Human Rabies in the WHO Southeast Asia Region: Forward Steps for Elimination

Abstract

There are eleven Member States in the WHO southeast Asia region (Bangladesh, Bhutan, Democratic People's Republic of Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand, Timor-Leste) of which eight are endemic for rabies. More than 1.4 billion people in the Region are at risk of rabies infection, and approximately 45% of worldwide rabies deaths occur in Asia. Dog bites account for 96% of human rabies cases. Progress in preventing human rabies through control of the disease in dogs has been slow due to various factors. Innovative control tools and techniques have been developed and standardized in recent years. The introduction of cost-effective intradermal rabies vaccination regimens in Asian countries has increased the availability and affordability of postexposure prophylaxis. Elimination of rabies is not possible without regional and intersectoral cooperation. Considering the importance of consolidating achievements in rabies control in Member countries, the WHO Regional Office for southeast Asia has developed a regional strategy for elimination of human rabies transmitted by dogs in the Region. They have committed to provide technical leadership, to advocate national health authorities to develop major stakeholder consensus for a comprehensive rabies elimination programme, and to implement national strategies for elimination of human rabies.

Human rabies in India: a problem needing more attention

“…An estimated 45% of all deaths from rabies occur in that part of the world. 2 The situation is especially pronounced in India, which reports about 18 000 to 20 000 cases of rabies a year and about 36% of the world's deaths from the disease. 3 Rabies incidence in India has been constant for a decade, without any obvious declining trend, and reported incidence is probably an underestimation of true incidence because in India rabies is still not a notifiable disease.…”

Epidemiological study of animal bite victims and admission in general surgery department, in Southern Odisha: a cross sectional institutional study

“…6 Human rabies is endemic in India and according to recent studies 20000 persons die of this disease every year. 7 The aim of the study was to estimate the prevalence and pattern of animal bites in southern Odisha and rate of admission in Surgery Department.…”

One health: The interface between veterinary and human health

“…There are a variety of definitions of the One Health. Zinsstag, Meisser [53] state that "One Health is anything that adds value to the health of animals and humans, or economic savings, not achievable without the cooperation of the two medicines. It should just become normal that doctors and veterinarians work together as closely as possible."…”

“…There have been concerns over the effective implementation of One Health within veterinary profession [53,[60][61][62], within the medical profession [63], by wildlife specialists [64], and by environmentalists [65]. The strikingly broad definition obviously allows multiple interpretations of the concept.…”