Rabies epidemiology and control in India: a review.

Rabies, though a disease of low public health priority, still continues to be a major public health problem in India. In humans, rabies is almost invariably fatal once clinical symptoms have developed. WHO reports around 50 000 rabies deaths every year, out of which 20 000 are estimated to occur in India alone. There is often gross under-reporting of human rabies deaths in India. Despite potent anti-rabies vaccines and immunoglobulins available, rabies is far from control and elimination. An effective strategy for control of rabies takes into account the epidemiology of animal bites, rabies and factors influencing post exposure treatment. Hence it becomes pertinent to review the current status of rabies and strategies for its control in the country. In this article, an attempt has been made to discuss the epidemiology of Rabies, pathogenesis, diagnosis and its prevention and control including the various regimens of anti-rabies vaccines and immunoglobulins available for post-exposure prophylaxis. The importance of primary preventive measures like Animal Birth Control (ABC) and vaccination of dogs has also been highlighted. It is emphasized that rabies should be recognized as priority public health problem and cell culture vaccines should be made available free of cost at all government health facilities. Other important measures include generation of awareness about rabies and first aid of animal bites.