A Study of Human Rabies in Adults Admitted At Infectious Diseases Hospital of Tertiary Care Centre

Abstract

Aims and Objectives: To study epidemiological characteristics and clinical profile with specific attention to non classical/atypical clinical presentation and deficiencies/lacunae in post exposure prophylactic management as per WHO guidelines in adult rabies patients. Method: In this observational study, 96 cases of adult human rabies admitted at IDH of parent institute in 5 years duration (1/11/2008 to 31/10/2013) were studied. Data were collected and analyzed statistically. Results: Majority (95.9 %) of victims belonged to lower and lower middle socioeconomic class predominantly males (76.05 %) in age group of 12- 50 years (70.8 %) with WHO category III exposure (72.92 %). Principal biting animals was dog (95.84%). Majority (44.79%) cases had incubation period between 31-90 days post-exposure. Hydrophobia is the main pathognomonic feature of human rabies was present in 88.54 % cases. Majority (91.7 %) of cases had not received any rabies vaccination. 8.3 % victims received anti-rabies vaccine, 7.3 % received PCECV and 1% received PDEV. 1% had completed the course of PCECV (5 doses as relevant) and another 4.2% had received the 3 doses PCECV, 2.1% cases received 2 doses of PCECV. One case (1%) received 1 dose of PDEV. Conclusion: Human rabies is a major health problem, equally affecting rural as well urban population. The epidemiological characteristics and clinical profile of the disease are not much different from other studies and have not changed much over the decades. Hence, there are need to educate the community and health workers about the importance of immediate and adequate post-exposure treatment, to start effective control program for dog and to make availability of TCV as well as RIG.