WRD activities in Delhi

19 Sept 12

This year in Delhi, World Rabies Day will be marked by a full two weeks of events from 16^th Sept. to 30^th Sept. Several key messages about rabies in India will be publicized.  An estimated 17 million animal bites occur annually in India, with 91.5% from dogs, 40% of which are pets. These bite injuries result in about $25 million and 38 million person-days lost every year. About 70% of animal bite victims being children younger than 15 years, and the majority of deaths due to rabies are people of poor or low-income socioeconomic status.

Dr A. K. Gupta, who is coordinating the WRD activities, sees that not just the public, but also doctors need to increase their knowledge of rabies and it management. The key to survival of a rabies exposure is administration of correct post-exposure prophylaxis (PEP) as soon as possible, as there is no treatment available once symptoms start. However, only 2.1% of bite victims in India receive Rabies Immunoglobulins (RIGs), despite RIG being a life-saving drug for category III rabies exposures. In Delhi this can be improved, as private practices can supply the more costly human RIG, but if the patient cannot afford this, equine RIG is available free of charge at government hospitals.

Myths about rabies and it treatment prevent people seeking proper medical care, and many still believe that PEP consist of a series of very painful injections in the abdomen (with the old Nerve tissue vaccine). Scratches and licks on open wounds or mucous membranes are often not regarded as rabies exposures, which endangers people’s lives. In India, many incorrect practices of animal bite management still persist, especially in rural areas. These include the application of turmeric, salt, ghee, chilies, hydrogen- peroxide and cow dung to the wound, and a belief that washing the wound actually causes hydrophobia. The belief that witchdoctors, herbal extracts, gems and stones, a change in diet or religious practices can prevent rabies stops people seeking effective treatment. Even around vaccination, inaccurate beliefs can hamper treatment as people believe that one vaccination dose is sufficient, or that that dietary or other activities can reduce the effectiveness of vaccination.

The events set to challenge these misunderstandings scheduled for around WRD are diverse and include: - a rabies awareness program for school and college students, Medical, Nursing and other paramedical students, trainee health workers, health inspectors and representatives from pharmaceutical companies.

- 2 launchings of Dr Gupta’s book “Rabies – the worst death”
- a Seminar with Indian Medical Association - Delhi North Zone Branch.
- rabies education displays on rickshaws will tour the areas and distribute leaflets and pamphlets on rabies.
- a dog walk with participants wearing T-shirts and caps with rabies control slogans.
- large, road-side hoardings in places across Delhi.
- a press release to address awareness among lay persons, and radio and TV shows on rabies.
- the launch of a Rabies Pre-Exposure program.
- an exhibition on Rabies, stickers and posters to increase awareness.
- the distribution of dispensing envelopes with WRD messages for chemists and other shopkeepers to use.

Contributed by Dr A.K. Gupta, a private medical practitioner in Delhi, and Joint Secretary of the Association for Prevention and Control of Rabies in India (APCRI)