APCRI Journal (E-ISSN: 0973-5038)

FROM THE EDITOR’S DESK

2026-07-18T04:51:25+00:00

Dear Readers,

It gives me great pleasure to present you with this issue of the APCRI Journal, Volume - 28, Issue – 1, July 2026.The APCRI Journal is being regularly published continuously for the last 28 years.

Eliminating Dog Mediated Human Rabies from India by 2030: Mission Mode Implementation of a Revised National Programme is the Need of the Hour

2026-07-18T04:51:25+00:00

The World Health Organization (WHO) in 2015 envisioned a dog mediated human rabies free world by 2030 with the goal of Zero by 30. In 2021 though a bit late, the Government of India despite the ongoing Covid -19 pandemic, supporting this global cause launched the National Action Plan for Rabies Elimination (NAPRE). Now with only four more years to go it is time for a critical appraisal of the current scenario and need for urgent actions. With my over four decades of work experience in the field of rabies prevention and control in India in particular, Asia and the world over in general I am recommending the following after due reflection of thoughts.

Effect of Educational Intervention on the Knowledge and Awareness of Rabies Among College Students in Dehradun City of Uttarakhand State

2026-07-18T04:51:26+00:00

Introduction: Although rabies is highly fatal, with timely and correct postexposure prophylaxis (PEP) for animal bite victims, it could be prevented. The young population should be aware of the appropriate rabies management during their formative years so that they put the right practice into play later on.

Objective: The present study was conducted with the objective of assessing the effectiveness of a brief educational intervention in the form of “Rabies Awareness” on knowledge of rabies among college students without control. A total of 1354 college students from 4 colleges situated in Dehradun City, Uttarakhand State, were included in the study that was conducted between January and March 2026.

Methodology: 1354 college students answered a predesigned and pretested questionnaire on various aspects of rabies. This was followed by an awareness session consisting of a PowerPoint presentation and video clips, followed by a question-and-answer session. One month later, 1280 (94.5%) of the same students answered the same questionnaire. The difference between the pre-session and the follow-up answers was analyzed using proportions and McNemar’s test.

Results: The analysis of knowledge regarding rabies revealed that college students’ understanding of rabies significantly increased after participating in the awareness session. Knowledge that animals other than dogs can transmit rabies increased from 20.3% to 41.6%. Knowledge that rabies can be transmitted by scratch increased from 18.3% to 43.9%. As a symptom of rabies, hydrophobia was known to only 20.0% of students, which increased to 82.5% after attending the session. Knowledge regarding treatment of bite wounds through washing with soap & water increased from 55.6% to 92.1%. The knowledge that the vaccination schedule consists of 5 injections increased from 40.8% to 70.9%. This clearly indicated the effectiveness of the awareness session.

DOI: https://doi.org/10.24321/0973.5038.202603

How to cite this article:
Hanspal J S, Hanspal R. Effect of Educational Intervention on the Knowledge and Awareness of Rabies Among College Students in Dehradun City of Uttarakhand State. APCRI J. 2026; 28(1): 5-9.

A longitudinal study on safety and clinical efficacy of rabies biologicals for post exposure prophylaxis among the vulnerable elderly population at the anti-rabies clinic, Bangalore

2026-07-18T04:51:26+00:00

Introduction: Animal exposures are a public health problem that occurs largely in the underserved populations where there is close habitation of human and dog populations. The elderly are more vulnerable to animal bites, often unable to defend themselves, and require immediate post-exposure prophylaxis (PEP), which is effective in preventing rabies. The present study was conducted to study the safety and clinical efficacy of post-exposure prophylaxis among this vulnerable group.

Methodology: All the elderly individuals who came for post-exposure prophylaxis to the anti-rabies clinic were included in the study after obtaining written informed consent. The details on socio-demographic profile and characteristics of animal bites and PEP provided were recorded. A safety assessment was done by recording the adverse drug reactions (ADRs), both local & systemic, immediately & subsequently up to day 28. Likewise, all the patients were followed up to 6 months after PEP to know their health status and for the clinical efficacy of PEP.

Results: The study included 54 subjects with category III exposure, aged between 60 and 97 years. All the subjects were provided post-exposure prophylaxis as recommended by NCDC, India. Among the study subjects, 12 (22.2%) reported ADRs such as pain (14.8%), itching (3.7%), erythema (1.9%), and malaise (1.9%), which were mild and resolved without any complications. All the study subjects were healthy and alive at the end of 6 months.

Conclusion: The post-exposure prophylaxis provided was safe and clinically effective in preventing rabies among the elderly in category III animal exposures and supports its continued usage in this vulnerable group.

DOI: https://doi.org/ 10.24321/0973.5038.202606

How to cite this article:
Ravish H S, Vijay G G, Navyashree N S, Bharathi D G. A Longitudinal Study on Safety and Clinical Efficacy of Rabies Biologicals for Post Exposure Prophylaxis Among the Vulnerable Elderly Population at the Anti-Rabies Clinic, Bangalore. APCRI J. 2026; 28(1): 10-14.

Profile of HRIG Utilization among Category III Animal Bite Patients Attending an Anti-Rabies Clinic: A Cross-Sectional Study

2026-07-18T04:51:26+00:00

Background: Rabies remains a major public health challenge in India despite the availability of effective post-exposure prophylaxis (PEP). Human Rabies Immunoglobulin (HRIG) plays a crucial role in the management of WHO Category III animal bite exposures by providing immediate passive immunity. However, HRIG utilization remains inadequate in many tertiary care Anti-Rabies Clinics because of delayed presentation, limited availability, and operational challenges.

Objective: To assess the utilization profile of HRIG among WHO Category III animal bite patients attending a tertiary care Anti-Rabies Clinic and to identify factors associated with its non-utilization.

Methods: A hospital-based descriptive cross-sectional study was conducted at the Anti-Rabies Clinic of a tertiary care teaching hospital from July 2025 to December 2025. Out of 2316 patients attending the ARV OPD during the study period, 1829 patients with WHO Category III animal bite exposure were included using universal sampling technique. Data regarding sociodemographic characteristics, bite profile, HRIG utilization pattern, and reasons for non-utilization were collected using a predesigned semi-structured questionnaire and treatment records. Data were analyzed using Jamovi software and expressed as frequencies and percentages.

Results: Among the 1829 Category III animal bite patients, HRIG was administered to 631 (34.5%) patients. Majority of the patients were males (64.5%) and from rural areas (69.1%). Dog bites constituted 89.5% of exposures, while lower limb bites were the most common site of injury (60.3%). HRIG utilization was higher among children below five years, head and neck bite victims, patients with multiple deep wounds, and individuals with comorbidities. Delayed presentation after initiation of ARV beyond the recommended period (36.6%), healed or minor appearing wounds (27.1%), limited HRIG availability (22.1%), and patient refusal (14.2%) were the major reasons for non-utilization. Adverse reactions following HRIG were minimal and predominantly mild local reactions.

Conclusion: HRIG utilization in the tertiary care Anti-Rabies Clinic was selectively prioritized for high-risk exposures. Delayed healthcare seeking behaviour and limited HRIG availability were major barriers to optimal utilization. Strengthening uninterrupted HRIG supply, increasing public awareness regarding early reporting after animal bites, and implementing standardized institutional protocols may improve adherence to rabies PEP guidelines in tertiary care settings.

DOI: https://doi.org/ 10.24321/0973.5038.202607

How to cite this article:
Sahu P, Behera T R. Profile of HRIG Utilization among Category III Animal Bite Patients Attending an Anti-Rabies Clinic: A Cross-Sectional Study. APCRI J. 2026; 28(1): 15-19.

Large-Scale Pre-Exposure Prophylaxis for Children for Rabies Elimination: Is it the Right Approach?

2026-07-18T04:51:26+00:00

A global framework for eliminating dog-mediated human rabies by 2030 has been developed by the World Health Organization (WHO) and the World Organisation for Animal Health (WOAH), in collaboration with other partners. Most Asian countries where rabies is endemic have controlled human rabies by focusing on human rabies prophylaxis; therefore, human rabies incidence can be brought down, but not rabies elimination. There has been an attempt to focus on PrEP in children, as children account for a significant proportion of exposures to dogs and deaths due to rabies. In this communication, we discuss the pros and cons of relying on PrEP in children to eliminate rabies, where dog-mediated rabies prevails. Large-scale PrEP for children is not simple and easy to implement, and technical challenges should not be ignored. PrEP of the child population should not distract from controlling and subsequently eliminating rabies at source, i.e., dog rabies.

DOI: https://doi.org/10.24321/0973.5038.202610

How to cite this article:
Gongal G, Sampath G, Bastola A, Gunesekera A. Large-Scale Pre-Exposure Prophylaxis for Children for Rabies Elimination: Is it the Right Approach? APCRI J. 2026; 28(1): 20-25.

Intramuscular Use of Rabies Immunoglobulin may be Dangerously Interfering with Rabies Vaccine Immune Response

2026-07-18T04:51:26+00:00

India reports the highest number of dog bites and consequent rabies deaths in the world. Though rabies vaccines (RV) and rabies immunoglobulins (RIG) are covered under the Free Drugs Initiative of National Health Mission (NHM) of Government of India, still their shortages are a regular feature all over the country mainly due to exponential increase in dog bite cases over the years and the use of high dose-high-cost human rabies post-exposure prophylaxis (PEP). In this context, we need to implement the low dose-low-cost human rabies PEP as recommended by the World Health Organization (WHO) in its recent Rabies Prophylaxis Guidelines 2018.1 High potency of RVs and RIGs available in the Indian market further necessitates using low dose-low-cost PEP.

DOI: https://doi.org/10.24321/0973.5038.202601

How to cite this article:
Bharti O K. Intramuscular Use of Rabies Immunoglobulin may be Dangerously Interfering with Rabies Vaccine Immune Response. APCRI J. 2026; 28(1): 26-28.

Role of Cats as Intermediate Rabies Vector: A Cross-Sectional Retrospective Laboratory Surveillance in Kerala (India)

2026-07-18T04:51:26+00:00

Introduction: Rabies in cats has been reported from all parts of the world where animal rabies is present. Today, cats are a popular and beloved pet.

Objective: A preliminary attempt to understand the role of cats in rabies epidemiology is made by undertaking a cross-sectional retrospective analysis of rabies cases in cats in the state of Kerala (India) for a period of 4 years from 2021 to 2024.

Methodology: The data on the rabies occurrence in cats brought for routine rabies diagnosis to the State Institute of Animal Diseases (SIAD), Palode, Kerala, are analyzed for test positivity, positivity in clinically suspected cases, the proportion of feline rabies in animal rabies, and the performance of different tests for cat rabies diagnosis, namely the Lateral Flow Immunochromatography Test, Direct Fluorescent Antibody Test (DFAT), and Microchip-based PCR (TrueNat PCR).

Result: The test positivity in cat samples was 6.5% from among all the cat samples received for rabies diagnosis. The test positivity was 24.6% for those samples from cats with clinical symptoms suggestive of rabies. DFAT detected 16 brain samples as positive out of the 69 tested. Out of the 16 cases detected as positive by DFAT, only 5 (31.3%) were positive in the lateral flow immunochromatography test. TruNat PCR detected all 16 positive cases detected by the reference test as positive, demonstrating 100% sensitivity.

Conclusion: This document discusses the potential of feline rabies infection and the importance of considering rabies in cats along with dog rabies control in rabies-endemic areas.

DOI: https://doi.org/10.24321/0973.5038.202604

How to cite this article:
Sujatha A, Abraham S S, Devarajan S, Abeena B, Vijayakumar S. Role of Cats as Intermediate Rabies Vector: A Cross-Sectional Retrospective Laboratory Surveillance in Kerala (India). APCRI J. 2026; 28(1): 29-33.

Adverse Cutaneous Reaction Following Intradermal Rabies Vaccination with PVRV in a Category III Monkey Bite Exposure: A Case Report

2026-07-18T04:51:26+00:00

Rabies continues to be a major public health concern in India, and timely post-exposure prophylaxis (PEP) remains the cornerstone of prevention. Although intradermal rabies vaccination (IDRV) is considered safe and cost-effective, clinically significant adverse reactions may occasionally occur. We report a case of a 59-year-old female who developed severe pruritic vesicular eruptions over both deltoid regions following intradermal administration of purified vero cell rabies vaccine (PVRV) and human rabies immunoglobulin (HRIG) after a category III monkey bite exposure. The patient initially received standard anti-rabies prophylaxis but subsequently developed marked local cutaneous reactions characterized by erythema, itching, and blister formation at the injection sites. In view of the adverse reaction, the vaccination regimen was shifted from the intradermal to the intramuscular route and from PVRV to the Purified Chick Embryo Cell culture Vaccine (PCEC), and symptomatic treatment was provided. The patient tolerated subsequent doses well with PCEC and recovered without complications. This case highlights the importance of recognizing uncommon adverse events following rabies vaccination while ensuring uninterrupted completion of life-saving post-exposure prophylaxis.

DOI: https://doi.org/ 10.24321/0973.5038.202608

How to cite this article:
Sahu P, Behera T R. Adverse Cutaneous Reaction Following Intradermal Rabies Vaccination with PVRV in a Category III Monkey Bite Exposure: A Case Report. APCRI J. 2026; 28(1): 34-37.

Rabies Case on Dog at Debre Tabor Town, Amhara Region, Ethiopia: Case Report

2026-07-18T04:51:26+00:00

This report is about a rabies case in a dog in Debre Tabor Town, Amhara region, Ethiopia. The dog was owned but unknown; it developed signs of rabies and was found dead after the quarantine period. The dog has no known history of being bitten by another dog. After the death of the dog, the sample was collected by decapitating and submitted to the laboratory in collaboration with the local veterinary clinics and animal owner, and a confirmatory test was done by using a lateral flow assay and direct fluorescent antibody test, and the result was positive on both tests. Proper vaccination of the owned and stray dogs, community awareness, and active surveillance conduct early detection of the case in the town and provide pre-exposure vaccine for veterinarians.

DOI: https://doi.org/10.24321/0973.5038.202602

How to cite this article:
Mekonnen A S. Rabies Case on Dog in Debre Tabor Town, Amhara Region, Ethiopia: Case Report. APCRI J. 2026; 28(1): 37-39.