Monday, December 11, 2023

Man best friend churning out Master of all Terrors

Jamshedpur: Historically Rabies has been known for thousands of years in India. The word Rabies is derived from the Sanskrit ‘Rabhas’ which means �to do violence�. Dog is depicted as a faithful animal and also as a vehicle of death.

In the epic �Mahabharata�, the Lord of Death, Yama,appears in the form of a dog and accompanies King Yudhishtira in his final journey, towards �Swarga�, the abode of gods. India accounts for about one third of the global burden and two thirds of the Asian burden of human rabies. Dogs account for most of these human rabies deaths in India. Rabies is endemic in mainland India.

The main reasons for the deaths due to rabies are large population of stray dogs, poor vaccination coverage of domestic dogs and cats; and incomplete Post Exposure Prophylaxis (PEP) coverage of human victims of dog bite.The landmark Survey conducted in the year 2003 by the Association for Prevention and Control of Rabies in India, under the aegis of the World Health Organization (WHO-APCRI Survey) revealed many interesting and previously unknown facts about the situation in India.

The number of animal exposures per year in India is 17.4 per 1000 population. The current population of India is around 1.27 billion and presently the number of persons getting exposed to animals would be about 22 million every year. Importantly the annual man days lost due to exposures to animals is 38 million.

This is comparable to that due to cardiovascular diseases, which are emerging and have gained importance in a developing country like India.The number of deaths due to Human Rabies is about 20,000 per year in India.. The maximum no. of deaths in the world due to human rabies (36%) are reported from India. The main reasons for human deaths due to rabies are not taking Post Exposure Prophylaxis and use of indigenous forms of treatment instead of modern PEP.The main animal reservoir of Rabies in India is the Dog.

The pet or owned dog population in India is about 28 million and the pet dog is to man ratio is 1:36. (The stray dog population may be 2 to 3 times that of the pet dogs).Due to a high dog: man ratio the incidence of animal bites is high in IndiaThe pet dog care and management practices are not satisfactory and the municipal licensing of pet dogs is inadequate.

Vaccination of dogs and dog population control (ABC programme) have an important part to play in controlling the disease in the animal reservoir. The common animal reservoirs of Rabies, after dogs, are cats, cattle, goats, and pigs and mongoose and jackal among the wild animals. Human Rabies is endemic throughout the mainland and only the islands of Andaman & Nicobar and Lakshadweep are free of Rabies.

Proper wound management, which includes washing of the wounds with soap and water and application of antiseptics, plays an important role as a first aid measure after exposure to an animal and helps in preventing the disease.Association for Prevention and Control of Rabies in India (APCRI), established in 1998, is a Professional Association which is active in the field of Rabies prevention/control in India.

A Pilot project on control of Human Rabies was initiated by the Government of India with a vision to formulate a comprehensive Rabies Control Strategy for nation-wide implementation. This project was started under the supervision of the National Center for Disease Control, New Delhi. Five cities viz. Ahmedabad, Bangalore, Delhi, Madurai and Pune were included under this project.

The introduction of Cell Culture Vaccines in 2005 and IDRV in 2006 and increased use of Rabies Immune globulins in our country seem to have reduced the mortality due to human Rabies .Proper planning, involvement of all stake holders and awareness among the public are necessary to eliminate this killer disease.

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