Human Rabies in Delhi

Objective: Analysis of human rabies cases admitted in Infectious Diseases Hospital, Delhi during the course of one year was undertaken to understand the epidemiology of rabies. Methods: The data was collected using standardized proforma and was analyzed on EPI Info 6.02 software version. A total of 49.8% of the human rabies came from Delhi and rest belonged to adjoining states of UP (30.3%), Haryana (18.3%), Bihar (0.8%), Punjab (0.4%) and MP (0.4%). Children in the age group 5-14 years fell victim to the disease in significantly higher numbers (36.7%) as compared to other age groups. Male Female ratio was 4:1. Biting animals involved were dog (96.7%), jackal (1.7%), cat (0.8%), monkey (0.4%) and mongoose (0.4%). Majority (78.8%) had Category III exposure. Hydrophobia, which is the pathogonomic feature of human rabies, was present in 95% of cases. Remaining (5%) gave history of animal bite and presented with features of aerophobia, photophobia along with fever, weakness in limbs, parasthesia, and/or paralysis. Significantly higher number (93.4%) did not receive any local wound treatment. Most (91.7%) cases never received any vaccination and remaining were inadequately vaccinated; only five had received 10-14 injections of Neural Tissue Vaccine (NTV) and one child who had multiple bites on face, received 5 doses of NTV, local wound treatment and intramuscular ARS on 3rd day. Result: The data strongly reveals that people who died due to rabies either did not receive any treatment or were inappropriately and inadequately treated. Hence, there is need to educate the community and the health care professionals about the importance of immediate and adequate post exposure treatment. The data also indicates that the epidemiology of the disease has not changed much over the decades. Conclusion: The disease can be prevented with the available tools and all we need to do is to implement them effectively.