Rabies prevention: cost to an Indian laborer.
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Biomedical subjects
Publications and source records attributed to J K Dutta.
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The treatment of symptomatic rabies is a challenging problem; no specific drug is yet available. Isolation in intensive care unit with symptomatic and supportive measures is the mainstay of treatment at present. Antiviral drugs, particularly interferon and interferon-inducers, have been employed with variable results. Corticosteroid is not effective. Anti-rabies vaccine has no proven efficacy in treatment. Effective treatment of systemic complications during survival period with appropriate therapy is essential.
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In contrast to past experience, transmission of rabies by routes other than bite or licking by rabid animals has been identified in recent years. Man to man spread via corneal transplant is a well recognised phenomenon now. Airborne infection in caves as well as in laboratories among workers dealing with rabies virus has been well documented. There is also a potential risk of infection to attendants of rabies patients. Hence, adequate protective measures should be adopted.
Treatment of symptomatic rabies is a challenging task as no effective drug is yet available. Hence, prophylactic immunization is an important step. The development of adequate level of antibody (greater than or equal to 0.5 IU/ml serum) is necessary for protection against the disease. In contrast to the nerve tissue vaccines, tissue culture vaccines particularly human diploid-cell strain type is highly potent and least reactogenic. To minimize the costs of immunization by this expensive vaccine, small dose intradermal administration has been advocated for developing countries with endemic rabies. Concurrent use of serum and antimalarials may interfere with adequate immune response. Efforts are in progress for the development of more potent subunit and recombinant antirabies vaccine for future human use. This review makes an attempt to study the antibody levels in the vaccinees regarding its role in the protection and failure against clinical and experimental rabies.