In most endemic countries stray dogs are the main source of rabies infection in humans. In India 95–97% of rabies patients are infected by dogs. Most pet dogs do not regularly receive booster doses of vaccine. In Thailand, most rabies patients develop the disease within 1 month of exposure. Rabies immunoglobulin is costly and usually not available. So in India nervous tissue vaccine is commonly used — it is inexpensive and freely available despite frequent neurological complications. The cost of immunization by tissue culture vaccines may be reduced by nearly 60% by intradermal vaccination.
References
1.
JunnarkarRSuryawarsshiSR. Carrier state of rabies: observation from epidemiologic field investigations. Ind J Clin Practice (Infectious Diseases)1993;30:25–26, 31.
2.
BhanganadaKWildeRSakolsatayaornPConsembatP. Dog-bite injuries at a Bangkok teaching hospital. Acta Tropica1993;55:249–55.
3.
KrishnaKDuttaJK. Human rabies in Delhi (1976). Ind J Pub Health1978;22:259–64.
4.
LakhanpalUSharmaRC. An epidemiological study of 177 cases of human rabies. Int J Epidemiol1985;14: 614–17.
5.
MadhusudanaSNAggarwalP. Human rabies: epidemiological and laboratory studies in 80 cases. J Ind Med Assoc1992;90:169–71.
6.
SudarshanMKNagarajSSavithaBVeenaSG. An epidemiological study of rabies in Bangalore city. J Ind Med Assoc1995;93:7, 14–16.
7.
SiwasentiwatDLumlertdachaBPalsuwanCHemachudhaTChutvengseSWildeH. Rabies: is provocation of the biting dog relevant for risk assessment?Trans Roy Soc Trop Med Hyg1992;86:443.
8.
SageGKhawplodPWildeH. Immune response to rabies vaccine in Alaskan dogs: failure to achieve a consistently protective antibody response. Trans R Soc Trop Med Hyg1993;87:593–5.
9.
VeeraraghavanN. Case of hydrophobia following bat bite. Annual Report of the Director. Coonoor: Pasteur Institute. (b) Scientific Report. Coonoor: Pasteur Institute, 1954:40.
10.
WHO Expert Committee. Report on rabies — post-exposure prophylaxis. WHO Tech Rep Ser1992;824:21–6.
11.
VeeraraghavanN. Studies on the salivary excretion of rabies virus by the dog from Surandai. Diamond Jubilee Souvenir. Coonoor: Pasteur Institute, 1967:65.
FekaduMShaddockJHBaerGM. Intermittent excretion of rabies virus in the saliva of a dog two and six months after it had recovered from experimental rabies. Am J Trop Med Hyg1981;30:1113–15.
14.
Your-KovskyAM. Hydrophobia following bite of apparently healthy dogs. J Hyg Epidemiol Microbiol Immunol1962;6:73–8.
15.
DuttaJKDuttaTK. Rabies in endemic countries [Editorial]. BMJ1994;308:488–9.
16.
SmithJSFishbeinDBRupprechtCEClarkK. Unexplained rabies in three immigrants in the United States: a virological investigation. N Engl J Med1991;324:205–11.
17.
WarrellDAWarrellMJ. Human rabies and its prevention: an overview. Rev Infect Dis1988;10(suppl 4):s726–s731.
18.
WarrellDADavidsonN McDPopeIM. Pathophysiologic studies in human rabies. Am J Med1976;60:180–90.
19.
DuttaJK. Rabies presenting with priapism. J Assoc Physicians Ind1994;42:430.
20.
BhandariMKumarS. Penile hyperexcitability as the presenting symptom of rabies. Br J Urol1986;58:224.
21.
UdwadiaZFUdwadiaFERaoPFKapadiaF. Penile hyperexcitability with recurrent ejaculations as the presenting manifestation of a case of rabies. Post Grad Med J1988;64:85–6.
22.
DuttaJK. Excessive libido in a woman with rabies. Post Grad Med J1996;72:554.
23.
DuttaJK. Priapism in rabies. J Assoc Physicians Ind1992;40:555.
24.
PrabhakarSMalhotraRMGoelDS. Rabies presenting as catatonic stupor. J Assoc Physicians Ind1992;40:272.
25.
HemachudhaTPhanthumchindaKPhanuphakPManutsathitS. Myoedema as a clinical sign in paralytic rabies. Lancet1987;i:1210.
26.
NicholsonKG. Human rabies. In: PattisonJR, ed. Rabies a Growing Threat. Workingham: Van Nostrand Rheinhold, 1983:6–17.
27.
ChopraJSBanerjeeKMurthyJKPalSR. Paralytic rabies: a clinico-pathological study. Brain1980;103:789–802.
28.
HattwickMAWWeissTTStechschulteCJBaerGMGreggMB. Recovery from rabies: a case report. Ann Intern Med1972;76:931–42.
29.
PorrasCBardozaJJFuenzalidaEAdarosIBOviedo de DiazMOFurstJ. Recovery from rabies in man. Ann Intern Med1976;85:44–8.
30.
TillotsonJRAxelrodDLymanDC. Rabies in a laboratory worker — New York. MMWR1977;26:183.
31.
UdwadiaZFUdwadiaFEKatrekSM. Human rabies: clinical features, diagnosis complications and management. Crit Care Med1989;17:834–6.
32.
GodeGRRajuAVJayalakshmiTSKaulHLBhideNK. Intensive care in rabies therapy: clinical observations. Lancet1976;ii:6–8.
33.
RubinRHSullivanLSummersRGreggMBSikesRK. A case of human rabies in Kansas: epidemiologic, clinical and laboratory considerations. J Infect Dis1970;122:318–22.
34.
EmmonsRWLeonardLLDe GenareF. A case of human rabies with prolonged survival. Intervirology1973;1:60–72.
35.
DuttaJK. Adverse reaction to purified chick embryo cell vaccine. Vaccine1994;12:1484.
36.
Centers for Disease Control. Systemic allergic reactions following immunization with human diploid cell rabies vaccine. MMWR1984;33:185–7.
37.
World Health Organization. Recommendations on Rabies Post-exposure Treatment and the Correct Technique of Intradermal Immunisation Against Rabies, WHO/EMC/ZOO.96.6. Geneva: WHO, 1997;1–26.
38.
WildeHChomcheyPPunyaratabandhuPPhanuphakPChutivongseS. Purified equine rabies immune globulin: safe and affordable alternative to human rabies immune globulin. Bull WHO1989;67:731–36.
39.
SureauPPortnoiDRollinP. Prevention de la transmission inter-humaine de la rage après grefte de, cornée. C R Acad Sci Paris1981;293(Série iii):689–92.
40.
WildeHChutivengseSHemachudhaT. Rabies and its prevention. Med J Australia (Tropical Health)1994;160:83–7.
41.
WildeHBhanganadaKChutivongseS. Is injection of contaminate animal bite wounds with rabies immune-globulin a safe practice?Trans R Soc Trop Med Hyg1992;86:86–8.
42.
BernardKWFishbeinDB. Pre-exposure rabies prophylaxis for travellers: are the benefits worth the cost?Vaccine1991;9:833–6.
43.
MannJM. Routine pre-exposure rabies prophylaxis: a reassessment. Am J Public Health1984;74:720–2.
44.
PappaioancuMFishbeinDBDreesenDW. Antibody response to pre-exposure human diploid-cell rabies vaccine given concurrently with chloroquine. N Engl J Med1986;314:280–4.
45.
TaylorDNWasiCBernardKW. Chloroquine prophylaxis associated with a poor antibody response to human diploid cell rabies vaccine. Lancet1984;i:1405.
46.
HurvitzDHirschhoraK. Suppression of in vitro lymphocyte responses by chloroquine. N Engl J Med1965;273:23–6.
47.
LeeKCWengMSpitzerD. Chloroquine as a probe for antigen processing accessory cells. Transplantation1982;34:150–3.
48.
SalmeronGLipskyPF. Immunosuppressive potential of antimalarials. Am J Med1983;75(suppl):19–24.
49.
ScaleGOppenheimJJ. Antigen presentation by human monocytes: evidence for stimulant processing and requirement for interleukin I. J Immunol1983;131:1160–6.
50.
DuttaJK. Rabies prevention: cost to an Indian laboror. JAMA1996;276:32.
51.
RupprechtCEKeinyMP. Development of vaccinia rabies glycoprotein recombinant virus vaccine. In: CampbellJSCharltonKM eds. Rabies. Boston: Kluwer Academic, 1988.