A Serological Study in Response to People at Occupational Risk of Rabies Virus Exposure in Nepal Ganesh Raj Pant 1* , Arjun Raj Pant 2 , Bol Raj Acharya 1 , Manish Man Shrestha 1 , Vivek Pant 3 , Nayana Pant 3 and Dwij Raj Bhatta 4 1 Rabies Vaccine Production Laboratory, Tripureshwor, Nepal 2 Sukraraj Tropical Hospital, Teku, Nepal 3 Institute of Medicine, TU, Maharajgunj, Nepal 4 Central Department of Microbiology, TU, Kirtipur, Nepal * Corresponding author: Ganesh Raj Pant, Rabies V accine Production Laboratory , T ripureshwor , AFU, Chitawn, Nepal, T el: 01-4109753; E-mail: pantganesh@hotmail.com Received date: March 01, 2016; Accepted date: March 15, 2016; Published date: March 18, 2016 Copyright: © 2015 Pant GR, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract A serological study to know the antibody titer against rabies virus in human beings, who are at occupational risk, was conducted in Nepal in 2014. A total 44 serum samples were collected out of which 21 samples were collected from medical professionals (working at Sukraraj Tropical Hospital) and 23 were collected from veterinary professionals (working at Central Veterinary Hospital, Central Veterinary Laboratory and Rabies Vaccine Production Laboratory) in Kathmandu. Among the 44 samples, 4 were collected from unvaccinated persons. The other 40 people sampled were vaccinated with inactivated rabies vaccine. All samples were subjected to the Rabies Fluorescent Focus Inhibition Test (RFFIT) test at Centre for Disease Control and Prevention, Atlanta, USA. The antibody level of 7 persons was found to be less than the WHO recommended titer of 0.5 IU/ml. Six medical professionals and one veterinary professional had a low rabies virus neutralizing antibody titer. The 4 samples collected from unvaccinated persons, and 3 collected from vaccinated persons had a titer below 0.5 IU/ml. This study shows that medical and veterinary professionals who are responsible to nurse or handle rabies patients, rabid animals or rabies virus are still at high risk. This underscores the importance of recommendations for regular serological testing of occupationally exposed individuals and vaccinating booster dose when necessary. Introduction Rabies is endemic and priority zoonotic disease in Nepal. Te death of 200 [1], human being and 300 animals [2], per year has been reported in this country. Te disease has been confrmed in cattle, bufaloes, goats, alpaca, dogs and mongoose [3]. Rabies occurs throughout the year and dog is the principle vector for the transmission of disease. Rabies Vaccine Laboratory in Kathmandu produces 50, 000 doses of cell culture vaccine for animal use whereas vaccine for human use is imported from other countries [3]. Health authority purchased 300,000 doses expending 1 million USD every year to purchase inactivated cell culture rabies vaccine for human use (personal contact with EDCD). In 2012, 334,737 doses of cell culture rabies vaccine were purchased by Epidemiology and Disease Control Division, the Department of Health Service. Vaccine is not available to all victims at risk in country side therefore the case fatality is higher [4]. More than 45,000 people receive post exposure vaccination annually in Nepal. Number of dog bitten cases per month coming to Sukraraj Tropical Hospital (STH) for post exposure treatment is 1520 and in average 50 cases receives post exposure rabies vaccine daily in this hospital (Personal contact with STH Hospital). Human or animal health workers, in contact with rabid animal or patient or rabies virus are at high risk of rabies infection. Terefore pre exposure rabies vaccine has been recommended by World Health Organization (WHO) for medical peoples, veterinarian and laboratory personals. Te immunization protocol includes three injections, e.g. at days 0, 7, and 28. Te serological evaluation of immunization is made 1-3 weeks afer the last injection, and checked every 6 months in the case of laboratory workers or every 2 years for other diagnosticians. Booster vaccination must be given when the titer falls below 0.5 International Units (IU) per ml. In the absence of serological monitoring, the vaccination regimen should consist of a booster vaccination at 1 year and thereafer every 1-3 years [5,6]. Terefore the antibodies tire in response of rabies vaccine in vaccinated people or animal should be tested periodically by performing Rabies Fluorescent Focus Inhibition Test (RFFIT) afer vaccination to avoid unnecessary vaccination and to reduce the risk of rabies infection. In this study we have measured antibody tire against rabies vaccine in professional people who have high risk hazard of Rabies. Methodology Blood samples were collected from 44 persons (13 female and 31 male) afer getting oral consent in 2014. Sampled persons were 21 medical professional and 23 veterinary professional having occupational risk of rabies. Among medical professional 4 were doctors and 17 were technicians (paramedical) working at Sukraraj Tropical Hospital, Kathmandu. Among veterinary professional 9 working at Central Veterinary Hospital, 7 working at Central Veterinary Laboratory and 7 working at Rabies Vaccine Production Laboratory in Kathmandu. All 44 samples person were 28-58 years old. Among 44 collected samples, 4 were from unvaccinated persons and rest was from vaccinated persons in diferent time. Serum was separated labeled accordingly and stored at -20°C in refrigerator. Te description of samples was presented in table 1. Samples were packed and transferred to Centre of Disease and Prevention Rabies Journal of Vaccines & Vaccination Pant et al., J Vaccines Vaccin 2016, 7:2 DOI: 10.4172/2157-7560.1000312 Short Communication Open Access J Vaccines Vaccin ISSN:2157-7560 JVV, an open access journal Volume 7 • Issue 2 • 1000312 J o u r n a l o f V a c c i n e s & V a c c i n a t i o n ISSN: 2157-7560