As a result of an increase in deaths caused by rabies in Kerala, a three-member central panel, which visited the state to investigate the cases, has informed the Union Health Ministry that these deaths have not been caused by an ineffective vaccine or viral variants eluding immunity.
The study concluded that there was no evidence to support the claims regarding anti-rabies vaccine efficacy/potency and the circulation of rabies virus variants escaping protection provided by vaccines.
Several issues were identified, including limited availability of anti-rabies vaccine and serum, knowledge gaps in essential wound washing after animal bites, and health workers not knowing when to administer rabies immunoglobulin. According to the report, all anti-rabies clinics must provide washing areas with soap and water for the “target audience” and staff members.
Additionally, the report stated a knowledge gap regarding the choice of an anti-rabies serum for people who have suffered a category 3 animal bite, which is critical to preventing mortality. When an animal bites or scratches the skin multiple times, the skin is broken, the animal has licked the skin, or bats have been contacted, the bite is considered category 3. It is necessary to administer rabies serum in cases of infection. Dr Simmi Tiwari, joint director at the Division of Zoonotic Disease Programme, and Dr Monil Singhai, joint director of the National Centre for Disease Control’s Centre for Arboviral and Zoonotic Diseases, were members of the committee.
As for the availability of anti-rabies vaccines and serums, the committee reported that vaccines were available in only 30% of primary or urban health centres. In comparison, serums were available in only 3.5%. According to the report, “uninterrupted supply… at all levels… must be ensured.” According to the committee, there was a delay in seeking and receiving appropriate bite management in the cases examined. It also suggested reporting the failure of newly introduced monoclonal anti-rabies antibodies, antibodies created artificially in labs to combat rabies, reducing costs and allergic reactions.