An Epidemiological follow-up study of unpasteurized milk exposure from Rabid Cattle in a village of India
Background: Possibility of acquiring rabies due to consumption of unboiled milk exists and specific research documenting containment plan for such epidemics does not exist. Vaccination policies and specific criteria need to be decided for such vulnerable groups. Material & Methods: A longitudinal follow-up study of 146 persons after consumption of milk form rabid buffalo was done for four years from 2012 to 2016 in village situated on western coast of India. Post exposure prophylaxis (PEP) was provided to exposed population according to WHO Essen regimen. Results: Early identification and PEP was possible due to coordination between health and medical services, medical education and veterinary departments. Among 146 at risk people, PEP for four doses was completed by 89% and five doses by 71% respectively. No untoward events related to rabies were reported after four years surveillance. The community participation in surveillance and vaccine uptake was backbone of outbreak containment plan. Timely reporting of laboratory confirmed cattle death helped to identify potential impounding outbreak. Conclusions: Addition of intradermal regimen PEP to people exposed to unpasteurised/unboiled milk from rabid cattle should be done to existing guidelines for emergency situations to prevent panic, vaccine costs and rabies epidemic among community.