Published Date: 2011-05-17 19:40:39
Subject: PRO/AH/EDR> Rabies - India (04): (AP) canine, human
Archive Number: 20110517.1500
RABIES - INDIA (04): (ANDHRA PRADESH) CANINE, HUMAN
***************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Sun 15 May 2011
Source: The Times of India [edited]
http://timesofindia.indiatimes.com/city/hyderabad/Woman-dies-of-rabies-in-Rajahmundry-third-dog-bite-victim-in-a-week/articleshow/8350036.cms
Close on the heels of deaths of 2 persons due to dog bites, another
woman died of rabies in the government general hospital here
[Rajahmundry] on Sunday [15 May 2011]. Worried over the escalating
deaths due to dog bites, the state government has set up a 5-member
committee to study the situation even as it acknowledged that the
hospital was facing a severe shortage of anti-rabies vaccine for
treating the patients.
The 60-year-old woman, a resident of the Municipal Colony in
Rajahmundry died in the early hours of Sunday [15 May 2011]. She was
bitten by a street dog 2 months ago and treated at AP [Andra Pradesh]
Vaidya Vidhana Parishad Hospital, Rajahmundry. But, a few days back,
she was admitted to the same hospital for treatment. She was referred
to GGH [Government Hospital] on Saturday afternoon [14 May 2011] and
she died later. It may be recalled that 2 persons had died in the
government hospital on Saturday [14 May 2011] due to dog bites.
With 3 deaths in a week, the government has roped in 5 experts to
take stock of the situation. Health secretary PV Ramesh told newsmen
in Hyderabad that there was a shortage of anti-rabies vaccine in the
GGH, Rajahmundry. He said action would be initiated against the
medical superintendent.
"Efforts are on to set up special counters in both Kakinada and
Rajahmundry hospitals to ensure vaccines for dog bite victims," he
said.
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
[This press report attributes the deaths of these 3 patients to
deficiencies in the availability of post-exposure treatment. The
magnitude of the problem has been reviewed recently by P Chatterjee
(Bull World Health Organ. 2009; 87(12): 890-1;
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2789368/) from which
escerpts are quoted below.
India accounted for 36 percent of the world's rabies cases (mainly
canine in origin). Currently, approximately 500 000 are given
post-exposure vaccination each year (35 percent to 40 percent of these
are children) consisting of cell-based vaccine administered through
government centers.
The federal government has also adopted national guidelines in favour
of intradermal vaccination, whereby a smaller quantity of vaccine is
injected into the outer layer of the skin and costs 60-80 percent less
than the USD 40-50 paid for intramuscular vaccination. This is an
important consideration in contexts where the cost of treatment is met
in part -- if not fully -- by the patient. 8 out of India's 28 states
and 7 federally administered Union Territories have announced plans to
introduce intradermal regimens this year [2009]. Finally, according to
government statistics, India is currently producing just under 15
million doses of human rabies vaccine and just over half a million
vials of equine rabies immunoglobulin annually -- quantities that meet
the national requirement.
Meanwhile the government is doing more to promote rabies awareness
with initiatives such as a pilot project to prevent human rabies
deaths launched by the National Centre for Disease Control (NCDC) --
formerly the National Institute of Communicable Disease -- in 2008 in
5 Indian cities. The pilot includes training of health professionals
in animal-bite management and raising public awareness about the need
to seek post-exposure treatment, notably through posting messages on
buses and in other public places.
In the longer term, control of rabies in the canine population may be
the best solution.
Rajahmundry is a city and municipal corporation of the Andhra Pradesh
state in India. It is located 400 km (249 mi) east of the state
capital, Hyderabad. The HealthMap/ProMED-mail interactive map of India
can be accessed at http://healthmap.org/r/0QOQ. A map of the states
of India showing the location of Andhra Pradesh can be accessed at
http://www.mapsofindia.com/maps/india/india-political-map.htm. -
Mod.CP]
See Also
Rabies - India (03): (TN), dog control, human 20110421.1249Rabies - India (02): (MZ) canine control, human exposure
20110407.1088
Rabies - India: (AP) canine, human exposure 20110102.0018
2010
----
Rabies, canine, human - India (03): (MI) 20101018.3780
Rabies - USA: (VA) ex India, 2009 20101003.3585
Rabies, animal, human - India (02): (GA) 20100720.2431
Rabies, animal, human - India: (HR) 20100629.2164
Rabies, canine, human - India: (JD) susp, RFI 20100228.0666
2009
----
Rabies, human, animals - India: (HP), susp. RFI 20091119.3991
Rabies, human, control - India (TN) 20090422.1511
Rabies, human - UAE ex India 20090220.0723
2008
----
Rabies, vulture die-off - India (02): link susp. 20080818.2576
Rabies, vulture die-off - India: link susp. 20080817.2554
2007
----
Rabies, canine, bovine - India: (Kerala), susp. 20071115.3708
2006
----
Rabies, human, canine - India (Kerala) 20060427.1230
Rabies - India (Manipur) 20060324.0909
2005
----
Rabies, human, bovine - India (Kerala) 20051121.3382
Rabies, human, dog - UK (England) ex India (02) 20050729.2208
Rabies, human, dog - UK (England) ex India 20050723.2125
2004
----
Rabies, human - Germany (ex India) 20041112.3054
2003
----
Rabies and vulture die-off - India 20030207.0329
2000
----
Rabies, wolf - India (Karnataka) 20000623.1033
Rabies virus challenge model - India (02) 20000221.0231
Rabies virus challenge model - India: RFI 20000218.0220
.................................................sb/cp/mj/jw