This document discusses rabies, including facts about the disease, its transmission, prevention, and treatment. Some key points: - Rabies is a fatal viral disease spread through animal bites, but is over 99% preventable through vaccination. - It is most commonly spread to humans by rabid dogs. Over 95% of rabies deaths occur in Africa and Asia. - Proper wound cleansing and post-exposure vaccination including rabies immunoglobulin can prevent onset of the disease after a bite. - World Rabies Day is observed annually on September 28th to increase awareness and promote vaccination to eliminate rabies.

1. Dr. V. V. Limaye.
Joint Commissioner of Animal Husbandry,
Disease Investigation Section.
Department of Animal Husbandry,
Government of Maharashtra.
And
Western Regional Disease Diagnostic Laboratory (WRDDL),
Department of Animal Husbandry and Dairying,
Government of India.

2. World Rabies Day
• Every Year 28th September is observed as World Rabies
Day to mark the death anniversary of Louis Pasteur, a
French biologist, microbiologist and chemist who
developed the first rabies vaccine.
• It’s a day when Anti Rabies actions are collated,
intensified and showcased.

3. Why this theme in 2021?
• The global COVID-19 pandemic has raised many doubts and
misconceptions about diseases, their spread and about vaccination in
general. Because of this, there has been some hesitancy about the roll-
out of the COVID-19 vaccines in many countries and many people are
afraid to get vaccinated.
• For rabies, this is nothing new, as fears, misconceptions and
misinformation about the disease and its prevention dates back
hundreds of years.
• For that reason, this year’s theme is focused on sharing facts about
rabies, and not spreading fear about the disease by relying on
misinformation and myths.

4. Facts: 100% Fatal, Yet 99% preventable disease.
• Facts are essential for raising disease awareness, preventing rabies cases,
having the animal population vaccinated, and educating people about
the dangers of rabies and how to prevent it.
• Without facts we would not have data for decision-makers to inform
them of the serious nature of the disease.
• We would not be able to advocate for its elimination and the burden of
the disease would remain unknown, resulting in tens of thousands of
people and animals continuing to die from rabies each year.
• Let us use facts to raise awareness and educate others about rabies.

5. • Fear:
The word “fear” has three meanings in this year’s theme.
1. Firstly, it relates to the general fear caused by rabies, the fear people
experience when encountering rabid animals, and the fear that
people live with in communities plagued by rabies.
2. The second meaning relates directly to the fear of symptoms that
people may experience when infected with rabies.
3. Lastly, fear relates to the fear caused by ‘fake news’ or myths about
rabies – making people afraid of vaccination, making people afraid to
get their animals sterilized or vaccinated, and making people believe
in ineffective treatments for the disease

6. Introduction
• Rabies is a zoonotic disease that is almost always fatal yet is practically
100% preventable. Worldwide, annually about 55,000–60,000 persons die
of rabies,of which 20,000, that is nearly one-third are from India alone.
• About 99% (97% in India ) of these deaths are due to bites/exposures to
rabid dogs, i.e., dog-mediated human rabies.
• Till date, the disease is classified widely under the neglected tropical and
zoonotic diseases.
• All Warm Blooded Animals are vulnerable, degree of species susceptibility
varies considerably.
• Dogs, Jackals and Foxes are most susceptible.
In India domestic dog is a major reservoir of Rabies.
• One of the oldest diseases described (Vedic Period)

7. Rabies Facts
Around 99% of human rabies cases are due to bites
from infected dogs.
More than 95% of the world’s fatal rabies occur in
Africa and Asia
80 % of rabies cases occur in rural areas with limited or
Inexistent access to health education campaigns
and post-bite treatment
4 out of 10 rabies deaths are in children

8. Introduction
• Acute, progressive viral encephalitis caused by Lyssavirus belonging to Order
Mononegavirales , Rhabdoviridae family.
• “Bullet” shaped- Rhabdovirus 100nm -
300 nm long, 75 nm dia.
• 400 trimeric spikes on surface of virus
• Nonsegmented, Negative stranded RNA
genome.
• 5 Viral Proteins
– Nucleoprotein (N), Glycoprotein (G),
– Phosphoprotein (P), Matrix Protein(M)
– RNA dependent RNA Polymerase (L)
Protein

10. Rabies in Humans
• Virus enters the body through wounds or through
mucosal surfaces.
• Cannot enter through intact skin.
• Replicates in the muscles or other local tissues , gains
access to motor end plates and motor axons to reach
CNS.
• Once reaches CNS , replication occurs in neurons and
spreads by budding.
• Dissemination through CSF in late stages of infection.
• Incubation period 3 weeks to 3 months (rarely 4 days to 2
years).

11. Rabies in Humans
• Hydrophobia, Photophobia, Aerophobia as rabies affects brain
stem function.
• 80% cases exhibit furious or neurologic type and 20% cases
manifest dumb or paralytic form.
• Furious form : Hyperactivity (anxiety, agitation, running,
biting, bizzare behaviour with alternating periods of calm.)
due to auditory, visual or other stimuli.
• Most characteristic symptom : spasm of pharyngeal muscles
triggered by attempt to drink.
• Dumb Form : Acute progressive ascending myelitis with flaccid
paralysis.
• Complete paraplegia, with fatal paralysis of respiratory and
pharyngeal muscles

12. Rabies in Animals
• Dogs :
– Incubation period 3 to 8 weeks, varies from 10 days to 6 mths.
– Hyperexitability or lethargy, paralysis, frothing of saliva, posterior
paralysis, sudden coma and death.
– Behavioral changes common during early phases of the disease.-
– Furious form follows prodromal phase - affected dogs bite without any
provocation.
– Some dogs exhibit only paralytic stage with characteristic dropped jaw
and incoordination.
– Tone of bark changes due to partial paralysis of vocal cords.
– Paralysis, Convulsions and death in 3 to 8 days due to respiratory failure

13. Rabies in Animals
• Rabies in Cats:
– Clinical signs are of furious type similar to that of dogs.
– Tendency to hide in secluded places
– Might strike in air with its forepaws as if it is catching
imaginary mice.
– After 2 to 4 days of excitation phase, posterior
progressive paralysis and death.

14. Rabies in Animals
• Rabies in Cattle
– Average incubation period is 14 days
– Major clinical signs : excess salivation, behavioural
changes, muzzle tremors, bellowing.
– Some times low pitched voice and signs of heat.
– Aggression, hyperesthesia, aggressiveness,
pharyngeal paralysis, coma and death.

15. Rabies in Animals
• Sheep and Goats:
– Muzzle and /or head tremors.
– Aggressiveness, trismus, salivation, dropping ears,
vocalization, recumbence and death.
Rabies in Horse and mules
– Signs similar to tetanus.
– Avg. Incubation period 12 days
– Majority develop furious rabies
– Muzzle tremors, pharyngeal paralysis
– Lethargy, somnolence and death.

16. Dumb Rabies
Furious Rabies
Furious Rabies

17. Endemicity of Dog and Human Rabies.

18. Diagnosis

19. Seller’s dFAT H&E

20. Direct Fluorescent Antibody Test (DFA)
 The direct fluorescent antibody
test (dFA) is the test most
frequently used to diagnose
rabies. This test requires brain
tissue from animals suspected
of being rabid.
 The dFA test is based on the
fact that infected animals have
rabies virus proteins (antigen)
present in their tissues.
Positive dFA
Negative dFA
Gold Standard Test

21. M 1 2 3 4
5 6
607b
p
M- 100bp ladder
Lane1- Dog sample
Lane2- Dog sample
Lane3- Dog sample
Lane4- Dog sample
Lane5- Positive
control
Lane6- Negative
control

22. Personal Safety during Rabies sample Collection
• Person who is performing this procedure should
wear a polythene apron to cover clothes / PPE.
• Mask should be used to cover the mouth and nose
and a goggle to protect eyes.
• Heavy duty gloves could be worn.
• Preferably can wear boots to minimize direct contact
of body

23. It is this Easy to Pick up Rabies

24. Post Exposure Prophylaxis
• Rabies Endemic Country like India
– Every dog bite be suspected as potential rabid bite.
– Treatment to be started immediately after exposure.
Post Exposure Prophylaxis involves
Management of animal bite wound.
Active immunization with anti rabies vaccine.
Passive immunization with rabies Immunoglobulins

25. Management of animal bite wound.
• Thorough flushing and washing of wounds for 15 mins to
remove saliva and dislodge the virus from the wound.
• Wash with soap and water and apply Povidone iodine,
antiseptics having virucidal effect or alcohol for inactivation of
the virus.
• Infiltration of immunoglobulins in to the depth and around
the wound in Category III exposures for neutralisation of virus.
• Suturing of wounds
• Tetanus and antibiotic prophylaxis.

26. Type of Contact, Exposure and Post exposure
Prophylaxis
Category of
Exposure
Type of Exposure Recommended Post
exposure Prophylaxis
I Touching and Feeding of Animals
Licks on intact Skin
Contact of intact skin with secretions ,
excretions of rabid animal
None if reliable case history
is available.
Wash exposed area with
soap and water and apply
antiseptics.
II Nibbling of uncovered skin
Minor scratches or abrasions without
bleeding
Wound management
Rabies Vaccine
III Single or multiple transdermal bites or
scratches.
Licks on broken skin.
Contamination of mucous membrane
with saliva
Wound management
Rabies Vaccine
Rabies Immunoglobulins

27. Summary of Vaccination Schedule
Type of
Prophylaxis
Route of
Administra
tion
Dose of
Vaccine
Day of
Dose
No. of
injections
at each
visit
Total No.of
Injections
Site of
injection
Post
Exposure
Prophylaxis
Intra
Dermal
0.1 ml per
dose
Day 0,3,7
and 28
2 8 Adults :
1deltoid
muscle
Infants and
Small
children
Anterolater
al Thigh
Intra
Muscular
1 ml entire
vaccine vial
Day 0,3,7 ,
14 and 28
1 5
Pre
Exposure
Prophylaxis
Intra
Dermal
0.1 ml per
dose
Day 0, 7
and 21 or
28
1 3
Intra
Muscular
1 ml entire
vaccine vial
Day 0, 7
and 21 or
28
1 3
Re
Exposure
Intra
Dermal
0.1 ml per
dose
Day 0 and 3 1 2
Intra
Muscular
1 ml entire
vaccine vial
Day 0 and 3 1 2
Type of
Prophylaxis
Route of
Administra
tion
Dose of
Vaccine
Day of Dose No. of
injections
at each
visit
Total
No.of
Injections
Site of
injection
Post
Exposure
Prophylaxis
Intra
Dermal
Thai Red
Cross
Regimen
0.1 ml per
dose
Day 0,3,7 and
28
2 8 Adults :
1deltoid
muscle
Infants and
Small
children
Anterolater
al Thigh
Intra
Muscular
Essen
Regimen
1 ml entire
vaccine vial
Day 0,3,7 , 14
and 28
1 5
Pre
Exposure
Prophylaxis
Intra
Dermal
0.1 ml per
dose
Day 0, 7 and
21 or 28
1 3
Intra
Muscular
1 ml entire
vaccine vial
Day 0, 7 and
21 or 28
1 3
Re Exposure
Intra
Dermal
0.1 ml per
dose
Day 0 and 3 1 2

28. Rabies Immunisation in Animals
Type of
Prophylaxis
Route of
Administration
Dose of
Vaccine
Day of Dose Total
No.of
Injectio
ns
Site of
injection
Post
Exposure
prophylaxis
Intra Muscular
or Sub
cutaneous
1 ml Day 0,3,7 , 14
and 28
5 Thigh
muscle
Lateral flank
Pre
Exposure
prophylaxis
Intra Muscular
or Sub
cutaneous
1 ml 3 to 4 months
Booster after 21
to 28 days.
Annual
revaccination
2 Thigh
muscle
Lateral flank
Re Exposure Intra Muscular
or Sub
cutaneous
1ml

29. Pre Exposure Prophylaxis
• For High Risk Groups
– Laboratory Staff handling the virus and rabies
specimens
– Medical and Veterinary Doctors and attendant
staff handling rabies patients.
– Wild Life Wardens, Quarantine Officers
– Travelers from Rabies Free areas to Rabies
Endemic areas.

30. Use of Rabies Immunoglobulins
• All Category III Animal Bites
1.Equine Rabies Immunoglobulins (ERIG)
• 40 IU per Kg body weight.
2.Human Rabies Immunoglobulins (HRIG)
• 20 IU per Kg body weight.
3.Monoclonal Rabies Antibodies(Mab)
Cocktail of at least two antibodies against rabies virus

31. ‘Zero by 30’
The Global Strategic Plan
In 2015, the Conference “Global elimination of dog–mediated human
rabies: The Time Is Now” offered the platform for an urgent call to action to
tackle the disease and set the goal to reach zero human
deaths from dog-mediated rabies by 2030.
Building on this international momentum, the OIE, WHO and FAO
(the Tripartite) and the Global Alliance for Rabies Control
(GARC) have since developed the Global Strategic Plan Zero by 30.
With each partner bringing their specific expertise to the table, the Global
initiative launched in 2018 provides the basis and global tools for a
coordinated response to rabies and aims to support countries in their
elimination efforts. Countries are at the heart of this global strategic plan.
Developing and implementing their own national programmes with global
tools, structures and the needed support empowers them to progress
towards national goals as they fight against rabies.

32. National Action Plan for Eliminating Dog
Mediated Rabies From India ( NAPRE)
• In December, 2015, the World Health Organization (WHO) at a
global rabies conference held at Geneva, Switzerland, called
for the elimination of dog-mediated human rabies by 2030
and recommended the strategy of “one health approach” that
involves an effective coordination and cooperation of medical,
veterinary, and other related sectors.
• As a responsible nation of the global community, India needs
to drastically reduce its burden of human rabies. Hence,
• National Action Plan for Eliminating Dog Mediated Rabies is
being implemented in India by Director General of Health
Services, Ministry of Health and Family Welfare

33. National Action Plan for Eliminating Dog
Mediated Rabies From India ( NAPRE)
• Is based on Recommendations of WHO, OIE and GARC.
• Vision : To Eliminate Dog Mediated Rabies to Zero by
2030
• Vital Elements :
– Prevention :
• Animal Health Component : To achieve at least 70 % of
vaccination coverage among the dog population annualy for
3 consecutive years.
• Human Health component : Timely access of affordable post
exposure prophylaxis for al animal bite victims.
- Promotion and Partnership:

34. A successful National control programme to eliminate dog-
mediated rabies includes
Public awareness and education campaigns
Objective: improve the understanding of the risks related to rabies, as well as
how to prevent them
Mass dog vaccination campaigns, Vaccine Banks
Objective: tackling the disease at its animal source.
Vaccinating at least 70% of dogs in at-risk areas can reduce human
cases to zero
These measures need to be implemented alongside access to human medical care and post-bite treatments.
In this regard, collaboration with human health authorities, under a One Health approach is crucial to their
success
Effective control of stray dog populations
Objective: Reaching a rabies immune or rabies-free dog
population, while ensuring that animal welfare is respected.
Surveillance and reporting :
Objective: monitoring the disease trends and detecting potential new
cases as early as possible

35. Results of Rabies Control Programmes

36. Present

37. BSL II & BSL III LAB AT DIS, AUNDH, PUNE 67
For Diagnosis of Avian Influenza and Other Zoonotic Pathogens.
Upcoming.

38. New BSL II & BSL III Facility
 ‘Creation of Bio-safety Level-II & Bio-safety Level-III
Laboratory For Avian Influenza and Other Zoonotic
pathogens and associated works at DIS Aundh Pune on
‘Turnkey Basis’.
 Approximate Cost of the Project Rs. 75 crores.
 College of Engineering, Pune is appointed as Project
Management Consultant.
 It mainly comprises creation of BSL II & BSL III
laboratories, administrative building & associated works.

39. New BSL II & BSL III Facility
 This project is based on Design, Build, Equip, Operate,
Commission, Validate, Train & Maintain concept.
 BSL III - Bacteriology, Virology, Poultry Lab, FMD -
2000 Sq ft (500 Sq.ft. each).
 BSL II - Bacteriology, Virology, Pathology -Poultry, FMD ,
Parasitology, oxicology, Cattle Diseases,
Disease Surveillance. : 17000 Sq ft.
Administrative and other area - 11000 Sq ft
Total Area 30000 sq ft.
Work Started and will be completed by November .2022

40. Thank You.