R is for rabies

Of the 55,000 people who die from rabies every year, 20,000 of them live in India. Most of those deaths are young children. Why? Because they fail to receive the proper treatment in time. Between lack of knowledge about how to treat the disease and lack of resources to pay for the treatment, many parents unknowingly delay a life-saving treatment until it’s too late. Although the available vaccine can prevent the disease, less than 20 percent of all people bitten take these life-saving vaccines.

I am the 20 percent.

When a young cat bit me on the toe during our Dhobi Ghat tour, I called our trusted vet to ask for advice. Although the cat did not appear rabid, Dr. Chariar suggested that I receive the post-bite rabies vaccine protocol immediately. Off to Hiranandani Hospital I went. Within one hour, I had started the protocol for post-bite vaccination. The vaccine is administered using an intramuscular injection, just like the annual flu shot most people receive. Sure, it hurts, but only temporarily. I have bruised only one time during treatment so far.

Rabies myth: You receive 20 painful shots in the stomach to fight rabies.
Rabies fact: You receive 5 intramuscular shots in the arm over the course of 28 days. The shots are timed at days 0, 3, 7, 14, and 28.

Although the regimen is frequent and inconvenient, the shots are simple and inexpensive. The vaccine, called Rabipur, costs Rs. 318. Receiving the injection from the nurse costs Rs. 61. Total cost for each injection is Rs. 379. Less than Rs. 400 per visit. All five visits will cost about Rs. 1,895. That equals about  $32. Doesn’t seem like much does it? To a poor Indian, however, that cost is prohibitive. Some government hospitals offer the treatment at little or no cost, but to poor rural citizens, even a single treatment can represent a significant percentage of their monthly income.

The best way to prevent rabies is by vaccinating the stray dog population. Many NGOs in India work to do just that. Save our Strays, one of Mumbai’s many dog-focused NGOS, conducts annual vaccination drives to ensure as many strays are vaccinated as possible.

“The basic principles of dog rabies control are relatively simple. It is necessary to vaccinate 70% of the total dog population in a short period of time, maintain that immune coverage and protect the area from spillover through control of dog movement from affected adjacent areas,” says Dr François-Xavier Meslin, a team leader in WHO’s department of neglected tropical diseases.  —WHO report

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