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Letter from India

Voluntary Health Services Medical Center, Taramani Post, Chennai, 600113, India and T. S. Srinivasan, Dept. of Clinical Neurology & Research, Public Health Center, West Mambalam, Chennai 600033, India; Email: neurosrinivas{at}yahoo.com

EXTRACT

Rabies is a major public health problem in India. Most patients are looked after by general physicians and infectious disease specialists. But sometimes the case is atypical and can come to a neurological department. I have encountered rabies on three such occasions, presenting initially as a neurological episode, with rabies being subsequently identified. It is a frightening experience. Mary Warrell estimates that 30 000 people die annually in India from rabies (Warrell 2001). The Blue Cross, an Animal Welfare Organization, gives the same number. Seventy-five percent of the Indian population lives in villages and some are very remote. The stray dog population is very high and a large number of families keep pet dogs without immunising them. I personally estimate that there are at least 60 000 deaths annually, if not more, from rabies. Birth and death still go unreported, especially death, even though the law of the land demands ...

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