Rabies - An Indian Perspective

Rabies death is still a fact in India and sadly very little is being done to eradicate it. While eradication of polio is done on a very large scale because it affects the image of the country globally, rabies cases go unnoticed and unregistered. The actual number of rabies death is far more than what is being projected. It is mainly due to lack of attention by the administration towards these cases that we do not get the actual number of death taking place. Once a person shows signs and symptoms of rabies there is no hope for him, death is the only solution. In such circumstances when a person is brought to the hospital the concerned medical workers check whether he is showing signs of hydrophobia by getting a bottle of water near him. If he gets hydrophobic they immediately tell the relatives to take him away to the Infectious Disease Control Hospital. Many of them are simply not taken over there when their relatives realize that there is nothing more that can be done. Hence we see only a small number of cases getting registered each year.

Dog bites is one of the major cause for rabies in India. If you look at the dog bite cases taking place it is not the rich and the affluent who are the victims but mainly the man on the streets. Hence it becomes more important for the authorities to provide him a complete course of vaccine. But what is noticeable in government hospitals all across the country is shortage of these vaccines. They will provide the dog bite victim with a few dose and then will tell him to buy the remaining doses from a private pharmacy. Here lies the problem, many of the victims are daily wage earners and hence don't have money to purchase the vaccines from the pharmacies, they default on treatment and some later on land up with rabies.

The disease is so dangerous that it is not necessary that a person will develop rabies immediately after any animal bite. In some cases victims have developed rabies after a few years. This is because the rabies virus remains dormant in the victims body and once they become active they target the nerves. Once they enter the nervous system no amount amount of medication can help the victim. Death by rabies is very painful.

People have to be educated through public awareness campaigns on the first aid measures after any animal bite. Washing of the wound with soap and running water can wash of much of the virus. It was noticed in one recent survey conducted that people put chilli powder, petrol etc on the wound and in some cases the wound is also burnt to kill the virus. However they fail to realize that once the virus has entered the body only vaccines and immunogloblins can kill the virus before it enters the nervous system.

It is advised by WHO that the first dose of vaccine should be accompanied by rabies immunoglobulin (RIG) when ever there is oozing of blood. RIG offers immediate protection till fourteen days while vaccine offers protections only after 10days. But the usage of rabies immunoglobulins is very less in India. Human RIG are very expensive and most of the doctors are afraid to use Equine RIG for fear of any side effects. However the Equine RIG available in the markets are far safer now with very less chances of any side effects. But unless there is any government directive making the use of RIG mandatory its use in India will continue to remain what it is today.
I hope the government wakes up to this menace and take necessary actions so that we see its eradication.