CONTROLLING OF RABIES BY ONE HEALTH APPROACH
R S. Kathiravan and A. Varun
Post Graduate Research Institute in Animal Sciences, Kattupakkam,
Chengalpattu, Tamil Nadu
One Health approach is working at the local, regional, national, and global levels to achieving optimal health outcomes recognizing the interconnection between people, animals, plants, and their eco system. Rabies is an incurable viral disease and had high rate of fatality among all zoonotic diseases. Throughout the world, approximately 55,000 peoples were died due to rabies in every year. Even though rabies is a preventable disease, the impact of disease increased day by day in developing and developed countries. Before planning and implementation of control measures, we have to understand the epidemiology of the disease. Rabies has sylvatic and non-sylvatic cycles of transmission. So it require specific, strategic approaches to prevent control rabies with one health concept.
Problems
Even though incidence of rabies is high and the effective preventive strategies are recommended, very few states in India have follow the organised rabies control programme. However, most of these control programme have been implemented on a small scale by non-government organisations (NGOs) or municipalities with limited capacities to reach out to larger populations. Roughly 95% of reports on human rabies cases due to dog bites and 5 % cases are due to interactions with other animals. Major problem is unawareness among people, carelessness in getting vaccination even after bite, pet vaccination and etc.
Rabies in universe
Rabies is seen distributed in all over world, but in Australia and Antarctica no report of dog mediated rabies. Many countries have been declared as rabies free but, still the rabies is a major problem in many Asian and African countries. Bangladesh and India have reported as highly prevalent and Nepal, Myanmar, Bhutan, Thailand, and Indonesia have reported as moderately prevalent in rabies. Among world canine rabies, around 55% of the canine cases are reported in Asian countries.
One health approach
By implementing “One Health Approach” strategies, rabies can be obviate and managed effectively.
Data and effective surveillance
First stage of One Health approach is to reveal the status and severity of the diseases through available documented data. This information about rabies cases will be useful to frame the strategies or control programs at national level. By regular reporting methods, evaluation of periodic progress, endemic and sporadic status of disease, and their socioeconomic impact is analysed effectively. Collected data and analysed data reports will facilitate the identification problems leading to develop the management plan of action. Sharing of information collected about rabies throughout the world is more important in one health approach. Improper data collection, analysis and reports will increase the false information and it’s directly affect the creation of disease control management
Collection of data and analysis to be done in both human, domestic and wild animal cases. The surveillance and control programs of rabies requires extension up to wildlife so that any incidence of rabies from wildlife to domestic animals and humans could be checked effectively. A single hand will not produce the sound, so collaboration with all countries are more important for effective rabies control.
Availability of vaccines
The only ways to prevent the human rabies is get vaccination after dog bite. The major problem in rabies control is to reach the vaccination at correct time. To reach the vaccine from government and non-government medical centres is easy in urban areas. However in rural areas, vaccines are not easily available because of many reasons. Mostly urban areas are considered to create the all medical care facilities and this directly or indirectly influence the rural areas to get all medical facilities. To control human rabies, ensure availability of vaccine at all time especially in rural areas.
Vaccination
Majority of the human rabies cases are due to dog bitten, so vaccination of pet is a key factor to control the rabies. As per guidelines of World Organization for Animal Health (OIE) and World Health Organization (WHO), vaccination of 70% or more dog population can speedily reduce the incidence of rabies. Hence, mass vaccination programme of dog is one of the major principle methods to controlling rabies in both human and animal population. Post bite vaccination also more important in both human and animals. To control rabies in wild animal, large scale oral vaccination was practiced in Canada, unites States and Europe. The oral rabies vaccine (ORV) having bait can be deposited in wild animal zone, inside national parks and wildlife reserve centres and forests. It may be helpful to reduce transmission of rabies from wildlife to livestock to humans and vice-versa. To increase the success of this vaccination strategies, proper registration, confinement, and compulsory vaccination of domesticated and stray dogs is necessary.
Reasons for vaccination failure
Vaccination is one of the most important measures of rabies control. Both vaccine quality and efficacy play an important roles in successful rabies control programs. The reasons for vaccine failure,
- Not maintain the cold chain storage facility.
- Improper method of vaccine transportation.
- Handling in addition to manufacturing defects.
- Using vaccine after got expiry.
- Not follow the vaccination schedule protocol especially post bite vaccination.
- Wrong route of administration.
- Vaccines administered below the standard can fail to invoke immunity.
Increasing awareness about rabies
The lack of awareness about rabies might be due to many reasons including socioeconomic issues, low literacy rate, and the failure of rabies to get a priority disease status.
The following strategies may increase the awareness about rabies.
- Public awareness programme in where the number of rabies cases more.
- Mass vaccination programme for human and animals.
- Start the awareness programme by educating school students about rabies.
- Creating awareness by distributing pamphlets, short video clips, designed meme images etc.
- Educate the peoples regarding do’s and don’ts in rabies bite.
| S.No | Do;s | Don’ts |
| 1 | Visit a doctor immediately after got bitten by dog or other animals | Don’t do self treatment after bitten and Don’t take self medication |
| 2 | Rinse the wound under tap water with soap immediately. | Don’t clean the bitten wound every 3 hours once |
| 3 | To find out the history of bitten dog from owner regarding rabies vaccination | Don’t apply irritant antiseptics solutions over the wound. |
| 4 | Get vaccination as per post bitten vaccination schedule without fail. | Don’t close the bitten wound by clothes / bandages. |
| 5 | Wash your hands after handling, feeding or cleaning pets | Don’t apply sand, dung, turmeric, salt, ghee and lime on the wound |
| 6 | Make sure your pet get all vaccination as per veterinarian guidelines | Don’t kill the bitten dogs. |
| 7 | Educate your children about rabies and how to take care of your pets. | |
| 8 | Advise to monitor the bitten dog health status especially for rabies. |
Laboratory facilities and research activities
Improvement of diagnostic potential is possible through well-equipped laboratories. Development of rabies diagnostic laboratory in each districts of state. In this laboratory, staffs are regularly trained with latest techniques. Availability of laboratory should be popularised among the peoples. Make sure communication with all hospitals to get rabies samples. Conducting this research might be a very good starting point for formulation of integrated multi-disciplinary .rabies management strategies. Research is needed to access the magnitude of rabies infections, sensitivity and specificity of the diagnostic tests, environmental aspects of rabies management etc.
Conclusion
Many control measures are designed to eradicate the rabies from world with the concept of Zero human rabies death by 2030. However, due to lack of multi-sectorial management approaches on rabies control still the rabies cases have not reduced. In this, we suggest a “One Health Approach” is the most effective method to control rabies by tie-up with other countries.
