Mohanty Parimala, Boro Prasanta Kumar, Heydtmann Samira, Durr Salome, Tiwari Harish Kumar
Jyoti and Bhupat Mehta School of Health Science and Technology, Indian Institute of Technology Guwahati, Guwahati, Assam, India.
Department of Veterinary Medicine, Lakhimpur College of Veterinary Science, Joyhing, North Lakhimpur, Assam, India.
One Health. 2024 Jul 3;19:100850. doi: 10.1016/j.onehlt.2024.100850. eCollection 2024 Dec.
Dog-mediated rabies is endemic in India. The country records the highest mortality due to dog-bite-related rabies despite the availability of interventions to prevent deaths. We present a case study of the death of a 59-year-old man in a suburban town of Northeast India after a dog bite from an owned pup. Through this case study, we investigate various omissions and commissions in communities and health professionals that make rabies rampant in India. The circumstances surrounding the death were investigated by interviewing the wife, relatives, neighbour, the hospital/nursing home where the bite case was reported, the district Rapid Response Team (RRT), and the Veterinary and Animal Health Department Officer and through the information recorded in the disease outbreak report. While the biting animal was not vaccinated and had no restriction over its movement imposed by the owners, the response of the hospital staff and public authorities was delayed and inadequate. A poignant reminder of the complexities surrounding dog-mediated rabies in India, this case study calls for a holistic protocol to address dog bites through ensuring the One Health approach encompassing education, provision of post-exposure prophylaxis (PEP) and canine rabies vaccines for dogs, promotion of responsible dog ownership, and intersectoral collaboration. Moreover, strengthening communication channels through effective data exchange and encouraging synergy among healthcare, veterinary, and public health sectors is indispensable to maximize the impact of rabies prevention and control interventions.
犬传狂犬病在印度呈地方性流行。尽管有预防死亡的干预措施，但该国因犬咬相关狂犬病导致的死亡率最高。我们介绍了印度东北部一个郊区小镇上一名59岁男子被自家幼犬咬伤后死亡的案例研究。通过这个案例研究，我们调查了社区和卫生专业人员中导致狂犬病在印度肆虐的各种疏漏和不当行为。通过采访死者的妻子、亲属、邻居、报告咬伤病例的医院/疗养院、地区快速反应小组（RRT）以及兽医和动物卫生部门官员，并通过疾病暴发报告中记录的信息，对死亡相关情况进行了调查。虽然咬人动物未接种疫苗且主人未对其行动加以限制，但医院工作人员和公共当局的反应延迟且不力。这个案例研究深刻提醒人们印度犬传狂犬病问题的复杂性，它呼吁制定一个全面的方案，通过确保采用“同一健康”方法来应对犬咬，该方法包括开展教育、提供暴露后预防（PEP）和犬用狂犬病疫苗、促进负责任的养犬行为以及部门间合作。此外，通过有效的数据交换加强沟通渠道，并鼓励医疗、兽医和公共卫生部门之间的协同作用，对于最大限度地发挥狂犬病预防和控制干预措施的影响必不可少。
