This document outlines measures for rabies prevention and control, including animal and human components. Animal rabies control involves mass dog vaccination, movement restrictions, and stray dog control. Human prevention includes avoiding animal exposures, pre-exposure vaccination for high-risk groups, and post-exposure prophylaxis consisting of wound treatment, vaccination, and possibly rabies immunoglobulin. Effective rabies prevention and control requires legal frameworks, adequate resources, expanded diagnostics, collaboration among stakeholders, and community education.

1. Rabies Prevention and Control
Measures
Abraham Ali (DVM, MPH)
Ethiopian Public Health Institute

2. Outline
• Definitions
• Introduction
• Rabies Prevention and Control
• Elements of Animal Rabies Control
• Elements of Human Rabies Prevention
• Basic Issues on Rabies Prevention and Control
• Key Message

3. Definitions
• Prevention:
– The management of those factors that could lead
to disease so as to prevent the occurrence the
disease
– It is the first line of defense against disease.
• Control:
– Reduction of disease incidence, prevalence,
morbidity, or mortality to a locally acceptable level
as a result of deliberate efforts; continued
intervention measures are required to maintain
the reduction.

4. Introduction(1)
• Disease prevention and control program are
developed to monitor the occurrence of infectious
diseases, and safeguard the public.
• Prevention and Control program : is a set of policies
and exposure control plans that form a
comprehensive strategy to prevent and control
infectious diseases.
• The health policy of the Federal Democratic Republic
of Ethiopia has given due emphasis to promotive and
preventive interventions coupled with basic curative
services.

5. Introduction(2)
Generally, diseases can be controlled and
prevented by adequate measures which
involve:
1. Diagnosis
2. Notification
3. Isolation
4. Treatment
5. Quarantine
6. Investigation
7. Disinfection
8. Blocking of transmission
9. Immunization
10. Health education.

6. Rabies Prevention and control
• It has two components:
1. Animal Rabies Control
 Primary Prevention measures
 Measures used to prevent the
disease at the source
2. Human Rabies Prevention
 Secondary Prevention Measures

7. Elements of Animal Rabies Control
• Rabies control strategies include :
I. Mass vaccination of dogs
II. Movement restriction/Confinement
III. Control of ‘stray’ dogs

8. I. Mass vaccination of dogs
• Animal Pre-Exposure
Vaccination
• For effective control at
least 75-80% of the
population Should be
vaccinated
• Should be done at
regular Bases

9. II. Movement restriction/Confinement
• Isolation and Observation
Periods( 10 days for Dogs and
cats): -Suspect Rabid Animal
Exposes a Person-Lab Diagnosis
• Animal Quarantine(Six month) :
-Animal Exposes and previously
vaccinated
• Euthanasia of unvaccinated
animals If exposed

10. III. Control of ‘stray’ dogs
• Objective is to decrease
stray dog population on
certain level or to keep
and management with
the population on
certain level
• Stray dog : each dog
that is not under direct
control of the owner or
it is nor being stopped
in roam (including lost
and abandoned dogs)

11. Measures for stray dog control
• Create responsible dog ownership among the
community
• Dog registration and Identification:- mandatory rabies
vaccination and traceability.
• Environmental Control:-excluding dogs from sources of
food (e.g. rubbish dumps and abattoirs, and installing
animal-proof rubbish containers).
• Humane dog population management:- Animal Birth
control
• Euthanasia: -means the act of inducing death in a
humane manner.
• Control of dog movements:- (e.g. leash laws, roaming
restrictions)

12. Elements of Human Rabies Prevention
• Avoiding exposure :-
– Avoiding contact with unknown animals
– Nursing rabid Human /animal with Care
• Pre-Exposure Prophylaxis (PrEP) : –
– is recommended for anyone who is at continual,
frequent or increased risk for exposure to the rabies
virus such as laboratory workers, veterinarians and
animal handlers.
• Post-Exposure Prophylaxis (PEP):-
– anti-rabies prophylaxis ( Vaccine) administered after
an exposure

13. Post-exposure prophylaxis
• Post-exposure prophylaxis consists of:
a) Local treatment of the wound as soon as
possible after exposure,
b) Exposure assessment and administration of
potent, effective anti rabies vaccine that
meets WHO recommendations and/or
c) Administration of rabies immunoglobulin, if
indicated

14. a) Local treatment of wounds
The recommended first-aid procedures include
immediate, thorough flushing and washing of the
wound with soap and water, detergent, povidone
iodine or other substances with virucidal activity.
• Next visit health facility to
receive specialised treatments
such as:
– Post Exposure vaccination and
rabies immunoglobulin
– Administration of antibiotics
– Tetanus prophylaxis,

15. b)Exposure Assessment and Anti rabies Vaccination
• Exposure assessment for Anti Rabies administration is
done based on WHO guideline
• It consider the following points :
– Exposure status
– Availability of responsible animal for Diagnosis
– Laboratory Result
– Epidemiology of the disease
in the country

16. Categories of Exposure
• Exposure: Rabies exposure occurs when the virus is
introduced into bite wounds or open cuts in skin or onto
mucous membranes.
• Two categories of exposure, bite and non bite, should be
considered.
• Bite: Any penetration of the skin by teeth constitutes a bite
exposure.
• Non bite: The contamination of open wounds, abrasions,
mucous membranes, or theoretically, scratches, with saliva
or other potential infectious material (such as neural tissue)
from a rabid animal constitutes a non bite exposure.

17. Vaccines for post-exposure prophylaxis
Nervous Tissue vaccine
•17 Injections
•Administered around the umbilicus SC
Cell culture Based Vaccines
• 5 Injections
• Administered intramuscularly

18. c)Administration of Rabies immunoglobulin
• It is to provide neutralizing antibodies at the site of
exposure before patients can begin producing their
own antibodies physiologically after vaccination.
• It should be administered to all patients presenting
with single or multiple transdermal bites.

19. Basic Issues on Rabies Prevention and Control
• Should be backed by legal framework
• Allocation of Resources : availing Vaccines & RIG
• Expand diagnostic service and strengthen
surveillance system
• Skill man power
• Collaboration among stakeholders
• Community education and participation

20. Key Message
• ‘Prevention is better than cure’
• Since, there is no cure for Rabies
• Prevention is the only alternative
• Let’s work hard together to prevent
rabies

21. Thank You