Rabies In India Research Articles

Urgent call for cross-border approach to control rabies in India and Nepal.

Given the high possibility of rabies spread across borders a collaborative cross-border disease control partnership is necessary.

Rabies in rural northeast India: A case report emphasising the urgency of the One Health approach

Dog-mediated rabies is endemic in India. The country records the highest mortality due to dog-bite-related rabies despite the availability of interventions to prevent deaths. We present a case study of the death of a 59-year-old man in a suburban town of Northeast India after a dog bite from an owned pup. Through this case study, we investigate various omissions and commissions in communities and health professionals that make rabies rampant in India. The circumstances surrounding the death were investigated by interviewing the wife, relatives, neighbour, the hospital/nursing home where the bite case was reported, the district Rapid Response Team (RRT), and the Veterinary and Animal Health Department Officer and through the information recorded in the disease outbreak report. While the biting animal was not vaccinated and had no restriction over its movement imposed by the owners, the response of the hospital staff and public authorities was delayed and inadequate. A poignant reminder of the complexities surrounding dog-mediated rabies in India, this case study calls for a holistic protocol to address dog bites through ensuring the One Health approach encompassing education, provision of post-exposure prophylaxis (PEP) and canine rabies vaccines for dogs, promotion of responsible dog ownership, and intersectoral collaboration. Moreover, strengthening communication channels through effective data exchange and encouraging synergy among healthcare, veterinary, and public health sectors is indispensable to maximize the impact of rabies prevention and control interventions.

Incidence of human rabies following bite or exposure to laboratory confirmed rabid animals

Background: Rabies is one of the important endemic fatal zoonotic viral disease afflicting humans and animals in Punjab, India. The present study investigated the incidence of rabies in humans bitten/exposed to laboratory confirmed rabid animals, as well as incidence after use of vaccine or rabies immunoglobulin (RIG) and clinico-epidemiological studies. Methods: A study was conducted during August 2021 to September 2022 on forty (40) rabies suspected animals presented to diagnose rabies by direct fluorescent antibody test (dFAT) at rabies diagnostic laboratory (RDL), Guru Angad Dev Veterinary and Animal Sciences University (GADVASU), Punjab, India. A detailed questionnaire was prepared for obtaining information about exposure/bite of humans by rabid animals, death of humans, demographic and epidemiological information of victims. Results: Out of total forty (40) suspected rabies cases, 30(75%) were found positive for rabies by dFAT. Laboratory confirmed rabies (LCR) incidence was 60.80% and 21.73% in stray and pet dogs, respectively. All pet dogs were vaccinated but no stray dog was vaccinated. The LCR incidence in buffaloes and cattle was 77.77% and 100%, respectively. Further in humans exposed to rabid animals (59), males were at more risk than females. The human rabies incidence was 3.38% (2/59). Highest incidence of dog bites in adult males on lower limb was observed from urban stray dogs (60.80%) followed by children. Post exposure vaccination was given to 98.3% humans exposed to rabid animals. Human’s rabies in two cases was due to no vaccination or RIG. Conclusions: Vaccination is an important step in controlling rabies in India. There is a need for integrated and comprehensive management of street dogs and bite management.

Rabies is 100% Preventable – Yet It Continues to Kill: Can We Eradicate Rabies in India?

Rabies is 100% Preventable – Yet It Continues to Kill: Can We Eradicate Rabies in India?

India’s sustaining challenges to combat rabies elimination: a comprehensive review

Rabies is one of the fatal zoonotic diseases wreaking havoc on humanity since antiquity. India continues to suffer the greatest rabies burden of any country, both in terms of annual human deaths and disability-adjusted life years. While modern rabies management emphasizes the importance of achieving zoonotic disease control and prevention through a One Health approach, the disease remains challenging as its persistence is invariably multifaceted. Therefore, it is imperative to examine the enduring reasons for the increasing incidence of rabies in India. Between 2012- 2022, a systematic search of scientific publications, popular search engines like Google, as well as in the grey literature regarding rabies was carried out. Since rabies elimination boils down to addressing the reasons, it is first seen related to the large and unvaccinated stray dog population, where 97% of cases are by dog bites. A second finding is that many bite victims resorted to indigenous treatment practices due to insufficient awareness and knowledge about the disease. Incomplete treatment practices also led to some deaths, especially because rabies vaccines are not affordable or accessible to poverty-stricken populations. Rarely, vaccine failures were caused by a lack of vaccine potency, a wound type, or ineffective administration methods. Even with all these data incorporated, there was no information on prevalence/incidence estimates of dog bites in recent years through national data. Therefore, without intensified surveillance, sustained political commitment, enormous mobilization of resources, and rabies education, the epidemic waves of this fatal disease will continue in India.

A KAP Study on Dog Bite and Its Management in a Rural Community — Need for Increasing the Awareness

Objectives: To access knowledge, attitude, and practices about dog bites and their management in the rural community of Maharashtra. Methodology: A cross-sectional study was conducted in an identified rural community with a sample size of 279 using systematic random sampling data was collected using personal interview using pretested questionnaire and descriptive and inferential statistics was applied. Results: The mean age of the subjects was 42.8±7.5 years and the majority (68.8%) were male and 31.2% were female. 72.4% didn't have any pet dog and all (100.0%) have experienced a dog bite for themselves or anyone in the family in their lifetime. The majority (93.4%) have described rabies illness and 100% correctly know that the main animal of rabies in India is a dog and the correct mode of disease transmission. However, only 7.9% know the most common age group affected. The majority (59.1%) have heard about the anti-rabies vaccine. Awareness of anti-rabies vaccine varies in different groups based on their educational qualification and Pearson's chi-square value was statistically significant. Vaccination of pet dogs as a periodic activity to prevent rabies has been strongly disagreed by 22.2% of participants. 23.3% strongly agreed that stray dogs are a social nuisance. The majority 24.7% have disagreed with the implementation of the Animal Birth Control program. The relationship between the level of education and attitude towards native/traditional healers in preventing rabies after a dog bite was significant (p<0.05). It was also found that the following dog bite only 28.0% would like to wash the wound with soap and water following a dog bite. Conclusion: There exists a considerable gap in knowledge attitudes and practices about Dog bites and their management. Increasing the awareness, and changing the attitude and beliefs among the study population is the need of the hour, Accordingly Regular IEC activities to be planned at various centers Keywords: Knowledge, attitude, practices, Dog bite, Management

Review of Oral Rabies Vaccination of Dogs and Its Application in India.

Oral rabies vaccines (ORVs) have been in use to successfully control rabies in wildlife since 1978 across Europe and the USA. This review focuses on the potential and need for the use of ORVs in free-roaming dogs to control dog-transmitted rabies in India. Iterative work to improve ORVs over the past four decades has resulted in vaccines that have high safety profiles whilst generating a consistent protective immune response to the rabies virus. The available evidence for safety and efficacy of modern ORVs in dogs and the broad and outspoken support from prominent global public health institutions for their use provides confidence to national authorities considering their use in rabies-endemic regions. India is estimated to have the largest rabies burden of any country and, whilst considerable progress has been made to increase access to human rabies prophylaxis, examples of high-output mass dog vaccination campaigns to eliminate the virus at the source remain limited. Efficiently accessing a large proportion of the dog population through parenteral methods is a considerable challenge due to the large, evasive stray dog population in many settings. Existing parenteral approaches require large skilled dog-catching teams to reach these dogs, which present financial, operational and logistical limitations to achieve 70% dog vaccination coverage in urban settings in a short duration. ORV presents the potential to accelerate the development of approaches to eliminate rabies across large areas of the South Asia region. Here we review the use of ORVs in wildlife and dogs, with specific consideration of the India setting. We also present the results of a risk analysis for a hypothetical campaign using ORV for the vaccination of dogs in an Indian state.

Burden of illness of dog-mediated rabies in India: A systematic review

IntroductionIndia accounts for 35% of global burden of rabies. This systematic review attempts to measure the burden of illness of dog bites and dog-mediated rabies in India. MethodsA systematic literature search was conducted on MEDLINE, EMBASE, Cochrane Central, PROQUEST, Sodhganga and Google Scholar. Two independent reviewers screened titles and abstracts and included full texts as per inclusion criteria. Critical appraisal of included studies was conducted using appropriate checklists. Data was extracted using standardized data extraction tools, analyzed and reported in narrative summary and tabular formats. Results35 studies were included for narrative synthesis after screening for inclusion criteria. The annual crude dog bite incidence was reported between 0.26% and 2.5% with stray dogs as main biting animal. The bites were mainly reported in males, between age group 10–40 years, individuals belonging to low socio-economic status and people working in fields. The annual economic and humanistic burden is estimated to be 2.85 million USD and 1.3 million DALYs respectively. Use of intradermal route of vaccination and equine rabies immunoglobulins has been reported to save cost and resources over use of intramuscular route of vaccination and human rabies immunoglobulins. ConclusionThe review highlighted the burden of disease at local, regional and national level. There has been dearth of studies reporting economic and humanistic burden at national level. Systematic review registrationPROSPERO ID: CRD42020213261.

Epidemiological, humanistic and economic burden of dog-mediated rabies in India: a systematic review protocol.

Background: Rabies is a neglected zoonotic disease. It is transmitted through the bite of a rabid animal and dog bites are responsible for around 95% of human cases. The disease is almost always fatal after the onset of symptoms. It is an endemic and major public health problem in India with one-third of the global deaths reported from this country. Protocol: This systematic review aims to estimate the epidemiological, humanistic and economic burden of dog-mediated rabies in India. Initially the existence of controlled descriptors in MeSH terms (such as 'Epidemiology', 'Rabies', 'Cost', 'Dog bite', 'Quality of Life', 'India' etc), and their synonyms (key words) was identified in MEDLINE, and were later combined with Boolean operators 'AND' and 'OR' to develop a detailed search strategy. Two independent reviewers will screen the titles and abstracts and select the studies as per the inclusion criteria. The selected studies will be assessed for their quality and risk of bias. Data will be extracted using standardized data extraction tools and will be synthesized for analysis. Disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Discussion: This systematic review will be performed to critically examine relevant literature and report the epidemiological, humanistic and economic burden of dog-mediated rabies in Indian context. The findings will help in estimation of burden of the disease in India and expected to contribute in policy making and planning of the program and interventions in the country. Protocol registration: PROSPERO ID: CRD4202021326.

Environmental and human behavioral factors associated with Vulvovaginal Candidiasis among single and married Women in Eket

<strong>Background:</strong> The Indian Association for the prevention and control of rabies estimates that 80, 00, 000 individuals receive the treatment for dog bites each year. The matter with dog rabies in India is that dogs are asymptomatic in each human establishment.

Clinical study on blood routine and dynamic changes, condition and prognosis of hand foot and mouth disease (EV71)

<strong>Background:</strong> The Indian Association for the prevention and control of rabies estimates that 80, 00, 000 individuals receive the treatment for dog bites each year. The matter with dog rabies in India is that dogs are asymptomatic in each human establishment.

Factors promoting schistosomiasis infection in endemic rural communities of Ifedore and Ile-Oluji/Oke Igbo local government areas in Ondo State, Nigeria

<strong>Background:</strong> The Indian Association for the prevention and control of rabies estimates that 80, 00, 000 individuals receive the treatment for dog bites each year. The matter with dog rabies in India is that dogs are asymptomatic in each human establishment.

Epidemiological, humanistic and economic burden of dog-mediated rabies in India: a systematic review protocol

Background: Rabies is a neglected zoonotic disease. It is transmitted through the bite of a rabid animal and dog bites are responsible for around 95% of human cases. The disease is almost always fatal after the onset of symptoms. It is an endemic and major public health problem in India with one-third of the global deaths reported from this country. Protocol: This systematic review aims to estimate the epidemiological, humanistic and economic burden of dog-mediated rabies in India. Initially the existence of controlled descriptors in MeSH terms (such as 'Epidemiology', 'Rabies', 'Cost', 'Dog bite', 'Quality of Life', 'India' etc), and their synonyms (key words) was identified in MEDLINE, and were later combined with Boolean operators 'AND' and 'OR' to develop a detailed search strategy. Two independent reviewers will screen the titles and abstracts and select the studies as per the inclusion criteria. The selected studies will be assessed for their quality and risk of bias. Data will be extracted using standardized data extraction tools and will be synthesized for analysis. Disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Discussion: This systematic review will be performed to critically examine relevant literature and report the epidemiological, humanistic and economic burden of dog-mediated rabies in Indian context. The findings will help in estimation of burden of the disease in India and expected to contribute in policy making and planning of the program and interventions in the country. Protocol registration: PROSPERO ID: CRD4202021326

A Case for Pre-Exposure Prophylaxis of High-Risk Groups against Rabies in India

Rabies is a fatal zoonotic disease which has tormented humanity since antiquity. It is transmitted after the bite of a rabid animal and is 100 % fatal if timely intervention of appropriate wound management and Anti Rabies Prophylaxis is not given to the animal bite victims. About 96% of the mortality and morbidity is associated with dog bites. How to cite this article:Shewale A, Nale T, Daptardar M, Tiwari S. A Case for Pre-Exposure Prophylaxis of High-Risk Groups against Rabies in India. J Commun Dis 2021; 53(1): 110-116. DOI: https://doi.org/10.24321/0019.5138.202118

Attitude of rabies among dog bite victims in Srinagar, Kashmir

<strong>Background:</strong> The Indian Association for the prevention and control of rabies estimates that 80, 00, 000 individuals receive the treatment for dog bites each year. The matter with dog rabies in India is that dogs are asymptomatic in each human establishment.

Epidemiological, humanistic and economic burden of dog-mediated rabies in India: a systematic review protocol.

Background: Rabies is a neglected zoonotic disease. It is transmitted through the bite of a rabid animal and dog bites are responsible for around 95% of human cases. The disease is almost fatal after the onset of symptoms. It is an endemic and major public health problem in India with one-third of the global deaths reported from this country. Protocol: This systematic review aims to estimate the epidemiological, humanistic and economic burden of dog-mediated rabies in India. Initially the existence of controlled descriptors in MeSH terms (such as 'Epidemiology', 'Rabies', 'Cost', 'Dog bite', 'Quality of Life', 'India' etc), and their synonyms (key words) was identified in MEDLINE, and were later combined with Boolean operators 'AND' and 'OR' to develop a detailed search strategy. Two independent reviewers will screen the titles and abstracts and select the studies as per the inclusion criteria. The selected studies will be assessed for their quality and risk of bias. Data will be extracted using standardized data extraction tools and will be synthesized for analysis. Disagreements that arise between the reviewers will be resolved through discussion, or with a third reviewer. Discussion: This systematic review will be performed to critically examine relevant literature and report the epidemiological, humanistic and economic burden of dog-mediated rabies in Indian context. The findings will help in estimation of burden of the disease in India and expected to contribute in policy making and planning of the program and interventions in the country. Protocol registration: PROSPERO ID: CRD4202021326.

Utilising Group-Size and Home-Range Characteristics of Free-Roaming Dogs (FRD) to Guide Mass Vaccination Campaigns against Rabies in India

Adequate vaccination coverage of free roaming dogs (FRD) against canine rabies is not achieved primarily due to difficulties in administering parenteral vaccinations to this population. One factor associated with this difficulty is the tendency of FRD to form groups, which increases their aggressive behavior, resulting in a significant risk of dog-bites for the vaccinators. This study investigated factors that influenced FRD forming groups and their home-ranges, using data obtained from photographic capture-recapture/sight-resight surveys conducted in rural Shirsuphal (584 sightings) and urban Panchkula (3208 sightings), India. In the rural site, older dogs (OR 0.5, 95% CI 0.2–0.9, p = 0.03) and FRD sighted within 20 m of garbage sites (OR 0.6, 95% CI 0.4–0.9, p = 0.02) were less likely to be in groups. The number of dogs sighted with an FRD decreased with increased resight-probability of that dog (β = −1.0, p < 0.001). The rural FRD with smaller home-ranges were more likely to be sighted alone (OR 2.3, 95% CI 1.0–95, p = 0.04) than those with larger home-ranges. In the urban site, females (OR 1.3, 95% CI 1.1–1.5, p = 0.002) and older dogs (OR 1.5, 95% CI 1.1–2.1, p = 0.07) were more likely to be found in groups, and groups of dogs were more likely to be seen within 20 m of garbage sites (OR 1.7, 95% CI 1.5–2.0, p < 0.001). The distribution of urban FRD sighted alone, in pairs, triads, and in packs of ≥4 dogs were not random in the administrative (p = 0.02), and the two industrial (p = 0.03 & 0.01) survey tracks of the urban site, implying stable groups. The resighting probability of a dog (β = 0.3, p < 0.0001) and presence of garbage within 20 m (β = 0.2, p < 0.0001) in the urban site increased the likelihood of sighting a FRD with other dogs. It is concluded that data on the resighting probability, presence of garbage points, and home-ranges can be utilised to guide the selection of parenteral or oral rabies vaccination to achieve a population vaccination coverage of 70% to break the transmission cycle of rabies virus in FRD in India.

Challenges to human rabies elimination highlighted following a rabies outbreak in bovines and a human in Punjab, India.

In August 2015, a rabies outbreak occurred in bovines in a Punjab village, India; subsequently, a farmer in the same village died of rabies in October 2015. We surveyed farmers to describe the outbreak, the demographics and rabies prophylaxis administered to householders on case farms, and farmers' knowledge of rabies prevention and treatment. We used multiple correspondence analysis to guide investigation of associations between demographics, farm status and rabies knowledge, attitudes and practices. The number of affected bovines was unusually high; 15 cattle and buffalo died on 13 smallholder farms (attack rate 4%). Post-exposure vaccinations were administered to 24 people (median 2 doses). Affected farms had significantly larger households and were more likely to keep their livestock outside (therefore, accessible by stray dogs), suggesting that the impact of the outbreak was disproportionally borne by households of lower socio-economic status. Primary sources of rabies information were friends and neighbours, not health authorities or media. Women who had not received formal education were less likely to have heard of rabies. Although case farm participants were more likely to have heard about rabies from a veterinarian, their knowledge and practices to prevent rabies did not reflect the level expected considering their contact with a health professional; they were more likely to believe that traditional remedies prevent rabies and less likely to tell their children to avoid playing with stray dogs than participants from other farms. This study highlights knowledge dissemination disparities that, if typical of rural locations, could obstruct attempts to eliminate canine-mediated human rabies in India. Therefore, understanding the pervasiveness and influence of traditional medical beliefs on treatment-seeking behaviour, communication structures within villages and the impact of local practices such as carcass disposal on dog populations will be essential to ensure that rabies control strategies are effective in rural India.

An assessment of knowledge of prevention and management of Rabies in interns and final year students of Shri M. P. Shah Government Medical College, Jamnagar, Gujarat

Background: Rabies is one of the most important zoonotic diseases in India. Dogs are the main reservoir of rabies in India. In Southeast Asia, untreated, improperly treated or neglected cases lead to thousands of death yearly. Rabies can be completely prevented through proper management, but once contracted its almost always fatal. Objectives: To assess the knowledge regarding preventive measures, post-exposure prophylaxis, wound management and use of RIG among the interns and final year medical students of Shri M.P. Shah Government Medical College, Jamnagar, Gujarat. Materials and Methods: It is a cross-sectional study conducted in July, 2013. Data was collected using pre-tested questionnaire from 100 interns and final year students of Shri M.P. Shah Government Medical College, Jamnagar, Gujarat. Results: It was seen that only 59% knew that vaccination of dogs was an essential preventive measure, 80% and 68% agreed that pre-exposure vaccination and educating the people regarding pre- and post-exposure prophylaxis were useful, respectively. Also 89% and 59% were aware that wound should be washed immediately and antiseptics should be applied, respectively. 50% and 29% were not aware of the schedule and dose of the PEP, respectively. Only 35% knew about both IM and ID route of administration of PEP. Only 66% were aware that the site of administration of PEP is deltoid. Conclusion: The study showed that there was no proper knowledge about the prevention and management of rabies in the study population which needs to be overcome immediately with proper training.

Providing evidence for effective prevention and control of rabies in India

Providing evidence for effective prevention and control of rabies in India