PANAJI: The Mission Rabies team in Goa is stepping up surveillance efforts to detect rabies cases and target control measures at remaining problem areas, even as instances of the disease comes under control in the state. The intensive surveillance techniques include integrated bite case management (IBCM), wherein bite victims are studied to assess the risk of rabies.
As a result, instead of waiting for people to report dogs showing signs of rabies, surveillance officers actively screen cases of bites at hospitals to find ones most likely to be from rabid animals.
“The primary objective of IBCM is to find the maximum, if not all, cases of known rabid bite to coerce post exposure compliance, other victims from the same dog, reduce unnecessary post exposure prophylaxis and remove suspected rabid dog from the locality with the help of the rabies response team,” a rabies surveillance officer said. IBCM also involves following up on bite victims from primary health centers across Goa where cases are recorded, and post exposure prophylaxis is administered.
Approximately 22,000 bites are reported to directorate of health services every year, according to Mission Rabies Goa. “This method of surveillance also reduces unnecessary administration of vaccine and immunoglobulins in people bitten by a healthy animal,” they said.
April 2018 onwards, a rabies surveillance officer had been employed to pilot IBCM follow-up on suspected rabies cases reported to the hotline as well as examine dog bite victims coming to PHCs. The phone numbers, age and name of people reporting to three PHCs of Siolim, Valpoi and Mapusa, were provided to the rabies surveillance officer daily basis follow-up.
Bite victims would be interviewed over the phone to gather information about the circumstances of their bite and the biting animal. Cases with the lowest risk were monitored through follow-up phone consultation. High-risk cases, where the dog could be identified, were followed up by the rabies surveillance officer in person.
“Surveillance measures must be maintained long term to detect re-incursion of rabies from surrounding endemic areas of India until wider regional control is achieved. Methods for assessing dog bites to determine the risk of rabies have recently been described by Center for Disease Control, USA. This involves follow-up investigation for bites which are considered to be high risk of being from a rabid animal and tailoring recommendations accordingly,” another officer said.