Disastrous results of indigenous methods of rabies prevention in developing countries.

Dogs and a few other mammalian species such as cats, jackals, monkeys and mongooses live in close proximity to human establishments, which accounts for a large number of animal exposures every year. Canine transmission causes the vast majority of rabies cases in 1ndia.l In Thailand, nearly 90.6% of rabies cases are caused by canine exposure.2 One in 10 stray dogs in that country are reported to be infected.3 To avoid high costs, indigenous methods are often used in place of modern vaccines for the prevention of rabies in developing countries. Eight patients who initially used different methods of indigenous treatment and later came under the author’s care during 1996-1998 were studied. Epidemiologic and clinical history were recorded in detail. The epidemiologic and demographic characteristics were tabulated (Table 1). Laboratory investigations were carried out on biting animals and the bitten victim, whenever possible, to ascertain the cause of death. All the patients were inhabitants of rural areas in India. The age of the patients varied from 10 to 60 years. Seven patients were bitten by stray dogs and one by an unimmunized family dog. The lower extremity was the site of bite in all patients. Negri bodies were detected in the brain of one patient and two biting animals. Hydrophobia was evident in all the patients in the terminal stage. The outcome of indigenous treatment was invariably fatal. Indigenous methods for prevention of rabies are frequently practiced in developing countries. One method commonly employed in India is to apply a charmed ‘metal plate’ on the back of the bitten patient, accompanied by hymns, mainly to determine the presence of infection (Figure 1). It is believed that the plate remains stuck on the back if infection is present. Patients found to be infected are given oral medicine for prevention of rabies. It is also believed that the plate does not stick if there is no infection or when the patient becomes infection-free after treatment.