advanced search

<< Back To Home

Human Rabies in India: An Audit from a Rabies Diagnostic Laboratory

Sunday, 24th of January 2016

Human Rabies in India: An Audit from a Rabies Diagnostic Laboratory

1. Reeta Subramaniam Mani^*,
2. Ashwini Manoor Anand and
3. Shampur Narayan Madhusudana

Tropical Medicine & International Health

1. This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/tmi.12669

Abstract below ; full text is available to journal subscribers.

Objectives

Rabies, an acute progressive encephalomyelitis, continues to be a serious public health problem in India and many other countries in Asia and Africa. The low level of commitment to rabies control is partly attributable to challenges in laboratory diagnosis and lack of adequate surveillance to indicate the disease burden. A laboratory audit of human rabies cases was undertaken to disseminate information on the clinical, demographic, prophylactic and most importantly the laboratory diagnostic aspects of rabies.

Methods

A retrospective analysis of all clinically suspected human rabies cases, whose samples were received at a rabies diagnostic laboratory in south India in the last 3 years, was performed. Clinical and demographic details of patients were obtained. The clinical samples included cerebrospinal fluid (CSF), serum, saliva and nuchal skin biopsy collected antemortem, and brain tissue obtained postmortem. Various laboratory tests were performed for diagnosis.

Results

Clinical samples from 128 patients with suspected rabies, from 11 states in India, were received for diagnostic confirmation. 94% of the victims reported dog-bites, more than a third of them were children and most of the victims did not receive adequate post-exposure prophylaxis. Antemortem confirmation of rabies by a combination of laboratory diagnostic assays (detection of viral RNA in CSF, skin and saliva, and neutralizing antibodies in CSF) could be achieved in 40.6%.

Conclusions

Increasing awareness about adequate post-exposure prophylaxis, additional rabies diagnostic facilities, and enhanced human and animal rabies surveillance to indicate the true disease burden are essential to control this fatal disease.

This article is protected by copyright. All rights reserved.