Acharya Anita S, Kaur Ravneet, Lakra Kulwant
J Commun Dis. 2012 Jun;44(2):59-69.
Rabies, though a disease of low public health priority, still continues to be a major public health problem in India. In humans, rabies is almost invariably fatal once clinical symptoms have developed. WHO reports around 50 000 rabies deaths every year, out of which 20 000 are estimated to occur in India alone. There is often gross under-reporting of human rabies deaths in India. Despite potent anti-rabies vaccines and immunoglobulins available, rabies is far from control and elimination. An effective strategy for control of rabies takes into account the epidemiology of animal bites, rabies and factors influencing post exposure treatment. Hence it becomes pertinent to review the current status of rabies and strategies for its control in the country. In this article, an attempt has been made to discuss the epidemiology of Rabies, pathogenesis, diagnosis and its prevention and control including the various regimens of anti-rabies vaccines and immunoglobulins available for post-exposure prophylaxis. The importance of primary preventive measures like Animal Birth Control (ABC) and vaccination of dogs has also been highlighted. It is emphasized that rabies should be recognized as priority public health problem and cell culture vaccines should be made available free of cost at all government health facilities. Other important measures include generation of awareness about rabies and first aid of animal bites.
狂犬病虽然是一个公共卫生优先级较低的疾病,但在印度仍然是一个主要的公共卫生问题。对于人类而言,一旦出现临床症状,狂犬病几乎无一例外会导致死亡。世界卫生组织报告称,每年约有5万例狂犬病死亡病例,其中仅印度就估计有2万例。在印度,人类狂犬病死亡病例常常存在严重的漏报情况。尽管有有效的抗狂犬病疫苗和免疫球蛋白,但狂犬病远未得到控制和消除。控制狂犬病的有效策略需要考虑动物咬伤的流行病学、狂犬病以及影响暴露后治疗的因素。因此,审视该国狂犬病的现状及其控制策略就变得十分必要。在本文中,我们试图探讨狂犬病的流行病学、发病机制、诊断以及预防和控制措施,包括用于暴露后预防的各种抗狂犬病疫苗和免疫球蛋白方案。还强调了诸如动物绝育(ABC)和犬类疫苗接种等一级预防措施的重要性。需要强调的是,应将狂犬病视为优先的公共卫生问题,并且所有政府卫生机构都应免费提供细胞培养疫苗。其他重要措施包括提高对狂犬病的认识以及动物咬伤的急救知识。
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