Published: 2018-04-24

Pattern of exposure among victims of suspected rabid animal attending anti-rabies clinic of tertiary care hospital

Uruj A. Qureshi, Mariya A. Qureshi


Background: Rabies, a neglected tropical disease, is vaccine preventable and occurs in more than 150 countries. It is almost always fatal. About 40% of deaths due to rabies occur in children under the age of 15 years. Objectives were to study the pattern of injury following exposure to canine bite, bear maul and rabid cow among the attendees of Antirabies clinic of SMHS hospital, Srinagar and to classify the type of exposure using WHO guidelines for initiation of post exposure prophylaxis.

Methods: The study was conducted over a period of three months from 1st June 2016 to 31st August 2016, in Anti Rabies Clinic of Department of Community Medicine, Government Medical College, Srinagar. It was a descriptive Study and included all victims of canine bite and rabid cow. A total of 134 patients were received.

Results: Most [83 (61.9%)] of the patients were males with mean age of 36.63 years. Legs were the most common [57 (43.2%)] site of exposure followed by hands [15 (11.2%)] and thigh [13 (9.7%)]. Contact with a rabid cow was present in 5 (3.7%). Class II exposure was most frequently encountered [83 (61.9%)]. Class III exposure was seen in 49 (36.6%). All patients who attended anti rabies clinic for post exposure prophylaxis received free Antirabies Vaccine. Combined Antirabies vaccine and immunoglobulin was received by 49 (36.6%).

Conclusions: Dog bite related injuries happen frequently in Srinagar. There is proper post exposure prophylaxis in place in SMHS hospital. There is need for curbing the ever increasing dog population and enforcing rabies vaccination in dogs.


Rabies, World Health Organization, Post exposure prophylaxis, Antirabies vaccine

Full Text:



Fooks AR, Brookes SM, Johnson N, McElhinney LM, Hutson AM. European bat lyssaviruses: an emerging zoonosis. Epidemiol Infect. 2003;131:1029-39.

Botvinkin AD, Poleschuk EM, Kuzmin IV, Borisova TI, Gazaryan SV, Yager P, et al. Novel lyssaviruses isolated from bats in Russia. Emerg Infect Dis. 2003;9(12):1623-5.

Wunner WH, Briggs DJ. Rabies in the 21 century. PLoS Negl Trop Dis. 2010;4:e591.

World Health Organization. WHO expert consultation on rabies: second report. WHO Press, 2013.

Carrara P, Parola P, Brouqui P, Gautret P. Imported human rabies cases worldwide, 1990-2012. PLoS Negl Trop Dis. 2013;7:e2209.

Crowcroft NS, Thampi N. The prevention and management of rabies. BMJ. 2015;350:g7827.

Nel LH. Discrepancies in data reporting for rabies, Africa. Emerg Infect Dis. 2013;19:529-33.

Shim E, Hampson K, Cleaveland S, Galvani AP. Evaluating the cost-effectiveness of rabies post-exposure prophylaxis: a case study in Tanzania. Vaccine. 2009;27:7167-72.

Gogtay NJ, Nagpal A, Mallad A, Patel K, Stimpson SJ, Belur A, et al. Demographics of animal bite victims & management practices in a tertiary care institute in Mumbai, Maharashtra, India. Indian J Med Res. 2014;139:459‑62.

Umrigar P, Parmar GB, Patel PB, Bansal RK. Epidemiology of animal bite cases attending municipal tertiary care centres in Surat city: A cross‑sectional study. Natl J Community Med. 2013;4:153‑7.

WHO Expert Consultation on rabies. World Health Organ Tech Rep Ser. 2005;931:1-88.

Lone KS, Bilquees S, Khan MS, Haq IU. Analysis of dog bites in Kashmir. An unprovoked threat to population. National J Comm Med. 2014:5:66-9.

Salve H, Kumar S, Rizwan SA, Rai SK, Shashikant, Pandav CS. Feasibility of sustainable provision of intradermal Postexposure prophylaxis against rabies at primary care level-evidence from rural Haryana. BMC Health Services Res. 2014;14:278.

Abubakar SA, Bakari AG. Incidence of dog bite injuries and clinical rabies in a tertiary health care institution: a 10-year retrospective study. Ann Afr Med. 2012;11(2):108–11.

Schalamon J, Ainoedhofer H, Singer G, et al. Analysis of dog bites in children who are younger than 17 years. Pediatrics. 2006;117(3):374–9.

Fleisher GR. The management of bite wounds. N Engl J Med. 1999;340:138–40.