TITLE:
Spontaneous Rabies in a Stray Bitch after Parturition Induced Immunosuppression —Investigating an Impending Outbreak of Rabies with One Health Approach
AUTHORS:
Omesh Kumar Bharti, Hamender Sharma, Uppinder Sharma, Archana Phull
KEYWORDS:
Human Rabies, Dog Rabies, Rabies Outbreak, Local Rabies Immunoglobulins, Anti Rabies Vaccination, Immunosuppression, FAT Testing, ONE Health
JOURNAL NAME:
World Journal of Vaccines,
Vol.6 No.1,
February
26,
2016
ABSTRACT: Background: Rabies is endemic in India and every half an hour a person dies of this dreaded disease.
Stray roaming dogs, mostly unvaccinated, are most dangerous host in spread of rabies in India
and in our state of Himachal Pradesh. Timely prophylaxis is the only method to save animal
bite victims, including that of rabid dog bite patients. Objectives: Objective of this study was to investigate
an impending outbreak of rabies in Shimla town in the absence of life saving rabies immunoglobulins
(RIGs) in the market, and to know the source of infection by using one health approach
and using epidemiological tools. Methods: On April 7, 2015, there was a sudden surge in
cases of suspected rabid dog bites. Impending rabies outbreak was suspected as there were no
RIGs available in the market. A rapid Response Team (RRT) consisting of the author, veterinary
doctor, dog squad of Municipal Corporation (MC) Shimla along with the vehicles to impound rabid
dogs was constituted to investigate the terror spread by two rabid dogs on biting spree in the
Shimla Municipality. Results: A total of 18 people were bitten by suspected rabid dogs within three
days period. A black bitch and a brown dog, on the identity of affected people, were captured by
the dog squad of Municipality next day on April 8, 2015 and taken to Dog Sterilization Centre, Animal
Birth Control (ABC) programme, MC Shimla for observation. The most furious Black bitch
died of clinically confirmed symptoms of furious rabies after three days. The second rabid dog,
brown in color, died after a month of observation due to paralytic dumb rabies. The brain of the
brown dog was extracted for Fluorescent Antibody Testing (FAT) at central research Institute (CRI) Kasauli and was found to be positive for FAT. Follow up of patients was 100% by house to house
visit and over telephone and no casualty was reported. Conclusion: While we were working on
hypothesis of rabid dogs getting the infection from nearby forest about 8 - 10 KM away but on follow
up of the patients, they reported that both the dog and bitch used to stay in the compound of
their colony since the bitch was pregnant and there was no history of the bitch moving for away to
forests neither any outside dog which was seen near them in the compound. This led us to think of
other causes of what must had happened to the bitch that caused her to be rabid as for the past 9
years we had observed bitches becoming rabid after litter birth (Whelping) and making their pups
rabid due to licking. Since the carrier state for rabies virus in bitches/dogs is known and a state of
immunosuppression after whelping/parturition is also known, therefore there is a possibility of
latent rabies virus getting activated due to immunosuppression after litter birth and it is thought
to be as one of the probable causes of black bitch getting rabid and inflicting the infection to accompanying
brown dog. We need to do further studies to ascertain this phenomenon before coming
to a definite conclusion and suspect such a possibility in case a dam suddenly becomes rabid
among a pack of stray dogs in rabies endemic countries like ours.