Rabies elimination policy guidelines: Where do we stand?
Keywords:Humans Rabies, Immunologic Factors, Rabies Vaccines, Rabies Immunoglobulins, India
Introduction: Rabies is one of the Neglected Tropical diseases. India accounts for 35% of rabies-related human deaths globally. Despite effective preventive and control strategies, India hasn't been able to eliminate rabies. Methodology: A narrative review was done by comparing various policies and programmes related to rabies control and elimination in India and other countries, and the gaps persisting in the Indian guidelines and its implementation were assessed. Results: There are multiple gaps in the Indian programme implementation ranging from multiple stockouts of vaccines, unavailability of rabies immunoglobulin, and lack of a robust surveillance system to lack of refreshing training of the health staff. Recommendations: For effective implementation, the population should have increased awareness, with increased production and an effective supply chain of vaccines and immunoglobulins. There should also be a robust surveillance system with periodic refresher training of the health staff.
Integrated Disease Surveillance Programme: Training manual for veterinary consultants under IDSP; 2015. Available from: https://idsp.nic.in/showfile.php?lid=3793
World Health Organisation. Rabies factsheets [Internet]. Updated 2023 Jan; last accessed on 25/09/2023. Available from: https://www.who.int/news-room/fact-sheets/detail/rabies
Communicable Disease Network Australia. Rabies Virus and Other Lyssavirus (Including Australian Bat Lyssavirus) Exposures and Infections?: CDNA National Guidelines for Public Health Units. Australia; June 24, 2022. 28. Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/ED62D139B56F7B80CA257BF0001B7422/$File/ABLV-rabies-song-gl-June2014.pdf
Briggs D, Bourhy H, Cleaveland S, Cliquet F, Ertl H, Fayaz A, et al. WHO expert consultation on rabies. World Health Organization - Technical Report Series. 2005. Available from: https://apps.who.int/iris/bitstream/handle/10665/85346/9789240690943_eng.pdf;jsessionid=04BF4F26290C3A9E5B61940305CF4EE6?sequence=1
Sudarshan, M. K., Madhusudana, S. N., Mahendra, B. J., Rao, N. S., AshwathNarayana, D. H., Abdul Rahman, S., Meslin, F.-, Lobo, D., Ravikumar, K., &Gangaboraiah (2007). Assessing the burden of human rabies in India: results of a national multi-center epidemiological survey.IJID : official publication of the International Society for Infectious Diseases. 2007;11(1):29–35. https://doi.org/10.1016/j.ijid.2005.10.007
Radhakrishnan S, Vanak AT, Nouvellet P, Donnelly CA. Rabies as a public health concern in India?a historical perspective. Trop Med Infect Dis. 2020;5(4):1–23. https://doi.org/10.3390/tropicalmed5040162
World Health Organisation. Stimulus package for eliminating dog-mediated human rabies[Internet].Dated 2016 Dec; last accessed on 25/09/2023. Available from: https://www.who.int/ publications/i/item/WHO-HTM-NTD-NZD-2016.6
Yamada A, Makita K, Kadowaki H, Ito N, Sugiyama M, Kwan NCL, et al. A comparative review of prevention of rabies incursion between japan and other rabies-free countries or regions. Japanese Journal of Infectious Diseases. 2019;72(4):203–210. https://doi.org/10.7883/yoken.JJID.2018.431
Yamamoto K, Ujiie M, Noguchi A, Kato Y, Fujiya Y, Mawatari M, et al. Rabies post-exposure prophylactic vaccination for returning travelers to Japan. J Infect Chemother [Internet]. 2019;25(12):931–5. Available from: https://doi.org/10.1016/j.jiac.2019.05.004
Government of Canada. Canadian Immunization Guide[Internet]. Updated 2015 Jan; last accessed on 25/09/2023. Available from: https://www.canada.ca/en/public-health/services/publications /healthy-living/canadian-immunization-guide-part-4-active-vaccines/page-18-rabies-vaccine.html
Rosatte RC. Rabies in Canada: History, epidemiology and control. Can Vet J. 1988;29(4):362–5.
Freuling CM, Hampson K, Selhorst T, Schröder R, Meslin FX, Mettenleiter TC, et al. The elimination of fox rabies from Europe: Determinants of success and lessons for the future. Philos Trans R Soc B Biol Sci. 2013;368(1623):1-13. https://doi.org/10.1098/rstb.2012.0142
National Centre for Disease Control. National Action Plan for dog-mediated Rabies Elimination by 2030. [India]; 2021. Available from: https://www.awbi.in/awbi-pdf/NationalActiopPlan.pdf
Benavides JA, Megid J, Campos A, Rocha S, Vigilato MAN, Hampson K. An evaluation of Brazil’s surveillance and prophylaxis of canine rabies between 2008 and 2017. PLoS Negl Trop Dis. 2019;13(8):1–16. https://doi.org/10.1371/journal.pntd.0007564
National Centre for Disease Control. National Rabies Control Programme[Internet].Dated 2018;last accessed on 25/09/2023. Available from: https://ncdc.gov.in/index1.php?lang=1&level=1& sublinkid=146&lid=150
Suraweera W, Morris SK, Kumar R, Warrell DA, Warrell MJ, Jha P. Deaths from Symptomatically Identifiable Furious Rabies in India: A Nationally Representative Mortality Survey. PLoS Negl Trop Dis. 2012;6(10):e1847 https://doi.org/10.1371/journal.pntd.0001847
John D, Royal A, Bharti O. Burden of illness of dog-mediated rabies in India: A systematic review. Clin Epidemiol Glob Heal [Internet]. 2021;12:100804. Available from: https://doi.org/10.1016/j.cegh.2021.100804
Shankaraiah RH aradanahall., Rajashekar RA nnadan., Veena V, Hanumanthaiah AN arayan. D. Compliance to anti-rabies vaccination in post-exposure prophylaxis. Indian J Public Health. 2015;59(1):58–60. doi: 10.4103/0019-557X.152867
Sudarshan MK, Haradanhalli RS. Facilities and services of postexposure prophylaxis in anti-rabies clinics: A national assessment in India. Indian J Public Health. 2019;63:S26–30.doi: 10.4103/ijph.IJPH_367_19.
Haradanhalli RS, Anwith HS, Pradeep BS, Isloor S, Bilagumba G. Health-seeking behavior and compliance to post exposure prophylaxis among animal bite victims in India. Indian J Public Health. 2019;63:S20–5.doi: 10.4103/ijph.IJPH_364_19.
Wilde H. Acute demyelinating encephalomyelitis due to neural antirabies vaccine. J Travel Med. 2008;15(3):206.
Penjor K, Marquetoux N, Dorji C, Penjor K, Dorjee S, Dorjee C, et al. Evaluation of post-exposure prophylaxis practices to improve the cost-effectiveness of rabies control in human cases potentially exposed to rabies in southern Bhutan. BMC Infect Dis. 2020;20(1):1–12.
Buchy P, Preiss S, Singh V, Mukherjee P. Heterogeneity of rabies vaccination recommendations across Asia. Trop Med Infect Dis. 2017;2(3):1-17.
Lau C, Sisson J. The effectiveness of intradermal pre-exposure rabies vaccination in an Australian travel medicine clinic. J Travel Med. 2002;9(6):285–8.
Dhaduk KM, Unadkat S V., Katharotiya PR, Mer AR, Chaudhary MC, Prajapati MM. Case profile, volume analysis, and dropout rate of antirabies vaccination regimens among animal bite victims in Gujarat. Indian J Public Health. 2016;60(4):268–72.
Abbas SS, Kakkar M, Rogawski ET. Costs Analysis of a Population Level Rabies Control Programme in Tamil Nadu, India. PLoS Negl Trop Dis. 2014;8(2):2721.
Sudarshan MK, Ashwath Narayana DH, Jayakrishnappa MB. Market mapping and landscape analysis of human rabies biologicals in India. Indian J Public Health. 2019;63:S37–43.
Sreenivasan N, Li A, Shiferaw M, Tran CH, Wallace R, Blanton J, et al. Overview of rabies post-exposure prophylaxis access, procurement and distribution in selected countries in Asia and Africa, 2017–2018. Vaccine. 2019;37Suppl1(1):A6–A13.
M V S, Culas R. Cost Analysis of Post Exposure Prophylaxis of Rabies in A Tertiary Care Centre- A Cross Sectional Study. IOSR J Dent Med Sci. 2014;13(12):08–12.
Fan L, Zhang L, Li J, Zhu F. Advances in the progress of monoclonal antibodies for rabies. Hum Vaccines Immunother [Internet]. 2022;18(1):1–8. Available from: https://doi.org/10.1080/21645515.2022.2026713
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