Rabies

Vaccine:

• Rabies is a disease that is caused by a family of viruses called the Lyssaviruses and found in a range of mammals.
• The virus targets the central nervous system & is nearly 100% fatal to the host animal if it succeeds in infecting it.
• Though many animals can be transmitters of the virus(from cats to crocodiles), it is mostly spread to people from the bite of an infected dog or cat.
• Despite being potentially lethal, the virus is slow-moving and takes several weeks before the disease manifests into fatal encephalitis, which is the reason for administering the vaccine, even after being bitten by an infected animal is effcetive.
• A shot of rabies immunoglobulin followed by a 4-week course of anti-rabies vaccine, is nearly guaranteed to prevent rabies.
• Rabies immunoglobulin: Rabies-antibodies against the virus derived from either people or horses.
• This translates to the first dose being given on the same day as the immunoglobulin followed by vaccinations on the 3rd, 7th & 14th day.
• Other regimens are also available like 5 shots which include one on the 28th day approved by WHO which clinics may consider, depending on the availability of the vaccine.

It is widely known that vaccinating dogs is essential for the elimination of rabies. According to experts, vaccinating animals doesn't guarantee lifelong immunity from the disease.

 

• The vaccine is made up of an inactivated virus that is expected to induce the body into producing antibodies that can neutralise the live virus in case of infection.
• There are also test vaccines that involve genetically modified viruses.
• There is no single-shot rabies vaccine or one that offers permanent immunity.
• There are two ways of administering the rabies vaccine.

Post-Exposure Prophylaxis(PEP)	Pre Exposure Prophylaxis(PrEP)
Is given to persons who were exposed via a bite to an animal suspected to be infected. Four-course prescription is mandatory.	1.Is given to persons who have a  high risk of being infected like veterinarians, animal handlers,rabies-prone areas etc. 2 . One doesn't need any immunoglobulin injection & 2 subsequent shots of the vaccine will suffice for full protection.

 

The WHO doesn't recommend PrEP as a general preventive.

Availability of Vaccines:

• According to the Health Ministry, there are at least 6 rabies vaccines approved for India.
• They all contain inactivated viruses made of duck, chicken, or human cell cultures and are marked as safe, efficacious & with long immunity.
• Rabies vaccines are available for free in government dispensaries and cost up to ₹500 per dose in private clinics.
• Reports of hospitals running out of vaccines surface continue & knowledge about vaccines, and treatment is inadequate in India.
• According to the health ministry, there is no maintenance of availability of a centralised database of vaccines, but a shortage had been reported in Punjab, Karnataka, Haryana, and  West Bengal.
• The Centre says that from 2016-18, around 300 laboratory-confirmed rabies deaths were reported in India.
• WHO says India is endemic for rabies, & accounts for 36% of the world's deaths.
• The true burden of rabies in India is not fully known.
• About 30-60% of reported rabies cases & deaths occur in children under the age of  15 years, as bites that occur in children often go unrecognised & unreported.

Vaccines for animals:

• Rabies treatment requires multiple shots of the vaccine including immunoglobulin, sticking to the schedule is challenging.
• Rabies endemic countries set a target to eliminate the disease- India has committed to do so by 2030.
• It is widely acknowledged that this elimination requires the vaccination of dogs.
• Dogs are deemed responsible for 99% of rabies infections in people.
• The government in its 2021 plan, called the 'National Action for Plan- Rabies Elimination', aims to vaccinate at least 70% of all dogs in a defined geographical area annually for three consecutive years.
• A herd immunity is expected to lead to eventual elimination within eight years.
• Instead of inoculating all dogs, the plan is to identify "Rabies Hotspots" in the country & target them.

 

Prelims & Mains Perspective

 

For Prelims: About rabies, Vaccine, PEP, PrEP