Rabies control in high-burden countries: role of universal pre-exposure immunization

Rabies is a fatal zoonotic encephalitis that is responsible for approximately 59,000 deaths worldwide every year. A significant portion of these deaths, about one-third, occur in India alone. In order to meet the World Health Organization's objective of eliminating dog-mediated rabies by 2030, India has made considerable progress in this regard. However, implementing the current strategies of canine immunization, sterilization, and providing post exposure prophylaxis to exposed individuals is challenging in a large and diverse country like India. This article aims to highlight the limitations of relying solely on post-exposure prophylaxis for the prevention of human rabies. Moreover, it presents the necessity and rationale for including pre-exposure immunization in India's national immunization schedule.Copyright (c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).