Published Date: 2012-10-08 17:26:54
Subject: PRO/AH/EDR> Rabies - India (11): public health developments
Archive Number: 20121008.1331293

RABIES - INDIA (11): PUBLIC HEALTH DEVELOPMENTS
***********************************************
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: Mon 8 Oct 2012
From: Merritt Clifton <anmlpepl@whidbey.com> [edited]


re: Rabies - India (10): verbal autopsy mortality estimate 20121007.1329262
-----------------------------------------------
While the authors of this paper caution that their estimate of 12 700 furious rabies deaths in India in 2005 may be low because the verbal autopsy method does not identify deaths with atypical and paralytic symptoms, an estimate projected from 2005 data is almost certainly much too high in 2012, for 2 major reasons:

- The Indian government's Vaccine Institute in Vadodara only stopped producing the old Semple nerve tissue culture vaccine (NTV) at the end of 2004. The existing stocks of the Semple vaccine remained in use until exhausted. Thus, the introduction of the much safer and more effective tissue culture vaccine (TCARV) was not completed until at least midway through 2005.

- The major mechanism for vaccinating street dogs in India is the Animal Birth Control program, managed by the federally funded Animal Welfare Board of India. As of 2005, the national ABC program had been receiving federal subsidies for less than 2 years. According to AWBI chair Major General (Ret.) R M Kharb, the ABC programs are now sterilizing and vaccinating about 150 000 street dogs per year.

Incidentally, the Supreme Court of India on 3 Sep 2012 weighed the ecological and public health role of street animals in a case brought by the nonprofit organization Safai Karmachari Andolan on behalf of the poorest of the poor. Describing itself as "a national movement committed to the total eradication of manual scavenging and the rehabilitation of all scavengers for dignified occupations," Safai Karmachari Andolan extracted data from the 2011 national census to show that of 2.6 million public dry latrines still in use in India, 1.3 million discharge illegally into open drains, 794 000 are cleaned manually by humans, and 497 000 are cleaned entirely by animals, mostly dogs and pigs.

This suggests that while the presence of the dogs and pigs is associated with at least 2 major public health problems, rabies and Japanese encephalitis, the absence of the dogs and pigs could produce some much larger public health problems.

--
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
USA
<anmlpepl@whidbey.com>

[ProMED-mail thanks Merritt Clifton for his commentary on developments in India since 2004 affecting the prospects for control of rabies virus infection.

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1pSH. - Mod.CP]

See Also

Rabies - India (10): verbal autopsy mortality estimate 20121007.1329262
Rabies - India (09): (PB) stray dogs, human, susp. RFI 20120926.1310362
Rabies - China: (ex India) human, exposure unknown 20120921.1304335
Rabies - India (08): (GO) human, 2009 20120916.1296451
Rabies - India (07): (HA) vaccine withdrawn 20120829.1271575
Rabies - India (06): mortality estimates 20120614.1168031
Rabies - India (05): mortality estimates 20120611.1164493
Rabies - India (04): mortality estimates 20120610.1163188
Rabies - India (03): WHO travel alert 20120609.1162367
Rabies - UK (03): (London) ex India, fatal outcome 20120529.1148757
Rabies - UK (02): (London, England) ex India, human, canine 20120524.1143694
Rabies - UK: (England) ex India, human, canine 20120523.1142429
.................................................cp/msp/sh