Only a sixth of animal bite victims in India get antirabies treatmentBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6040 (Published 07 October 2013) Cite this as: BMJ 2013;347:f6040
India has the world’s highest incidence of rabies and 20 000 of the 55 000 deaths from rabies each year. An estimated 17.4 million animal bites occur in India every year, but 95% are from dogs, of which the country has some 25 million.1
Only three million bite victims receive appropriate post-exposure prophylaxis (PEP), including wound cleansing, vaccination, and administration of immunoglobulin if needed.2 Death from rabies, which is endemic across the nation, can be averted with timely PEP.
During its 11th five year plan the Planning Commission of the Government of India carried out a pilot project on prevention and control of rabies in five cities and identified a lack of organised rabies control projects and a limited availability of PEP in rural areas, where most cases occur.1
After the success of the pilot project in improving management and awareness the working group hopes to extend the programme nationally during the 12th five year plan (2012-17). It is hoped this will include vaccinating dogs in 30 cities and improving PEP and treatment facilities in rural and semi-urban areas.
Mysore K Sudarshan, a member of the World Health Organization’s Expert Advisory Panel on Rabies and president of the Rabies in Asia Foundation, told the BMJ that the high number of rabies deaths in India made prevention a priority. He said that it was important to promote the use of rabies immunoglobulin and to extend intradermal rabies vaccination for PEP. He also mentioned the importance of a mass dog vaccination programme.
In the United States and in South American countries sustained government efforts, particularly to vaccinate dogs, have much reduced the incidence of rabies, and these countries look set to eliminate rabies transmitted by dogs by 2015.3
In August “Mission Rabies,” an initiative by the UK based World Veterinary Services in association with the Blue Cross of India, embarked on a programme to vaccinate two million dogs in India over the next three years.4 The president of Mission Rabies, S Chinny Krishna, said that over 60 000 dogs had been vaccinated between 30 August and 28 September in 14 locations across the country. Vaccination coverage of 70% is required to ensure herd immunity. The group has the full support of India’s Animal Welfare Board and is looking to extend its efforts to as many cities as possible.
Cite this as: BMJ 2013;347:f6040
bmj.com Feature: Rabies: beware of the dog (BMJ 2013;347:f5912, doi:10.1136/bmj.f5912)