APCRI Journal (E-ISSN: 0973-5038)

Vaccinating 60 Million Dogs Annually or 25 Million Newborns – Indian Dilemma

Omesh Kumar Bharti — 2024-06-29

How to cite this article:
Bharti O K. Vaccinating 60 Million Dogs Annually or 25 Million Newborns – Indian Dilemma. APCRI J. 2024;26(1):1-2.

DOI: https://doi.org/10.24321/0973.5038.202402

A Descriptive Study on Obesity and Animal Exposure Cases attending an Anti-Rabies Clinic, Tertiary Care Hospital, Urban Bengaluru

Ramesh Masthi NR — 2024-06-29

Introduction: India is endemic for rabies and at the same time, obesity is assuming an epidemic proportion. There is a need to find out proneness of animal bites among overweight/ obese people as they are less agile and mobile.
Objective: To determine the proportion of obesity among animal exposure cases and compare the type and severity of exposure between obese and non-obese cases.
Methodology: A descriptive study was conducted among 287 animal exposure cases visiting the anti-rabies clinic of a tertiary care hospital from June to December 2023.
Results: Of the cases, 185 (64.5%) cases were overweight/ obese. Majority (88.7%) of bites were by dogs, 63.3% were by stray animals, and 62.8% were unprovoked bites. All the category II and category III cases had received post-exposure prophylaxis.
Conclusion: The majority of the cases were overweight/ obese and had category III exposures. There was no significant difference in animal exposure between obese and non-obese cases.

How to cite this article:
Ramesh Masthi N R, Niveditha C S, Deekshith J R, Sanjay T V, Pranav Srivatsav R . A Descriptive Study on Obesity and Animal Exposure Cases Attending an Anti-Rabies Clinic, Tertiary Care Hospital, Urban Bengaluru. APCRI J. 2024;26(1):3-8.

DOI: https://doi.org/10.24321/0973.5038.202403

Post-Exposure Prophylaxis in Animals: Insight on Biting Animals, Nature of Bites and Comparative Cost Analysis of Intradermal and Intramuscular Routes of Administration

Anil Kumar Sharma — 2024-06-29

Introduction: Rabies is an almost 100% fatal zoonosis and is only preventable through proper vaccination. Dogs are considered the main reservoirs (97%) of this disease. Vaccine supply for dogs is a global concern.
Methods: A comparative cross-sectional observational study analyzed the costs involved in the Rabies Control Programme in the Rampur Bushahr area, with intradermal (ID) immunization as an alternative to the standard intramuscular (IM) route for post-exposure prophylaxis (PEP).
Results: The study suggested achieving a similar immunogenicity and efficacy with five times less dosage compared to previous studies. This reduces the expenses of dog owners on vaccination costs by 5 times compared to intramuscular rabies vaccination (IMRV). Other miscellaneous and one-time expenses remain the same for intradermal rabies vaccination (IDRV) and IMRV regimens. It was seen that animal-to-animal bites are mainly through dogs (92.5%), followed by leopards, monkeys, and other wild animals, with lacerated wounds being the most common type (68.5%), followed by multiple wounds, abrasions, and puncture wounds.
Conclusion: The total cost incurred for PEP in the IDRV group was 13.6% less compared to the IMRV group.

How to cite this article:
Sharma A K, Bharti O K, Panda K A, Sharma J, John D, Isloor S. Post-Exposure Prophylaxis in Animals: Insight on Biting Animals, Nature of Bites and Comparative Cost Analysis of Intradermal and Intramuscular Routes of Administration. APCRI J. 2024;26(1):9-17.

DOI: https://doi.org/10.24321/0973.5038.202404

Management of Animal Bite: A Challenge to Health System – A Case Report

Rohit Katre — 2024-06-29

Background: Anti-rabies vaccine (ARV) and rabies immunoglobulin are given as post-exposure prophylaxis in animal bite cases to prevent the fatal disease of rabies. In most cases, especially category III bite cases, these need to be administered. Here we have reported case of animal bite presented at a rural health center.
Case Description: A 33-year-old female visited a Center for Rural Health AIIMS (CRHA) on July 22, 2023, with a complaint of a dog bite on the right arm and right ring finger 1 day back. Though the patient had washed the site of the bite under running water, she gave a history of applying turmeric paste. There was pain and swelling at the bite site along with a history of bleeding from bite sites.
Management: Post-exposure prophylaxis following intramuscular Essen regimen was prescribed based on the category of bite (category III). Tetanus toxoid 0.5 ml IM was administered. Symptomatic treatment was given for pain and swelling. The patient was referred for human rabies immunoglobulin (HRIG) as it was not available at CRHA. The patient could receive the first 3 doses of ARV but due to limited availability, she was referred for further doses.
Conclusion: The case report highlights the need for the provision of ARV and HRIG at health centers since the out-of-pocket expenditure is high.

How to cite this article:
Katre R, Singh P, Yadav P, Bhadoria A S, Aggarwal P. Management of Animal Bite: A Challenge to Health System – A Case Report. APCRI J. 2024;26(1):18-21.

DOI: https://doi.org/10.24321/0973.5038.202405

Should Rabies Vaccination in the Gluteus Muscle be Treated as Unimmunized? - A Case Report

Vrinda Lath — 2024-06-29

Rabies is a fatal disease with almost 100% mortality, with the recommended mainstay of management being preventive, postexposure prophylaxis, and mass dog vaccination. In India, there have been many reports of failure of post-exposure prophylaxis, often due to administration, vaccine quality, and storage. One of the contributing factors is the gluteal administration of rabies vaccine. Here we discuss a case of a partially vaccinated child presenting on day 3 following a category 3 bite, with the first two doses administered intramuscularly in the gluteal region. This case highlights a conundrum faced by clinicians who often encounter partially vaccinated patients, which in this case was treated similarly to an unvaccinated case as the route of previous doses was gluteal.

How to cite this article:
Lath V, Sirur FM, Ramya, Bharati OK. Should Rabies Vaccination in the Gluteus Muscle be Treated as Unimmunized? - A Case Report. APCRI J. 2024;26(1):22-24.

DOI: https://doi.org/10.24321/0973.5038.202401

Dr Henry Wilde

Omesh Kumar Bharti — 2024-06-29

The night of June 6, 2024, was difficult for me as I got a message on Skype from the wife of Dr Henry Wilde that he had passed away in the morning at 7:30 a.m. I paid my homage to him and went into thinking mode.
Dr Henry Wilde, a pioneer in the field of rabies, was born in Prague, Czechoslovakia in 1927. Life changed for him as a teenager with the German invasion of the Czech Republic during World War II. I had been in touch with him for over a decade to collaborate on the low-cost protocol for dog bite treatment. It was humble of him to have supported me from beyond the borders in the interest of humanity. He was so concerned and down to earth that he even came to pick me up at Bangkok airport when I flew there for a World Health Organization (WHO) conference on March 19, 2018. That was my first meeting with him and it brought us closer as collaborators in research.