Rabies vaccines

Abstract

Rabies is a viral zoonotic disease which kills about 55,000 persons worldwide every year of which 20,000 are from India. The animals which transmit the disease in India are dogs (97%), cats (2%), mongoose, jackals and others (1%). The David Semple (Nerve tissue or sheep brain) vaccine was discontinued in 2005 and replaced by modern rabies vaccines by intramuscular route. To promote cost-effective post-exposure rabies vaccination, the Government of India introduced administration of rabies vaccines by intradermal route in 2006. Currently the rabies vaccines produced and used in the country include purified chick embryo cell vaccine, purified vero cell vaccine, purified duck embryo vaccine and human diploid cell vaccine. The rabies immunoglobulins which are vital in category III (severe) exposures are now more widely used. The vaccine regimens approved for use in India are the five doses Essen regimen by intramuscular route and the four doses updated Thai Red Cross regimen by the intradermal route. Lastly, guidelines for re-exposure vaccination and preexposure vaccination are also described.