Epidemiology and prevention of animal bite and human rabies in a rural community-One health experiment

ObjectiveTo estimate the incidence of human rabies and animal bite/exposure; to describe the post exposure prophylaxis received by animal bite/exposure cases; to assess the safety and immunogenicity of rabies vaccine (purified chick embryo cell vaccine) administered as pre-exposure vaccination for school children and risk groups by intradermal route in the rural community and to demonstrate a decrease in the incidence of human rabies and animal bite/exposures through implementation of one health experiment.MethodsThis prospective interventional study was conducted over a period of 2 years (December 2009-November 2011) in a rural area near Bangalore, Karnataka, South India and consisted of six villages (project villages), three villages were identified as study villages with active interventions (Implementation of rabies awareness activities, post exposure prophylaxis, pre-exposure intradermal rabies vaccine) and three villages as control villages without any active interventions.ResultsA majority of the animal bite cases were category III exposures and all of them had received rabies immunoglobulin and anti-rabies vaccine as per WHO recommendation. A majority received 3 to 5 doses of vaccine. Three hundred and sixty eight subjects had received pre-exposure intradermal rabies vaccination thrice on days 0, 7 and 28 d.ConclusionsNo human rabies case was reported during the study period and there was 30% decrease in animal bite/exposure cases in study villages after the one health experiment project was implemented. Pre-exposure vaccination was safe and immunogenic.