The document discusses surveillance and reporting of animal bites and rabies cases in West Bengal, India. It outlines the importance of recording and reporting every animal bite case to maintain surveillance. It provides guidance on categorizing bite victims, administering post-exposure prophylaxis including wound washing and immunoglobulin, and preferred routes of vaccine administration. It also describes the process of recording bite cases at anti-rabies clinics and submitting monthly reports to higher levels using standardized formats.

1. Surveillance, recording and reporting of Animal
bite & Rabies
National Rabies Control Programme
PH & CD Branch,
Dept. of H & FW, Govt. of West Bengal

2. Surveillance and reporting - Human Health
Component
• Rabies surveillance aims to establish quality data on disease burden in
human as well as animals in order to identify population at risk in
human as well as animals.
• Recording & reporting of each and every case of Animal bite and
Rabies cases occurring in community is very essential step for
maintaining the surveillance of Animal bite and Rabies cases.

3. Important to Note
• Categorize Animal Bite victims properly – for :
- Proper management.
- Reporting.
- Proper logistic plan.
• Preferred route of administration of ARV in human, as per National
Programme, is Intradermal.
- No less effective,
- Yet cost effective as compared to I.M. route.
• Wound washing and RIG:
- Must be available in ER in addition to ARC.
- Cases coming beyond OPD-hours must get the above,
followed by ARV from ARC the next day.

4. Key points regarding surveillance activities
• Sub-centre level- ASHA & ANM should report animal bite in S form of
IDSP.
• Animal bite and rabies cases are reported through monthly reporting
form of NRCP and P form of IDSP.
• Line list of suspected/confirmed cases- In case of any such case
attended any health facility then share the line list.
• Follow Standard Case Definition of Rabies under IDSP.

5. Recordings and Reporting formats
1. Animal Bite Exposure Register– for record maintenance at ARC
2. Treatment card in duplicate (one for the bite victim and another for
ARC record).
3. Monthly reporting format for ARC (M03) and for District (M02)-
Animal bite and rabies cases are reported through monthly reporting
form of NRCP.
4. Line list format for suspected/ probable/confirmed human rabies
cases:
If any such case attended any health care facility then the line list
should be shared with respective district focal point at an earliest.

6. Record maintenance at Anti Rabies Clinic
Each ARC should maintain a minimum sets of information on each animal
bite victim attended ARC that shall be readily available for monitoring and
evaluation.
• Animal bite exposure register: for maintaining record of each bite victim
like patient detail; exposure history; exposure detail (category of bite);
post exposure prophylaxis; previous history of ARV, date of ARV
administration- which also helps to generate the monthly report as per
the NRCP-M03 format.
• Rabies PEP Treatment Card: prescribed by the MO I/C of ARC which
contain the patient details, history of exposure and record of
immunizations being provided.

7. Animal Bite Exposure Register format
• Following information added as footnote in all pages:
 Any cluster of cases observed: if yes write the details.
 Total no. of New cases in this page…………… .
 Category wise Number of New Patients: I……... / II………./ III………. .
 Total no. of Cat III patients receiving ARS: ………….. .
 Break up of Biting Animals in this page :
Dog………../Cat…………/Monkey……………/Other (specify species with no.) ………..
Add up these information of individual pages at the end of the month and
easily derive the figures for the Monthly Report.
• For an old case go back to the page where it was initially entered and
gradually complete the row dedicated for it.
• Each month start with a new page.
• Category-I cases do not need ARV; yet record such cases in the Register.

8. Reporting of Animal bite and rabies
DATA LEVEL FORMATS FROM - TO PERIODICITY
ARC monthly
report
Anti-
Rabies
Clinics
NRCP-M03 ARC MO I/C to District
Focal Point
Monthly (within 5 days
of the following month)
District monthly
report
District NRCP-M02 District Focal Point to
State Focal Point
Monthly (within 7 days
of the following month)
The flow of information of monthly report with time line:

9. Report should be prepared
and submitted in MS Excel
format for easy compilation.
The NRCP monthly reporting
format both for ARC and for
District should be kept
exactly the same as
provided by NRCP State
focal point.

10. * Serial No. 1 and 2 should
match with each other.
** Please refer to “Remarks
(Month when PEP
completed/Referred out)”
column of register for
Previous month also.
It is the no. of bite victims of
previous month who have
completed PEP during
reporting month.

11. In ARC format all the
information should be
filled up in numerical
only except the Sl. No.
7 (Yes or No) and Sl.
No. 8 which needs
address where bite
incidence took place.

12. Some important points regarding filling up of ARC format 1/2
• In a particular month, total number of patients as per type of biting animal
should be equal to the total number of patients as per Category of bite.
• Although Category-I bite victims do not need ARV, record such cases in the
Register.
• Detail of patient as per route of vaccination (IM and ID route): It is the
total number of patients vaccinated either by ID route or by IM route for the
reporting month and not the no. of doses of vaccine given to each patient
during the month.
• No. of Patients completed PEP: It is the no. of bite victims of previous
month who have completed PEP (Please check remark column of previous
month).

13. Some important points regarding filling up of ARC format 2/2
• If a bite victim referred out from an ARC before completion of PEP and the same
patient complete the remaining doses from other ARC then the ARC from where the
bite victim completed it will count it as PEP completed in Animal bite exposure
register with date.
The ARC from where the patient referred out will write it in “Any other remarks” row
at the end of ARC format.
• Suspected/probable/Confirmed Rabies cases/Deaths reported:
The number of such cases should be shared in monthly report. However the line list
of admitted cases, LAMA/Referred out and deaths (with BHT) should be sent to the
respective district focal points and from there to State Focal point at an earliest. This
is necessary to carry out further investigation.

14. Qualitative Analysis of Monthly report of Hooghly for
2021 & 2022 (up to October)
No. of Animal bite victim Cat III & ARS utilization
Category II & III and ARV
given
All types
of animal
bite
Total
category
wise
% bites
included in
categories
Cat III
Cat III
received
ARS
% of Cat III
received
ARS
Cat II & III ARV given
% of Cat II &
III received
ARV
2021 63782 60979 95.61 9113 6891 75.62 52049 61166 117.52
2022 53332 53341 100.02 7233 6576 90.92 46108 54352 117.88

15. Actions to be taken at Block level/ District level based on the
ARC report
For Animal bite cases For Human Rabies cases
• Identify areas of clustering of animal bite
cases.
• Ensure the availability of ARV/ARS in centers
catering the identified areas.
•Conduct meeting with Vet. Dept. as part of
zoonotic committee for joint action.
• Follow up
• Identify areas of human rabies cases.
• Find out reasons (Incomplete treatment, No
PEP taken by victims, low awareness etc).
• Ensure the availability of ARV/ARS in centers
catering the areas.
• Intensify IEC activities in the area.
•Conduct meeting with Vet. Dept. as part of
zoonotic committee for joint action.
• Follow up