1. Dr.G.Sampath, Past President
2. Dr.Bankim B Patnaik, Vice President
3. Dr.Thomas Mathew, Secretary General
4. Dr.V.Srinivas Rao, Treasurer
5. Dr.Sumit Poddar, Zonal Representative East
6. Dr.D.Shobha Malini, Zonal Representative East
7. Dr.J.Ravi Kumar, Zonal Representative South
8. Dr.Kshirsagar Vikas Devidas, Zonal Representative West

Download: Operational Guidelines for Rabies Prophylaxis – Intra Dermal Rabies Vaccination and Rigs Administration in Kerala

As part of IDRV Kerala 2010, a state level Training of Trainers (ToT) was conducted to provide hands on training on RIGs administration on 25^th and 26^th January 2010 at the Anti rabies Clinic of General Hospital, Thiruvananthapuram. There were 75 participants including Medical officers and Staff nurses from 14 district hospitals, Regional PEID cell coordinators, Medical officers and Health inspectors of Anti Rabies Clinic of 5 Govt. Medical Colleges. The training was led by Dr.G.Sampath, Deputy Civil Surgeon, IPM, Hyderabad & President, APCRI and Dr.D.H.Ashwath Narayana, Asso.Prof, Community Medicine, KIMS, Bangalore. The World Health Organisation (WHO) protocols for administering RIGs were explained to the audience. Patients who came to the Anti rabies clinic were given RIGs and the process of administration was demonstrated to the whole participants through Close Circuit Television (CCTV).

The afternoon session was organized in KGMOA hall where the participants had discussion with the trainers on administration of IDRV. Dr.M.K.Jeevan, Director of Health Services and Dr.V.Geetha, Director of Medical Education graced the valedictory function held at KGMOA hall, Thiruvananthapuram. Dr.V.Geetha handed over the momentos to Dr.G.Sampath, Dr.D.H.Ashwath Narayana, Dr.Preetha,ARC General Hospital and Mr.Sathpathy,Bharat Serums and Biologicals.

On the second day the participants were given opportunity to administer RIGs to Cat III patients at ARC, General Hospital.

The rally was followed by the inauguration of The World Rabies Day State level by Sri. C. Divakaran, Honorable Minister for Husbandry, Food and Civil Supplies, Kerala. Dr. R. Vijayakumar, Director of Animal Husbandry Kerala, welcomed the gathering and Dr. A. P. S Nair, president, IVA; delivered the key note address. Sri. S. B. Jayaprasad, Chairman, Kerala State Pollution Control Board; Sri. A. Vikraman Nair, Additional Secretary, Animal Husbandry; Dr. Theodore John, President, KVSSA; Dr. Sukumara Pillai, president, AHOAK; Sri. G. Prakasam, Special Officer to MD, KMSCL and Dr. N. Ajayan, DAHO; felicitated in the inaugural ceremony. This was followed by the workshop on Rabies Control, inaugurated by Sri. S. M. Vijayanand IAS, Principal Secretary, LSGD and chaired by Dr. V. Ramkumar, Former Secretary, VCI; Dr. R. Vijayakumar, Director, Animal Husbandry Dept. and Dr. N. N. Sasi, Registrar, Kerala State Veterinary Council. The workshop aimed at developing a comprehensive strategy for the control of rabies in the State and to develop a road map to achieve a rabies-free State. The Indian Veterinary Association along with the Alliance for Rabies Control; the Association for Prevention and Control of Rabies in India; NRHM; Animal Husbandry Department; Kerala State Veterinary Council; Department of Health Services and the Local Self Government Department were the major representatives of the workshop.

Dr. Thomas Mathew, Nodal Officer, IDRV, NRHM; Dr. Rani S. S., Additional Director, Animal Husbandry Department and Dr. Jacob Alexander, Secretary, IVA made presentations on Strategy for Control of Rabies. Rabies is 100% fatal and 100% preventable and therefore intersectoral cooperation and community participation can control rabies in the state.

Download APCRICON 2009 Souvenir (pdf)

Rabies is an acute viral disease which causes fatal encephalomyelitis in virtually all warm blood animals including man. Intra muscular route has been the most commonly used route of administration of rabies vaccination in India. The use of Intra Dermal route of administration of rabies vaccination was approved by DCGI in 2006. The success of IDRV implementation in Andhra Pradesh and Karnataka set the ground for adoption of the same in the State of Kerala. Following which IDRV was launched in Kerala in February 2009. The Kerala model of implementation of IDRV has set an example of an ongoing successful partnership with the Government. IDRV as of current has become operational in eight centres and plans to be scaled up to 236 institutions, both primary and tertiary.

In this context, the 11^th National Conference of the Association for Prevention and Control of Rabies in India (APCRI) was held on 4^th and 5^th July, 2009 at Taj Residency, Thiruvananthapuram, focusing on the implementation of IDRV in the country. The theme of the conference, ‘Intra Dermal Rabies Vaccination – The Challenges Ahead’ is a significant contribution towards achieving the goal of a Rabies Free Kerala by 2015 and India by 2020. The Honourable Health Minister of the State, Smt. P. K. Sreemathi Teacher inaugurated the conference by lighting the lamp. The honourable minister delivered an encouraging and supportive inaugural speech. Dr.Usha Titus, Secretary Health and Medical Education delivered the keynote address. Dr. Dinesh Arora IAS, SMD, NRHM & MD KMSCL and Dr. Vishwas Mehta, Secretary H&FW were the chief guests of the conference. The release of Souvenir 2009 and APCRI journal was done by the Honourable Health Minister of the State, Smt. P. K. Sreemathi Teacher and Dr. Usha Titus, Secretary Health and Medical Education during the inaugural function. In the welcome speech Dr.G.Sampath highlighted the commitment of Government of Kerala and appreciated the efforts put by the State to achieve a Rabies free Kerala by 2015.

The Louis Pasteur oration presented by Dr.Veena Mittal, Joint director & Head, Zoonosis Division and Head, WHO Collaborating Centre for Rabies Epidemiology, highlighted the burning issues in rabies control in India. The scientific sessions were not restricted to IDRV but it extended to a broader spectrum of rabies prevention and control. The participation of delegates from different sectors including public health, corporates and organizations working in the field of rabies prevention, has brought an integrated approach in IDRV. Dr. Deborah J.Briggs, Executive Director, Alliance for Rabies Control, France; Dr. Christophe Python, Crucell Diagnostics, Switzerland; Dr. Claudius Malerczyk, Head – Medical Affairs, Middle East and Africa, Novartis Vaccines and Diagnostics, Germany; Dr. Michael Royals, CSO, PharmaJet, USA and Dr.Omala Wimalaratne, Head, Dept of Rabies and Vaccines, Medical Research Institute, Ministry of Health, Sri Lanka were the international delegates who shared the global approach on Rabies control. It was a delight to have Dr M.K Sudarshan, Dr M.S Madhusudhana, Dr R.L Icchpujani, Dr Veena Mittal are other experts who have abundant experience in this field, from India to share their valuable experiences through their presentation at the conference. Creation of awareness among doctors on dosage of vaccine; awareness generation among school children (as they contribute to about 1/3 of dog bite victims) and initiatives to decrease the IDRV drop out rates, were the major issues stressed at the conference. The conference created an ideal platform for all the stakeholders, both national and international delegates to coordinate and plan strategies to achieve the goal ahead. All the speakers and chairpersons were honoured by the unique “Aranmula kannadi” as momento.

Towards the end of the first day, the execute body meeting was held. Following this, the election of the office bearers for the year was conducted. Dr Sairu Philip was the returning officer for the election. The new office bearers were elected by a smooth and friendly contest. The newly elected office bearers include,

Dr. G Sampath, President.

Dr. Bankim. B. Patnaik, Vice president.

Dr. Sumit Poddar, Vice president.

Dr. Thomas Mathew, Secretary General

Dr. V.  Sreenivasa Rao, Treasurer.

This was followed by an enchanting musical evening and the gala dinner. Dr Vishwas Mehta IAS added to the flavour of this evening by his wonderful, soft, melodic voice.

This conference has been materialised by the synergistic support from the dedicated members of APCRI with their academic inputs and advocacy, the administrative support from the Department of Health, Government of Kerala and the artistic strategies actualized by SDCMC and HLFPPT team.  We would like to take this opportunity to thank Zydus, Novartis, Bharat Serums and Vaccines, Sanofi Pasteur, Bharat Biotech, ACE Pharmaceuticals, Med Life, Human Biologicals Institute, Kinfra and HLL Lifecare Limited for their whole hearted support for this  conference.

Let us work together to make our dream of rabies free Kerala by 2015 and rabies free India by 2020.

Workshop on Developing Guidelines for the Implementation of IDRV in Kerala

Watch IDRV Video Part-1

Watch IDRV Video Part-2

Operational Guidelines for Rabies Prophylaxis and Intra-Dermal Rabies Vaccination in Kerala (pdf)

Rabies is a major public health issue in many parts of the world causing an estimated 55,000 deaths every year.  India suffers a casualty of about 22,000 deaths per year due to rabies and in Kerala Rabies claims about 30-40 lives per year.

Timely and appropriate post exposure prophylaxis can prevent deaths in this one hundred percent fatal disease.  Approximately 3 million people receive post exposure prophylaxis in India.  Nervous Tissue Vaccine (NTV) has been replaced by more safe and effective Cell Culture Vaccines (CCVs) in India since December 2004.  WHO estimates that a full course of Post Exposure Prophylaxis (PEP) requires 31 days of wages for an Asian citizen thereby making it unaffordable to many.  Intradermal post exposure regimen has been approved by WHO as early as in 1992 and has now undergone extensive evaluations in India. It is found to be equally effective and at the same time cost effective (60-70% cost reduction). This regimen has been approved by the Govt. of India in 2006.  NICD, Delhi has formulated and published guidelines for intradermal vaccination for Govt. of India and is already being implemented in states like Uttar Pradesh, Orissa, Andhra Pradesh, Karnataka, West Bengal, Tamilnadu and Himachal Pradesh.

As a part of celebrating World Rabies Day 2008, a workshop on developing guidelines for IDRV (Intra Dermal Rabies Vaccine) in Kerala was held at Thiruvananthapuram on 20^th and 21^st September 2008 at Hotel Taj Residency, Thiruvananthapuram.

Dr. Thomas Mathew, Prof & HOD, Community Medicine, T. D. Medical College, Alappuzha and Nodal Officer, State Disease Control & Monitoring Cell took up the initiative and officiated as the organizing secretary. The workshop was inaugurated by Smt P.K Sreemathy teacher, Honble Minister for Health & Family Welfare. Sri C.Jayan Babu, Worshipful Mayor of Thiruvananthapuram Corporation, Dr Vishwas Mehta IAS, Dr Dinesh Arora IAS, Dr K. Shylaja, DHS, Dr V. Geetha, DME and Dr Alex Franklin, IMA were the other dignitaries who were present for the inauguration. The workshop was enriched by the presence of experts of International and National repute from within and outside the state. Faculties from 8 states, who had already implemented the IDRV regimen in their states, shared their experiences in the workshop.  The workshop was attended by key stakeholders from all over the state. There were representatives from Health Services Department, Medical Education Department and also Service Unions in Health Services. More than 320 delegates attended the workshop on 20^th September during which the faculty shared their experiences regarding IDRV implementation in their states. The workshop on 20^th was followed by a core group meeting on 21^st during which the National Guidelines put forward by NICD in 2007 was discussed in detail and was adopted to suit Kerala scenario. The core group had the presence of nearly 50 experts from within and outside the state.

There were 3 post workshop core group meetings as a result of which the draft guidelines for implementation of IDRV and draft operational guidelines were prepared. It was decided to implement IDRV in a planned phase in the state with the support of Kerala Medical Services Corporation Ltd (KMSCL). As the first step IDRV will be implemented in the Anti Rabies Clinics attached to the 5 Govt. Medical Colleges in the state and also General Hospital, Thiruvananthapuram. It is also planned to impart training to the stakeholders at three levels- National level training from Hyderabad, State level training and District level training.

At present Kerala is following the IM regimen for Anti rabies vaccination and only the bite victims belonging to BPL category are given the costly IM treatment free of cost that too subject to availability. With the adoption of ID regimen we will be able to cater to almost five times the patient load with the present quantity of vaccine. This will surely help in improving the acceptability of the more cost effective IDRV regimen thereby increasing the accessibility of the common man for treatment against this deadly disease. The workshop IDRVKERALA 2008 is believed to be the first step in the direction of a crucial policy change by Govt. of Kerala.