In response to a series of tragic rabies-related deaths, the Kerala Government Medical Officers' Association (KGMOA) has urged the state government to implement a universal pre-exposure rabies vaccination program, particularly targeting children and high-risk groups.
In spite of improvements in public health interventions like mass dog vaccination and awareness drives, rabies is still responsible for deaths in Kerala. Recent cases, like the death of seven-year-old Niya Faisal of Kollam district, who died due to rabies despite undergoing post-exposure prophylaxis (PEP), have pointed to the failure of existing strategies.
Rabies is almost always lethal if symptoms become apparent. An estimated 59,000 people die of the disease every year worldwide, 18,000 to 20,000 of whom are from India. Children make up almost 40% of the fatalities.
The KGMOA points out that pre-exposure prophylaxis (PrEP) allows for long-term immunity. According to the World Health Organization, a three-dose intradermal schedule at days 0, 7, and 21/28 is advised. Those who receive PrEP only need two boosters if they are exposed and do not need rabies immunoglobulin, which is both expensive and rare.
Rolling out a universal PrEP program, beginning with children in high-risk regions, could decrease rabies deaths by a substantial amount. Children are especially susceptible, tending to neglect reporting bites or cleansing wounds appropriately. The KGMOA recommends the establishment of a task force to organize a rollout on a phase-by-phase basis, ultimately including high-risk groups like veterinarians, animal handlers, and sanitation workers.
Including PrEP in current rabies control measures and pursuing national-level support to incorporate it in India's Immunization Programme for rabies-endemic areas are also suggested. Such forward-thinking measures are in line with the global vision of zero rabies deaths by 2030.
Kerala has a tradition of leading public health initiatives. By embracing a universal rabies vaccination program for children, the state can lead the way for overall rabies prevention measures across the country.
(Input from various sources)
(Rehash/Sakshi Thakar/MSM)
