Rabies on the Indian subcontinent.

Area of Science:

• Veterinary Public Health
• Infectious Disease Epidemiology
• Zoonotic Disease Control

Background:

• Rabies is endemic across the Indian subcontinent, except the Maldives, causing an estimated 59,000 annual deaths.
• Dog bites are the primary cause of rabies mortality, disproportionately affecting children and impoverished populations.
• Limited access to post-exposure prophylaxis, irregular vaccine supply, low public awareness, and inadequate dog vaccination hinder control efforts.

Purpose of the Study:

• To examine the current rabies situation in the Indian subcontinent.
• To identify needs, obstacles, and progress in rabies control across the region.
• To propose future strategies for the elimination of dog-mediated rabies by 2030.

Main Methods:

• Comprehensive review of the rabies situation in Afghanistan, Bangladesh, Bhutan, India, Nepal, Myanmar, Pakistan, and Sri Lanka.
• Analysis of existing control measures, including post-exposure prophylaxis and animal birth control programs.
• Examination of laboratory capacity, surveillance systems, and diagnostic tools.

Main Results:

• Significant burden of rabies mortality on the Indian subcontinent, with India accounting for a substantial portion.
• Challenges include limited access to and irregular supply of vaccines and immunoglobulins.
• Low public awareness and insufficient domestic dog vaccination programs are critical issues.

Conclusions:

• Eliminating dog-mediated rabies by 2030 requires a concerted effort across the Indian subcontinent.
• Increased laboratory capacity, improved surveillance, and accessible diagnostics are essential.
• A greater focus on mass dog vaccination is proposed as the most effective strategy to eliminate rabies at its source.