Rabies, a Vaccine Preventable Disease: Current Status, Epidemiology, Pathogenesis, Prevention and Control with Special Reference to India

Abstract

Rabies is a fatal viral zoonosis caused by lyssavirus. It affects warm blooded animals and humans. It is more prevalent in Asia, Africa and the Latin American countries. Although the exact magnitude of the disease is not reliably known, some studies estimated that 174 lakh persons are bitten by dogs and approximately 20,000 persons succumb to the disease annually. Global Alliance for Rabies Control estimated annual economic losses because of rabies in India is more than 2000 US dollars, mostly due to premature deaths, cost of vaccines, lost income for victims of animal bites and other costs. In spite of policies aimed for elimination of rabies, the same continues its reign as the most feared among the incurable human diseases, having rare declining trend. Being a neurotropic virus with variable incubation period within the host, death becomes inevitable once the pathogenesis has started with discernible clinical symptoms. Prompt diagnosis of the suspected cases is indispensable for effective cure and control of rabies. The diagnostic procedure recommended by OIE and FAO is direct fluorescent antibody test (dFAT). More than 3 million vaccine units are used annually as post-exposure prophylaxis in India. Both pre-exposure and post-exposure prophylactic vaccines for humans and animals are available for control and prevention of rabies. A greater impetus aimed for enhanced awareness of the disease, improvements in diagnosis and regular vaccination of target species shall hopefully free the globe from dog-mediated human rabies by 2030.