Abstract
A serological study to know the antibody titer against rabies virus in human beings, who are at occupational risk, was conducted in Nepal in 2014. A total 44 serum samples were collected out of which 21 samples were collected from medical professionals (working at Sukraraj Tropical Hospital) and 23 were collected from veterinary professionals (working at Central Veterinary Hospital, Central Veterinary Laboratory and Rabies Vaccine Production Laboratory) in Kathmandu. Among the 44 samples, 4 were collected from unvaccinated persons. The other 40 people sampled were vaccinated with inactivated rabies vaccine. All samples were subjected to the Rabies Fluorescent Focus Inhibition Test (RFFIT) test at Centre for Disease Control and Prevention, Atlanta, USA. The antibody level of 7 persons was found to be less than the WHO recommended titer of 0.5 IU/ml. Six medical professionals and one veterinary professional had a low rabies virus neutralizing antibody titer. The 4 samples collected from unvaccinated persons, and 3 collected from vaccinated persons had a titer below 0.5 IU/ml. This study shows that medical and veterinary professionals who are responsible to nurse or handle rabies patients, rabid animals or rabies virus are still at high risk. This underscores the importance of recommendations for regular serological testing of occupationally exposed individuals and vaccinating booster dose when necessary.
Highlights
Rabies is endemic and priority zoonotic disease in Nepal
The test revealed that 15.9% of tested samples had antibody titer 0.043 International Units (IU)/ml below than World Health Organization (WHO) recommendation 0.5 IU/ml serum and 84.1% of tested samples had adequate titer ranging from 1.1 to 3316 IU/ml
The variation of antibody titer was directly related to the number or frequency of dose, type of vaccine and duration between vaccination time and time of sample collection
Summary
Rabies is endemic and priority zoonotic disease in Nepal. The death of 200 [1], human being and 300 animals [2], per year has been reported in this country. Rabies occurs throughout the year and dog is the principle vector for the transmission of disease. Rabies Vaccine Laboratory in Kathmandu produces 50, 000 doses of cell culture vaccine for animal use whereas vaccine for human use is imported from other countries [3]. Health authority purchased 300,000 doses expending 1 million USD every year to purchase inactivated cell culture rabies vaccine for human use (personal contact with EDCD). In 2012, 334,737 doses of cell culture rabies vaccine were purchased by Epidemiology and Disease Control Division, the Department of Health Service. Number of dog bitten cases per month coming to Sukraraj Tropical Hospital (STH) for post exposure treatment is 1520 and in average 50 cases receives post exposure rabies vaccine daily in this hospital (Personal contact with STH Hospital)
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