Project in Northeast to collect data for comprehensive national rabies-elimination plan

A dog may be a human's best friend, but its bite could also be fatal, with India recording the highest human mortality rate worldwide due to dog-mediated rabies.

A group of scientists and their associates, who claimed that rabies control measures have been mostly ''sporadic and knee-jerk'', have come together to help eradicate rabies spread by dog bite through proper study, analysis and result-oriented interventions.

A project, 'Implementing a comprehensive One Health approach to eradicate dog-mediated rabies from India', is currently underway in Northeast, with Dr Harish Tiwari, a veterinary epidemiologist, at the helm.

''This project aims at generating empirical evidence of freedom from canine rabies in randomly selected rural, suburban and urban areas of the northeastern region by simultaneous application of multiple rabies control interventions under the umbrella of One Health,'' Dr Tiwari told PTI.

''Using the data obtained from the project, we will develop a comprehensive context-based rabies eradication plan for the rest of the country,'' he added.

One Health is a concept of how well-being and health of all living organisms is inter-linked and a robust balance is needed between a healthy environment, disease free animals and well-being of humans.

He said India records the highest number of dog-bite injuries in the world causing more than 20,000 human deaths and enormous loss to the national economy annually due to rabies.

The project is under DBT-Wellcome Trust India Alliance Project, with the veterinarian and his team being hosted by IIT-Guwahati.

Dr Tiwari has joined the newly started Jyoti and Bhupat School of Health Sciences and Technology (JBSHST) at the IIT-Guwahati as a DBT Wellcome India Alliance intermediate fellow for the project.

DBT-Wellcome Trust India Alliance is an independent, dynamic public charity that aims to improve the biomedical research landscape in India by supporting exceptional researchers at Indian institutions and facilitating highly trained and qualified scientists from overseas.

The project's duration is five years and carries a grant of Rs 3.56 crore.

The project will run in collaboration with University of Bern, Swiss Tropical and Public Health Institute University of Glasgow, University of Sydney, Ramaiah International Centre for Public Health Innovations, Bangalore, and Gauhati Medical College, Guwahati.

Dr Tiwari, citing his previous work, said that the control of dog-mediated rabies in rural and urban India is focused either on increased availability of human post-exposure prophylaxis (PEP) or confined to sterilisation of free-roaming dogs (FRD).

''The implementation of the interventions is sporadic, infrequent, fragmented in space and lacks community involvement. Improper dog-bite wound management practices by paramedical staff at public health centres also contribute to the high rate of rabies incidence,'' he claimed. Few rabies control campaigns consider the demography or the group behaviour of the FRD to plan eradication strategy, he said.

''Rabies elimination strategy in India warrants an approach where multiple intervention strategies, such as mass vaccination of 70 per cent of the FRD to achieve herd immunity, dog population control, disease surveillance and community awareness are applied simultaneously under the umbrella of One Health.

''We will demonstrate that an integrated approach with intensive communication between the human and animal health sector highly facilitates rabies control, makes it more cost-effective and is essential for its elimination,'' Dr Tiwari said.

Although PEP prevents human deaths from a rabid dog's bite, combating the disease in FRD, where the disease is maintained, is the key to successful elimination, the veterinarian, who is a retired Lieutenant Colonel of the Indian Army, said.

An alumnus of Assam Agricultural University, Dr Tiwari said the first activity as part of the project will be a teachers' workshop in Guwahati.

He emphasised on the role of educational institutes in enhancing children's knowledge about rabies and FRD, while also pointing out that though introducing interventions such as awareness campaigns in schools is a plausible way to make the students aware of these important topics, it is impossible to involve all schools due to the enormous scale of involvement required.

''This workshop seeks to transfer intervention materials and information to teachers, who would, in turn, carry out awareness-spreading exercises in the respective target schools. The over-arching goal of the workshop is to develop an economically viable, sustainable and effective awareness-imparting mechanism for school children through the active participation of school teachers,'' he said.

The workshop, being held at St. Vivekananda English Academy in Maligaon area of Guwahati later this week, will assess the current information levels, challenges and barriers for controlling dog mediated rabies.

''Finally, the workshop will gather suggestions of the pedagogical experts (participating teachers) for developing e-learning modules on rabies and FRDs that will be made available online for all schools in the state,'' Dr Tiwari said.

Various activities will be undertaken in different parts of the region under the project, he added.

His team comprises of project manager Parimala Mohanty and project assistants Sounika Karmakar and Dipankar Gogoi. They have been joined by Samira Heydtmann from the University of Zurich, Switzerland, for the first activity of teachers' workshop.