal disease once the symptoms develop, community awareness (especially among children) regarding risk and prevention of rabies is extremely important to bring about a reduction in the overall incidence of rabies.

Prevention of human rabies is possible through mass dog vaccination, promotion of responsible dog ownership and dog population control programmes with a partnership approach. Controlling canine rabies, especially in free-ranging dogs, is the first priority to reduce burden of human disease.

WHO recommends dog immunization campaigns that achieve at least 70% coverage combined with humane dog population management. Adopting the One Health approaches at state level (e.g. Tamil Nadu) and some isolated urban settings i.e., Sikkim Anti-Rabies and Animal Health Programme, have shown that controlling rabies deaths is possible through concerted efforts and commitment. The experience of rabies control in Chennai clearly demonstrated that a local municipality can play a catalyst role in coordinating animal birth control and anti rabies vaccination campaign popularly known as ABC/AR. However, these models need to be replicated at rural levels with community participation.

Experience in the industrialized countries and ongoing regionally coordinated programs in Europe and Latin America have shown that the elimination of human rabies transmitted by dogs is an achievable goal. Other countries in the South East Asia region such as Bhutan, Indonesia, Sri Lanka and Thailand have evolved nationally coordinated rabies control activities.

The Government of India has classified rabies as a priority zoonotic disease under the 12th Five year plan and has proposed a rabies control programme with emphasis on inter-sectoral coordination.

Messages for the public

  • Do not ignore any dog bite/scratches/licks as dog bite is the primary source of human rabies in India. Seek prompt medical attention and complete treatment as necessary.
  • Wound cleansing and immunization within a few hours after contact with a rabid or suspected rabies infected animal can prevent the onset of rabies and death. Recommended first-aid procedures include: immediate and thorough flushing and washing of the wound for a minimum of 15 minutes with soap and water, detergent, povidone iodine.
  • Rabies is most common in children aged under 15 as dog bites/scratches/licks go unrecognized and unreported. There is a need to educate the children as well as mothers/care-givers/school teachers about rabies risk and prevention; and include rabies prevention in school health promotion programmes.
  • It is essential to take a complete course of anti-rabies vaccination after dog bites If dog bite is severe or rabid dog has bitten above neck or on finger tips, rabies immunoglobulin must be given followed by four to five courses of anti-rabies vaccination in a month period.
  • Communities must be made aware of the importance of practices such as responsible dog ownership –it is important to get pets vaccinated as per schedule. Vaccination of pet dog and mass vaccination of stray dogs through community participation will certainly help to prevent human rabies and it is proven as cost-effective and sustainable for elimination of human rabies. Everybody can contribute in elimination of human rabies transmitted by dogs and it is a possible mission with the active participation of local civic bodies, NGOs, professional organizations, animal welfare organizations and local community.