Prevention and Control of Dog Rabies in India
Dr. Chandra Shekhar Sahukar, Director, www.agrmuseum.in
Rabies – a viral zoonosis– is recognized as a priority disease for global and national level control measures. Key interventions for rabies control include vaccination for high-risk individuals, surveillance of human cases, post-exposure prophylaxis following animal bites, vaccination and/or culling of the canine population and other animal reservoirs.
Over 20 000 people die from rabies each year in India. At least 95 % of people contract rabies from an infected dog. Annual vaccination of over 70 % of the dog population has eliminated both canine and human rabies in many countries including Indian State of Goa. Despite having the highest burden of rabies in the world, there have been very few studies which have reported the successful, large scale vaccination of dogs in India. Furthermore, many Indian canine rabies vaccination programmes had not achieved high vaccine coverage.
Rabies is known since 200 BC, the first rabies case was recorded in Mesopotamian codex of eshnunna. In ancient Greece rabies was supposed to be caused by lyssa , the first epizootic of rabies reported in in Boston in 1768.
Actual cause of rabies was reported by louis Pasteur and in 1885 nerve tissue vaccine was successfully tested by him and it was progressively improved to reduce side- effects.
Here the term rabies derived from the Latin word “rabere” that means “to be mad” and the same in Sanskrit word “Rabhas” means violent. Rabies is a fatal disease that poses a large number of deaths in the present-day world especially in small children, goat kids, calf, pigs, and dogs, here the dog acts as the main source of infection to all the other domestic animals. It is estimated that about 20000 individuals die every year in India especially the children.
Despite the known effectiveness of these interventions, many national policy-makers across India hesitate to introduce them. I argue that this hesitation may be caused by advocacy for technical solutions that do not account for local requirements of policy-makers and implementers. There has been a considerable amount of research on rabies in India, but key questions remain unaddressed. For example, while policy-makers need evidence for social, political and economic outcomes of control programmes, most rabies research is done in the basic sciences. The research–policy disconnect in rabies control and describe how this disconnect contributes to the lack of effective rabies-control policies in India.
Canine vaccination is the suggested strategy of choice towards elimination of rabies at only 10% cost. However, there is little documentation of the expectations of local communities or rabies-control programme managers as to how this strategy would work. The cost of a canine vaccination programme is about 10% than the cost of human post-bite prophylaxis.
Modelling of pilot canine vaccination interventions in India under “National Rabies Control Programme” had showed that a coverage of 70% would have to be sustained over two decades in order for the intervention to be effective. The total cost per year for a national programme of canine vaccination would be about 27% of the total budget of the State Department of Animal Husbandry. In addition, unless accompanied with dog population control, this strategy is not likely to reduce the number of dog bites or the costs of post exposure prophylaxis.
Eliminating rabies in dogs
Rabies is a vaccine-preventable disease. Vaccinating dogs is the most cost-effective strategy for preventing rabies in people. Dog vaccination reduces deaths attributable to rabies and the need for PEP as a part of dog bite patient care.
Awareness on rabies and preventing dog bites
Education on dog behaviour and bite prevention for both children and adults are an essential extension of a rabies vaccination programme and can decrease both the incidence of human rabies and the financial burden of treating dog bites. Increasing awareness of rabies prevention and control in communities includes education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite. Engagement and ownership of the programme at the community level increases reach and uptake of key messages.
Transmission of animal rabies is similar to that of human rabies, with virus-laden saliva from infected animals entering the body through wounds or by direct contact with mucosal surfaces. Following access to the muscle cells at the wound site, peripheral nerves and subsequently the central nervous system, the virus travels retrogradely from the CNS via peripheral nerves to various tissues, most importantly the salivary glands, from which it is shed, completing the transmission cycle. Dog rabies is characterized by clinical manifestations, including changes to normal behavior, such as:
- Biting without provocation
- Eating abnormal items such as sticks, nails, faeces, etc.
- Running for no apparent reason
- Vocal changes (e.g. hoarse barking and growling) or inability to produce sounds
- Excessive salivation or foaming from the mouth
https://ncdc.gov.in/index1.php?lang=1&level=1&sublinkid=146&lid=150
Investment in eliminating the risk of rabies at its source is the most cost-effective measure. Vaccination of at least 70% of dogs in areas at risk is now accepted as the most effective way of preventing human rabies deaths.
As per the Indian Livestock Census-2012 and 2019, the data shows that stray dog population is significantly higher than pet dogs. The pet owners are taking care for vaccination of dog during camp organized during World Rabies Day, however, stray dogs are more vulnerable for rabies.
The stray and feral dogs, which pose serious human health, animal health and welfare problems and have a socio economic, political, and religious problems in many countries. Whilst acknowledging human health is a priority including the prevention of zoonotic diseases notably rabies, the OIE recognizes the importance of controlling dog populations without causing unnecessary or avoidable animal suffering. Veterinary Services should play a lead role in preventing zoonotic diseases and ensuring animal welfare and should be involved in dog population control, coordinating their activities with other competent public institutions and/or agencies.
- The promotion of Responsible dog ownership can significantly reduce the numbers of stray dogs and the incidence of zoonotic diseases.
- Because dog ecology is linked with human activities, control of dog populations has to be accompanied by changes in human behavior to be effective.
Mission Rabies in Goa
The Mission Rabies was started in the year 2013. This year Mission Rabies is again offering the chance for volunteers to join their incredible teams out in Goa, who are working tirelessly to make Goa the first rabies-free state in India. This project is an amazing opportunity to get fully involved in the challenge of mass vaccination; providing lifesaving protection for both the dogs and human communities living within this incredible part of India.
This project is based in the coastal district of Salcete, in South Goa, working in teams across assigned wards to achieve the 70% vaccination coverage needed to create herd immunity. The volunteers are being trained to use their state-of the art epidemiological Mission Rabies App, used to collect vital vaccination and dog population data and to ensure that our work is scientifically robust. They welcomed all types of volunteers to join their teams, whether a vet, vet nurse, student or non-vet, who can play a crucial role in making a difference.
During, 2013, 61,143 dogs vaccinated in just 1 month!
International volunteers from 14 countries joined forces with local dog catchers and vets to make this campaign a huge success, not only protecting so many dogs from Rabies, but increasing awareness and making Rabies a country-wide issue.
Reaching our target of 50,000 dogs in just 25 days, Mission Rabies proved that they can and will make a huge difference in a short space of time. They set themselves a challenge – make Goa a Rabies free state!
Bordered by sea to the East and jungle to the North, South and West, the movement of dogs into and out of the state is limited, making it the perfect location for a state-wide vaccination campaign. In 2014 they also sterilised 20,400 dogs across Goa in a 6 month long campaign. By creating a more stable and healthier dog population, they lay the ground work for incredible future rabies-combating results. They also set up out Rabies hotline, a number that local residents could call to report rabid dog sightings. This allowed their team to locate and remove rabid dogs, and complete a ring vaccination of 200-300 at-risk dogs in the area, stopping the spread of the disease in its tracks. They are covering every 3,702 km of Goa with our catching teams working alongside the WVS sterilization teams. Mission rabies laboratory in Panjim is functioning for enabling them rapid response team to get a fast diagnosis from every dog they pick up. During 2018 Mission Rabies had started off being very busy for their teams in Goa. The education officers work alongside their vaccination teams while Mission Rabies officials engage in government meetings and in strengthening our contacts to local municipalities and panchayats. All Mission Rabies team members are continuously working on spreading their efforts and programmes.
Children are at high risk of dog bites and contracting rabies. Forty percent of reported rabies cases worldwide are children under the age of fifteen. In their project areas, the pediatric proportion is often even higher. Rabies most often persists in poor communities and rural regions of developing countries in Africa and Asia. If the risks are widely understood and appropriate dog bite treatment is well known – rabies is 100% preventable. The financial burden of human treatment is high, control via dog vaccination costs ten times less and protects whole communities. Mass canine vaccination will rid an area of rabies, but this takes time during which communities remain at risk – whilst they work to eliminate the disease, education helped them to save lives. The educational sessions are aimed to empower children, their teachers and their families with the knowledge to protect themselves from bites, preventing rabies and save lives. They also encouraged the members of the public to bring their dogs for vaccination and sterilization, and publicize to response team for humane canine rabies control.
They are creating communities who know how to protect themselves from rabies and who act to support rabies control. In 2013, Mission Rabies vaccination teams delivered education awareness leaflets in 14 cities in India. In 2014, they piloted several teaching methods to children in schools. They studied the impact on under 16’s knowledge, attitudes and behaviour over six months to guide in developing school’s programme. They visited schools in Tamil Nadu, Jharkhand and Goa reaching over 180,000 children and 3,800 teachers. In 2015, they began year-round awareness and education programmes in Goa and Jharkhand in India with permanent education officers. Alongside targeted work in schools, and also delivered outreach with local communities. In 2017, Mission Rabies passed a huge milestone; one million children educated on rabies prevention. Throughout the year, across India and Malawi, their education programmes reached 725,401 children, 19,860 teachers and 130,658 community members. In a 10-day programme in Thanjavur, Tamil Nadu, their own team member, Dr Murugan delivered the life-saving lessons to 15,010 children, 561 teachers and 131 community leaders. Alongside the awareness campaigns in schools. In 2018, Mission Rabies surpassed the milestone of two million children educated and exceeded their target to reach more than 80% of primary schools at our flagship project sites. The successful education campaigns led to reaching 723,687 children, 16,384 teachers and 243,011 community members across areas in India and Malawi.
I was associated with National Rabies Control Programme of NCDC under the Ministry of health and Family Welfare and had attended Meeting in 2018, the School awareness programme for dog rabies in Panaji, Goa.:
I had also prepared and submitted the project for whole India for Mass Dog vaccination and free vaccination of post bite victims, but the Ministry of Health and Family Welfare did not agree for the component of Mass Dog Vaccination, as it is a component of Department of Animal Husbandry, New Delhi. As it is not an economic activity, the DAHDF is not interested in this component like Mission Rabies in Goa for the entire Country. The Hon’ble PM had launched “National Animal Disease Control Programme” (NADCP) in the month of October, 2019 which focused on the vaccination of FMD and Brucellosis for the entire country. There is an urgent need to include dog vaccination for Rabies also, which would reduce the human deaths in India and eliminate rabies by the end of 2030.
The state-wise animal-bite data is collected by IDSP of National Centre for Disease Control, New Delhi and it is increasing significantly. During 2012, the All India animal-bite number was 4252392, which significantly increased to 6878845 during 2017. The death due to rabies is also underreported and actual data is not available. This year’s World Rabies Day theme is: “Rabies: Facts, not Fear”.
If, it is not possible to include dog rabies vaccination programme under NADCP, there is an urgent need to modify through One Health approach for “National Project for Control of Rabies” based on the success stories of Mission Rabies, Goa, on aspects for prevention and control of Rabies in dogs and post-bite vaccination of humans.
https://www.pashudhanpraharee.com/control-and-eradication-of-rabies-in-india-2/
