Animal Bite Victims Research Articles

Standardization And Evaluation Of An In-House ELISA For The Detection Of Rabies Antibody In A Tertiary Care Centre In South India

BackgroundRapid fluorescent focus inhibition test (RFFIT), a neutralization-based assay for detecting rabies antibodies, is the gold standard. The National Action Plan for Dog Mediated Rabies Elimination (NAPRE) is a national program that strategizes the establishment of enzyme-linked immunosorbent assays (ELISA) to detect rabies antibodies. ObjectiveWe developed an in-house ELISA to screen for rabies antibodies using rabies vaccine antigen to study vaccine response among health care workers (HCWs) who received pre-exposure prophylaxis and a few animal bite victims who received post-exposure prophylaxis with rabies vaccine. Study designA prospective study was carried out from April to September 2023 at the Department of Clinical Virology of a tertiary care center in South India. A total of 161 serum specimens, which included 155 serum samples from study participants and 6 samples from a reference laboratory (as controls), were obtained during the study period. Rabies antibody was determined by the in-house standardized ELISA developed using the rabies vaccine and compared with the reference assay, RFFIT. The accuracy indices of the in-house ELISA were estimated by MedCalc software (version 22.023). ResultsA panel of 86 positive and 75 negative serum samples was used for evaluating the in-house standardized ELISA. The sensitivity, specificity, positive and negative predictive values of the in-house ELISA were 98.8%, 100%, 100%, and 98.7% respectively. The accuracy of the in-house ELISA is 99.4%. ConclusionELISA can be a practically feasible and less expensive assay compared to RFFIT which is a cumbersome procedure with a long turn-around time of 3-4 days.

Epidemiological Profile And Practices Of Animal Bite Victims Attending The OPD Of Rural Health And Training Centre Affiliated To A Tertiary Care Centre In Rewa

Epidemiological Profile And Practices Of Animal Bite Victims Attending The OPD Of Rural Health And Training Centre Affiliated To A Tertiary Care Centre In Rewa

A cross-sectional epidemiological study of animal bite victims in district hospital Alwar, Rajasthan, India

Background: Rabies, an invariably fatal viral disease, transmitted to humans through animal bites, mostly dogs. According to WHO, each year, 23000-25000 people die in the SEA region due to rabies. These accounts for approximately 45% human deaths due to rabies worldwide. Objective was to study epidemiological trend of animal bite in Alwar district hospital. Methods: A retrospective, record-based study was conducted in 200 animal bite victims presenting to district hospital Alwar, Rajasthan wherein information on monthly number of animal bite cases was collected from records section of the hospital. Information on annual number of animal bite cases was available from the annual report of the hospital from 2018 onwards, this data was used for studying the monthly variation in animal bite cases. Data were compiled and analyzed using Microsoft Excel. Results: Among 200 victims 76.3% were males, 56.7% belongs to 15-45 years, 61.6% were living in urban area, 31.3% and 21.7% of the victims were agriculture worker and laborers respectively. Among 95.8% victims bitten by dog, 89% of them were stray. 89.4% had category III bite, lower extremity affected in 60.8%, fate of animal was unknown in 78.6% and 46% of the victims were bitten during evening hours. Conclusions: Majority of bites were by stray dogs, unprovoked and category III bites. This indicates the need of large amount of anti-rabies serum or HRIG thereby increasing the cost of management of animal bite cases. There is a need to control stray dog population and immunize pet dogs.

Adherence to the post-exposure prophylaxis among animal bite patients attending rabies clinic at tertiary care hospital – A cross-sectional study

Background: Rabies is an acute and 100% fatal viral disease transmitted to humans through the bite or lick of an infected animal. It can be successfully prevented if a complete course of anti-rabies vaccine (ARV) is taken following an animal bite. The present study reveals the compliance of animal bite victims to post-exposure prophylaxis (PEP). Aims and Objectives: The objectives of the study are as follows:(1) To determine the adherence to PEP among animal bite victims and factors influencing it. Materials and Methods: A retrospective record-based cross-sectional study was conducted at the anti-rabies clinic of VIMS Hospital Ballari. Information regarding sociodemographic variables, animal bite history, category of bite, treatment received, and completion of ARV schedule of all the animal bite cases were collected from the animal bite register and treatment card during the period from July 2023 to December 2023. Results: Out of the total 350 animal bite victims, all of them received the first dose of vaccine, 86.28% completed two doses, 72% completed three doses, and only 51.14% completed the schedule by taking all four doses, 37% of them completed the schedule without any delay, 14% delayed one or more doses, and the rest 49% did not complete the schedule. Conclusion: Adherence to PEP is a dire necessity as rabies is a fatal disease. Counseling the animal bite victims about the importance of adhering to the complete PEP schedule at the time of administering the first dose of vaccine is crucial.

Epidemiological profile of animal bite victims attending anti-rabies clinic in a tertiary care hospital in eastern Rajasthan: An observational study

Abstract Background: India has been classified by the World Health Organization as an endemic country with the highest incidence of rabies-related deaths globally. Therefore, any instance of a dog or wild animal bite is considered a potential exposure to rabies. The National Action Plan for Dog-Mediated Rabies Elimination emphasizes the importance of formulating state and district-level action plans tailored to local circumstances and evidence. A cross-sectional study analyzed the epidemiological traits of animal bites reported at the anti-rabies clinic of a tertiary hospital in Jaipur, Rajasthan, India. Materials and Methods: The research was conducted at Sawai Man Singh Medical Hospital in Jaipur, India, from September to October 2022. A pretested interviewer-administered questionnaire was used to collect data on the socio-demographic and epidemiological features of animal bites from a sample of 328 victims. Descriptive statistics and a spatial map were employed to analyze the results. Results: Among animal bite victims, 73% were males, and 35% fell within the age group of 5–18 years. The majority of cases, accounting for 92%, were categorized as category III exposure, with 61% of the victims being bitten on their lower limbs. Dogs were responsible for 76% of the bites, while monkeys accounted for 21%. Approximately 74% of dog bites were inflicted by stray dogs, and 82% of these incidents were unprovoked. Conclusion: The study highlights a higher prevalence of category III exposure and monkey bites compared to previous research, along with subpar adherence to prior immunizations. Most animal bite incidents were observed in public areas, particularly on streets and tourist destinations. These findings emphasize the importance of customizing district and state action plans to the specific context in Rajasthan to combat rabies effectively.

IJCM_306A: Patient compliance towards Post exposure Prophylaxis with Anti Rabies Vaccine - Hospital based study

Background: Rabies is a deadly viral disease that affects the nervous system. The components of rabies post-exposure prophylaxis involve wound treatment, Rabies Immune Globulin, and the anti-rabies vaccine. Proper compliance with the rabies vaccination schedule is crucial to prevent development of Rabies Objectives: 1) To assess prevalence of non-compliance and delayed compliance towards post-exposure prophylaxis of the anti-rabiess vaccine of GMC, Jammu 2) To study factors associated with and reasons of delayed compliance and non-compliance towards post-exposure prophylaxis of the anti-rabies vaccine of GMC, Jammu Methodology: A cross- sectional study was carried out from September 2022 to July 2023 on 594 animal bite victims presenting to OPD of the anti-rabies clinic of GMC, Jammu for the first time, with category 2 and 3 bites were included Results: Males were about 76.9%, and females, 23.1%. Graduates were 29.3%. Animal bites were mainly from stray dogs (58.2%), with category three wounds (93.8%). Wound washing practices were done by 540 (90.9%), about 58 (9.8%) had used only water and about 482 (81.1%) had used only soap and water for wound washing. 71.7% completed the full course of Anti-Rabies Vaccine (ARV), 24.6% showed delayed compliance, and 3.7% were non-compliant or dropouts. Delayed compliance was observed on the second (35%), third (42.4%), and fourth doses (22.6%). Reasons for delayed compliance included distant residence, loss of wages, and forgetfulness. Non-compliance reasons included negligence and health issues. No socio- demographic factors showed an association with compliance with ARV. Conclusion: The urgent need to increase awareness and counseling for individuals bitten by animals. Special attention is crucial for promptly administering Anti-Rabies Immunoglobulin in severe cases (category 3 bites) to prevent rabies

IJCM_365A: A prospective study on the safety and clinical efficacy of rabies monoclonal antibodies for post exposure prophylaxis in suspected animal exposures at the anti rabies clinic of KIMS Hospital and Research Centre, Bangalore

Background: Rabies immunoglobulins will provide timely passive immunity after exposure to suspected rabid animals along with thorough wound wash and full course of anti-rabies vaccination. The products include human derived RIG (HRIG) and equine derived RIG (ERIG), both having certain constraints for usage. In contrast, monoclonal antibodies (mAbs) produced by recombinant technology, have shown superiority in availability, safety and purity. Therefore, RmAb are an alternative to RIG for passive immunity component of post exposure prophylaxis (PEP). Only two products i.e., RabiShield (single human mAb) & Twinrab (cocktail of two mAbs) have been merchandised in Indian market. WHO has recommended monitoring the clinical use and outcomes of RmAb products for rabies PEP Objective: To assess the safety and clinical efficacy of presently available rabies monoclonal antibodies for post exposure prophylaxis Methodology: All the patients with category III exposure visiting the study site and consenting for the study were included. The details pertaining to socio demographic profile, details of biting animal, characteristics of bite wound, wound wash, details of active & passive immunization and details of adverse events following PEP were collected using a case record form. All the study subjects were followed up for the occurrence of any delayed reactions and further upto six months to know the clinical efficacy of PEP. Results: The present study included 475 animal bite victims. Among them 41.2 % were children, 49.6% were adults and 9.01 % were elderly. The ADEs among Rabishield and TwinRab were 3.18 % & 2.12 % respectively and the difference among them were not statistically significant. ADEs among all the patients receiving both RmAbs were mild and subsided without any complications. All the study subjects were healthy and alive after six months after PEP confirming clinical efficacy. Conclusion: The presently available RmAbs are safe and clinically effective in preventing rabies in suspected exposures

IJCM_280A: A prospective study on safety and clinical efficacy of rabies biologicals in paediatric patients with category III animal exposure

Background: Rabies remains a significant public health concern worldwide, particularly among paediatric populations who are vulnerable to animal exposures. This prospective study aimed to assess the safety and clinical efficacy of rabies biologicals in pediatric patients following Category III animal exposures. Objectives: 1. To describe the post exposure prophylaxis provided to the animal bite victims at the anti rabies clinic. 2. To asses the safety and clinical efficacy of currently available rabies biologicals for post exposure prophylaxis. Methodology: A prospective study was undertaken enrolling 289 pediatric patients fulfilling eligibility criteria who presented with Category III animal exposures at the anti-rabies clinic of KIMS Hospital and Research Centre, Bangalore. All the subjects received rabies biologicals as per NCDC guidelines. The details pertaining to socio demographic profile, biting animal, characteristics of wound, details of post exposure prophylaxis provided were recorded. All the study subjects were followed up for immediate and delayed adverse events. Subsequently, all were followed up for 6 months to demonstrate the clinical efficacy of PEP. Results: The mean age of study subjects was 9.4 years and most of them (43%) were going to school. Dog was the predominant biting animals (96.6%) with most bites were abrasions (45%), mainly on the lower limbs (42%). Single RmAb was the most commonly administered passive immunization (67%) and PVRV was the predominant vaccine (65%). Adverse events following post-prophylaxis were primarily local, predominantly pain (13.2%) and there were no systemic events. All the subjects were alive and healthy at the end of 6 months following PEP. Conclusion: This study contributes valuable insights into the safety and clinical efficacy of rabies biologicals in a pediatric cohort following Category III animal exposures, supporting the continued use of these biologicals in pediatric patients.

A prospective study on health seeking behaviour and post exposure prophylaxis received by animal bite victims at the anti-rabies clinic in a tertiary care centre of urban Bangalore.

Rabies is 100% preventable by administering early and complete post exposure prophylaxis (PEP). Animal bite victims must have the knowledge and attitude necessary to seek appropriate medical care at the earliest to receive the required PEP. The present study sought to ascertain the health-seeking behavior of animal bite victims, their knowledge and attitude regarding rabies prophylaxis, the PEP they received, and their level of compliance with the full course of anti-rabies vaccination. The study included animal bite cases that presented to the anti-rabies clinic and matched the eligibility criteria. All the required details were recorded using an internally validated structured questionnaire. All participants were followed up for six months to ensure their health conditions and compliance with the vaccination schedule. Out of 1058 respondents, 57.9% were adults, with 46.6% belonging to middle socioeconomic class. 91.1% of them were informed biting animals as dogs. Before arriving at the anti-rabies clinic, 93.3% of the study subjects washed their wounds, and 62.4% visited to another health facility. Rabies knowledge was inadequate among the study participants, only 54.8% being mindful about the disease and its prevention. The compliance with the full course of antirabies vaccination was found to be 77.9%. All subjects were healthy, confirming that PEP is safe and effective. Regular social and behavioral change communication (SBCC) needs to be implemented with regard to health-seeking behavior.

Prevalence of delayed initiation of rabies postexposure prophylaxis and factors influencing it among animal bite victims from Eastern Uttar Pradesh, India.

In a rabies-endemic country like India, every animal bite is potentially taken as rabid exposure and timely and appropriate postexposure prophylaxis (PEP) is crucial as rabies is an almost 100% fatal disease. A retrospective record-based study was conducted at an anti-rabies clinic (ARC) in Eastern Uttar Pradesh, India. Data of the animal bite victims attending the ARC for PEP from January to December 2022 were extracted from the records. A semistructured questionnaire was used for collecting information regarding the interval between exposure and the initiation of anti-rabies PEP, age, gender, residence, the bite site on the body, category of exposure and other risk factors associated with the delay in PEP. Most of the victims were male (67.6%), from an urban background (61.3%) and aged up to 20 y (43.9%). Out of the 222 victims, 62 (27.9%) had delayed initiation of PEP (>48 h after exposure). Factors found to be significantly associated with delayed initiation of PEP were residence (p=0.01), age (p=0.04) and the type of biting animal (p=0.002). Delayed initiation of PEP is common among animal bite victims in this region of India, although PEP is affordable. Educational programmes and awareness-raising campaigns for timely administration of PEP should be a priority, especially targeting rural residents, those aged<18 y and those bitten by animals other than dogs.

A Study on Seasonal Trends among Animal Bite Victims Reported to a Tertiary Care Hospital, Jabalpur

Abstract Background: Rabies is a viral zoonotic disease that is 100% fatal, yet 100% preventable. It is estimated that 17.4 million exposures with 20,000 deaths due to animal bites occur every year in India, with higher cases in particular seasons. Hence, this study aimed to find out the seasonal trend among animal bite victims for the past 3 years. Subjects and Methods: It was a record-based retrospective study conducted in a tertiary care hospital, Jabalpur, for a period of 2 months (September 2022 to October 2022) for the years 2018, 2019, and 2020 among 1518 victims. Data were entered into MS Excel, and descriptive statistical analysis was done using IBM-SPSS version 23.0. Results: It was observed that, majority were dog-bite victims with maximum unprovoked bite showing decrease in trend from 2018 to 2019, and then increase in 2020. In this study, maximum bites were seen in winter (23.99% in 2018, 52.61% in 2019, and 50% in 2020), followed by monsoon (12.64%) in 2018 and summer in both 2019 and 2020. Conclusion: In the study, maximum bites were noted during winter, followed by the monsoon in 2018 and summer in 2019 and 2020, showing an increase in trend and then a downfall in 2020, maybe due to the COVID-19 period lockdown. This study will help policymakers formulate appropriate plans, activities, and logistic support for the management of animal bite victims.

Knowledge &amp; Practice Regarding Animal Bite among Bite Victims Attending OPD Services in Karukachal (Tamil Nadu)

An animal bite is an injury caused by the mouth and teeth of an animal including humans. The present study was conducted in 2023 with the objective to assess the knowledge and practice regarding animal bite among bite victims attending OPD services of CHC, Karukachal. A descriptive research design &amp; convenient sampling technique were used to conduct the study among 50 animal bite victims attending OPD services of CHC, Karukachal. The data were collected using self-structured knowledge and practice questionnaire. The data were analysed by using descriptive statistics. The results showed that most of the samples (84%) had average knowledge regarding animal bite. Also, 90 percent of samples cleaned the area of animal bite using soap and water; 50 percent cleaned the area thoroughly for 15 minutes, 76 percent of samples kept the suspected animal under observation. Twenty-six percent applied antiseptic solution or creams to the affected area, 76 percent consulted the doctor at the day of bite itself. All the samples were got vaccinated against rabies after animal bite. The study concluded that improved community awareness regarding animal bite and its management is required to fight against rabies.

Evaluating adherence to government recommendations for post-exposure rabies vaccine among animal-bite victims: A hospital-based study in Bangladesh.

Rabies is a fatal but preventable zoonotic disease with an approximately 100% case fatality rate. The most common way to contract rabies is through the bite of a rabid animal. Post-exposure prophylaxis (PEP) by vaccination and/or immunoglobulin therapy is the most effective measure for rabies prevention. The effectiveness of vaccination depends on the level of completion of vaccination. In Bangladesh, no previous studies were conducted to evaluate adherence to government recommendations for post-exposure rabies vaccine among animal-bite cases. We conducted a cross-sectional study to collect information about adherence to government recommendations for post-exposure rabies vaccine. A total of 457 animal bite victims were selected to collect data and follow up after one month of enrollment. The majority of participants (58%, n = 265, 95% CI: 53-63%) had a history of animal bites. Most of the participants (77%) were advised to receive three doses of vaccine and 100% of them completed 3-dose of vaccine. Among the 4-dose recommended group of participants (n = 105), 78% completed full vaccination. Of the 457 participants, 20% received post-exposure vaccine on the day of bite/scratch and the majority of the participants (66%, n = 303, 95% CI: 62-71%) received post-exposure vaccine on the day between the first and third day of bite or scratch. Increasing awareness of the importance of timely vaccination is the key to reducing the time gap between animal bites and intake of the first dose post-exposure vaccine.

A Study of Clinico-social Profile of Animal Bite Patients Attending the Antirabies Clinic of BRD Medical College, Gorakhpur

Background: Rabies is one of zoonotic viral disease, estimated to cause 59000 human deaths annually in over 150 countries, of which 20,000 are from India alone; about 40% of which are in children under the age of 15. Rabies though 100% fatal is preventable with post-exposure prophylaxis which includes wound washing, anti-rabies vaccination and rabies immunoglobulin. Objective: To describe the clinico-social profile of animal bite patients attending the anti-rabies clinic of BRD Medical College, Gorakhpur. Methodology: A cross-sectional study was conducted in the anti-rabies clinic of Nehru hospital, BRD Medical College, Gorakhpur from January 2022 to May 2022. Study participants were interviewed by using a pre-phrased, pre-designed and pre-tested questionnaire. Data regarding socio-demographic and clinical profile of the study participants following animal bite exposure was collected. Results: The total number of animal bite victims were 250, in which majority of them were males (76.77%) and highest percentage was of adult population (20-59 years). Maximum number of victims were from rural area (78.70%). 19.35% were working and 39.35% were students. 77.43% were category III bites and in 50.96% cases lower limb was the site of bite and dogs were responsible for 89.67% of the bites. 60.64% victims did not wash the wound properly before reaching the anti-rabies clinic. Conclusion: This study concludes that as majority of the animal bite victims were students and majority of victims were unaware about the importance of wound care, therefore a step can be taken to create awareness in various schools.

TREND OF ANIMAL BITE CASES REPORTED TO ANTI RABIES VACCINATION CLINIC AT A TERTIARY CARE HOSPITAL.

Introduction: Rabies is a fatal viral zoonosis and serious public health problem. Though 100% fatal ,it is a 100% preventable disease .Rabies is a global burden and a fatal disease of the central nervous system .WHO reports around 55,000 rabies deaths out of which 20000 deaths are estimated to occur in India alone with 17.4 million exposures to animal bite every year. Rabies is transmitted to humans through animal bites, mostly dogs. Objectives: 1. To study the trend of animal bite cases over a period of last 10 years. 2. To study the distribution of cases according to gender, season and type of animal bite. Materials and Methods: This record based cross sectional study was carried out at the anti-rabies vaccination (ARV) clinic. All the new cases of animal bites reported to ARV clinic during the last 10 years, from January 2011 to December2020 were assessed. Data is presented using percentages and proportions. Results: In our study the number of animal bite cases were continuously increasing since 2011 till 2019 with an exception in 2013 and 2020 in which there were slight decrease in cases. Month wise distribution of animal bite victims attending the ARV clinic having highest number of animal bite cases in December i.e. 2951 followed by November (2878) followed by January (2874). Out of total 31,677 animal bite cases 28,303(89%) were urban &amp; 3374(11%) were rural. The ratio of urban to rural is 8.3:1. Among the cases, 69% were males and 31% were females. Majority of the cases were of dog bite (88.75%) followed by cat bite (7.3%) and monkey bite (2.2%) and 1.75% of the cases were bitten by other animals. Conclusion: Thus, an increasing trend of animal bite cases is seen and this shall increase in the future also. So appropriate preventive &amp; control measures with intersectoral coordination should be enhanced in endemic areas in a developing country like India.

Dropout rate of anti-rabies vaccination among rural and urban communities in Tamil Nadu: A comparative cross-sectional study

Background: Rabies is a vaccine preventable deadly disease. There is a lack of organized surveillance system on animal bite victims to ensure completion of full course of post-exposure prophylaxis. Aims and Objectives: The aim of the study was to estimate the dropout rate of anti-rabies vaccine (ARV) post-exposure regimen among rural and urban communities of Chengalpattu district, Tamil Nadu. To interpret the association between category of bite and vaccination outcome among rural and urban communities of Chengalpattu district, Tamil Nadu. Materials and Methods: A retrospective hospital record based study (ARV REGISTER) was done in urban primary health center (PHC) Haridosspuram and rural PHC, Kelambakkam during January 2021. Collected data were entered into MS Excel and analyzed using SPSS version 22.0. Total dropout rates of ARV regimen among rural and urban communities were compared by Chi-square test. Results: A total of 5262 animal bite victims were vaccinated during the past 2 years. The majority (37.4%) of victims belonged to 21–40 years of age. The total dropout rate observed among both rural and urban communities was 51.2% with the higher proportion (72.8%) of dropouts seen among victims of category I bite. Wound washing practice was observed among the victims. Higher dropout rate (61.3%) of ARV regimen was observed among urban communities compared to rural communities (50.2%). Significant association was found between the category of animal bite and the vaccination outcome in both rural and urban communities. Conclusion: The animal bite victims should be educated and counseled about the importance of complete vaccination. The health workers should ensure proper follow-up of the victims to complete the vaccination schedule and thus prevent drop outs.

Trends of Animal Bite Cases and Comparison of Cases Reported during Pre-COVID-19 and COVID-19 Period in a Dedicated Anti-Rabies Clinic from a Tertiary Care Hospital, Hassan, Karnataka, India: A Retrospective Cohort Study

Introduction: Rabies causes 100% case fatality in animal bite victims if left untreated, and it ranks as the 10th leading cause of death due to infectious diseases worldwide. India alone reports 20,000 human rabies deaths annually, accounting for one-third of global mortalities related to the disease. However, rabies is 100% preventable. The nationwide lockdown imposed from March 25, 2020, to curb the spread of the Coronavirus Disease-2019 (COVID-19) disrupted various essential health services, including Post-Exposure Prophylaxis (PEP) for rabies. Aim: to describe the socio-demographic profile of animal bite cases and assess the burden of animal bites during the pre and post COVID-19 Pandemic, specifically in patients reporting to the dedicated Anti-Rabies Clinic (ARC) of a tertiary care hospital in Hassan, Karnataka, India. Materials and Methods: A retrospective record-based study was conducted from January 2019 to November 2021 among animal bite cases reporting to the ARC at Hassan Institute of Medical Sciences, Hassan, Karnataka, India. Data on age, gender, locality, and socio-economic status were collected from the records maintained at the ARC. All subjects with complete data in the records were included in the study. All animal bite cases were managed according to the World Health Organisation (WHO) guidelines, with necessary COVID-19 precautions taken. A total of 3,706, 3,303, and 2,144 subjects were considered for the years 2019, 2020, and 2021, respectively. Results: There was a decreasing trend in the reported cases during the pandemic. The proportion of animal bite cases among those less than 19 years old was 1,146 (30.9%), 1,124 (34.1%), and 711 (33.1%) in the years 2019, 2020, and 2021, respectively. The majority of animal bite victims were males: 2,489 (67.2%), 2,240 (67.8%), and 1,173 (54.7%) in the years 2019, 2020, and 2021, respectively. The majority belonged to the rural population, with 2,668 (72.0%), 1,057 (32%), and 1,586 (74%) in the years 2019, 2020, and 2021, respectively. However, there was an increase in the number of victims from the urban population in the year 2020, with nearly 2,246 (68%). Most of them, 2,299 (62%), 2,114 (64%), and 1,441 (67.2%) in the years 2019, 2020, and 2021, respectively, belonged to a lower socio-economic status. Category-III bites made up the majority representation in all the years 2019, 2020, and 2021. Conclusion: The number of animal bite cases reported during the pandemic was lower compared to the pre-pandemic phase. This highlights either missed reporting of cases or a reduction in exposure to animals, which decreased the risk of animal bites.

Rabies Outbreak in the Urban Area of Delhi: An Investigation Report and One Health Perspective for Outbreak Management.

Rabies is a global problem and is endemic in India. Rabies cases occur throughout the year, and the majority of cases are associated with dog bites. We report a rabies outbreak investigation in an urban area of Delhi conducted by our multidisciplinary team, and its role in proactively controlling a rabies outbreak by concerted efforts and timely advice to various stakeholders using a "One Health Approach." A veterinary care NGO from Delhi picked up a suspected rabid stray dog and submitted a brain sample for diagnosis of rabies, as they had received information from a resident of the locality about an unprovoked animal bite incident involving a girl (category III bite) and close contact of two more stray dogs living in the vicinity of the suspected rabid dog. The laboratory diagnosis of rabies in the suspected dog brain sample was confirmed by using Fluorescence Antibody Test (FAT). A multi-expert investigation team with expertise in medicine, microbiology, veterinary sciences, laboratory diagnosis, and public health was constituted to investigate the outbreak. The timely, adequate, and appropriate anti-rabies management initiated for the animal bite victims in this incident could prevent rabies. Proactive involvement of multiple stakeholders and knowledge attributes and practice of local residents could prevent human rabies. As there were no further reports of dog bites from the area, the chain of rabies transmission in that area could be controlled. The presented work is a classical case scenario where concerted efforts of all stakeholders achieved effective control and prevention of rabies by adopting the "One Health approach".

Compliance rate of anti-rabies vaccination in patients presenting with an animal bite

Introduction: To prevent rabies in animal bite victims, complete postexposure prophylaxis (PEP) with an anti-rabies vaccination (ARV) is essential. This study was done to determine the compliance rate of ARV in patients with animal bites who presented to the emergency department (ED) during the COVID-19 pandemic. Materials and Methods: This was a prospective observational study done on patients presenting to the ED with a history of animal bites over 1 year (May 2020–June 2021). Categorical variables were presented as percentages, and quantitative variables were summarized using mean and standard deviation (SD). Results: A total of 122 animal bite (World Health Organization [WHO] Category II and III) victims presented to the ED during the study. The mean age of the cohort was 38.12 (SD: 16.4) years with a male (n = 67: 54.9%) preponderance. Based on the physiological stability, a majority were triaged as priority III (n = 119; 97.5%). Most patients presented with dog bites (n = 88; 72.1%), followed by cat (n = 14; 11.5%) and rat bites (n = 13; 10.7%). Two-thirds were unprovoked (n = 82; 67.2%) and were caused by stray animals (n = 62; 50.8%). More than half (n = 65; 53.3%) of the bites were WHO Category III bites. All Category II and III patients had received the first dose of ARV at our center and category III patients received immunoglobulin local injection as well. Noncompliance to ARV was seen in almost a quarter (n = 32; 26.2%) of patients of which forgotten dates (n = 11; 34.4%) were the most common cause. There was no significant statistical variable to determine the cause of noncompliance. Conclusion: Unprovoked bites by stray dogs were the cause of a majority of the animal bites. Compliance with PEP remains low at two-thirds of the total. The most common cause of noncompliance to ARV was due to forgotten dates. The following core competencies are addressed in this article: Medical knowledge, Systems-based practice, Practice-based learning and improvement.

KNOWLEDGE ATTITUDE AND PRACTICES ABOUT ANIMAL BITE AND RABIES AMONG VICTIMS ATTENDING TERTIARY CARE HOSPITAL IN GOVT THIRUVANNAMALAI MEDICAL COLLEGE, TAMILNADU

Background: Rabies is a deadly disease which spreads by the bite or scratch of an infected animal. The lack of awareness of this disease is one of the factors that leads to human mortality. 1. To Objectives: assess the knowledge attitude and practice among victims attending a tertiary care hospital.2. To nd the association of socio-demographic factors with the knowledge level. Materials Methodology: A hospital based cross sectional study was conducted at Govt.Thiruvannamalai Medical College among 230 animal bite victims attending Outpatient department during June to July 2018. Data was collected using pre-tested semi structured questionnaire. Simple random sampling was used. Mean age group of study participants was 36.75±15.8, 59% were ma Results: les and 41% were females. 72.1% of the participants had heard the word rabies. 75% among them had poor KAP score. KAP score was signicantly associated with age, sex, education. Conclusion: There is a need for generating awareness of Rabies and animal bite.Their knowledge attitude and practices can be improved by providing proper health education.