Rabies : en utmaning för Indien

Sammanfattning: This literature study describes the ways in which the spread of rabies can be prevented in India, what guidelines are set and also which methods have proved most effective. Every year rabies causes the death of around 20 000 people in India, which makes the prevalence in the country the highest in the world. The main source for human infection is bite wounds from infected dogs. People and animals can be vaccinated both prophylactic and post-exposure prophylactic (PEP), despite this the disease continues to claim high number of victims. The majority of those dying are young men and children from the poorer part of the population. Knowledge among the Indian population on rabies and its transmission routes, wound care and vaccinations is very limited. PEP treatment is both costly and complicated, which means that many choose not to complete the whole vaccination program. The disease is hard to diagnose and not notifiable, making it difficult to make accurate estimates of its incidence rate. Without monitoring the situation it is difficult to influence decision-makers which in the long run results in a lack of investment into possible solutions of the problem. Since PEP is both expensive and extensive, the most efficient long-term investment would be to eradicate the disease from its primary reservoir, i.e. the dog population. WHO and the World Society for the Protection of Animals (WSPA) have set guidelines on how to reduce the problem through vaccination and sterilization of dogs. In experiments where the work has been based on their recommendations a reduction in the number of deaths has been seen. Projects like these and information to the local population, as well as training for medical personnel is needed for rabies to be controlled.