{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:12:11Z","timestamp":1788268331819,"version":"build-2803163510"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:p>Rabies is endemic in India and responsible for 20,000 human deaths every year. It is 100% preventable when the vaccine is taken along with proper wound care and rabies immunoglobulin administration though update continues regarding the requirement of the number of vaccine doses, the need for immunoglobulin, and if required their types. We study four cases of rabies having street dogs' bite category grade 3. Everyone took vaccines at least three doses but none of them took rabies immunoglobulin. They developed symptoms of rabies with a gap of 15\u201328 days after the bites and admitted to a tertiary care center. One patient was left against medical advice and three patients were treated according to the modified Milwaukee protocol. But, none of them could be saved. So, it may be proposed that the reason of deaths may be due to lack of administration of rabies immunoglobulin (passive vaccination) or failure of vaccines. Hence, the government may focus on the administration of complete and quality post-exposure prophylaxis in all cases of animal bites. Although Milwaukee protocol saves few lives, it may be further improved or other treatment modalities may be developed for rabies treatment.<\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_658_20","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T05:57:47Z","timestamp":1598939867000},"page":"4437-4440","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Death from rabies: The reason being poor compliance to vaccination or it's failure"],"prefix":"10.4103","volume":"9","author":[{"given":"Shyam Kishor","family":"Kumar","sequence":"first","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pratima","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasan Kumar","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,8]]},"reference":[{"key":"R1-20260817","doi-asserted-by":"crossref","first-page":"e0004774","DOI":"10.1371\/journal.pntd.0004774","article-title":"Human rabies survivors in India: An emerging paradox?","volume":"10","author":"Subramaniam Mani","year":"2016","journal-title":"PLoS Negl Trop Dis"},{"key":"R2-20260817","first-page":"201","article-title":"Rabies vaccines-WHO position paper","volume":"93","year":"2018","journal-title":"Weekly Epidemiological Record"},{"key":"R3-20260817","doi-asserted-by":"crossref","first-page":"184","DOI":"10.4103\/0975-2870.202098","article-title":"The 'Milwaukee protocol' (MP) hope does not succeeds for rabies victim","volume":"10","author":"Agarwal","year":"2017","journal-title":"Med J DY Patil Univ"},{"key":"R4-20260817","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1086\/649873","article-title":"Failure of rabies postexposure prophylaxis in patients presenting with unusual manifestations","volume":"50","author":"Shantavasinkul","year":"2010","journal-title":"Clin Infect Dis"},{"key":"R5-20260817","doi-asserted-by":"crossref","first-page":"e0005663","DOI":"10.1371\/journal.pntd.0005663","article-title":"Improper wound treatment and delay of rabies post-exposure prophylaxis of animal bite victims in China: Prevalence and determinants","volume":"11","author":"Liu","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"R6-20260817","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1743-422X-9-50","article-title":"Rabies molecular virology, diagnosis, prevention and treatment","volume":"9","author":"Yousaf","year":"2012","journal-title":"Virol J"},{"key":"R7-20260817","first-page":"JD01","article-title":"Same dog bite and different outcome in two cases-case report","volume":"8","author":"Gadekar","year":"2014","journal-title":"J Clin Diagn Res"},{"key":"R8-20260817","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/S1201-9712(01)90092-X","article-title":"Rabies in Oman: Failed postexposure vaccination in a lactating woman bitten by a fox","volume":"5","author":"Scrimgeour","year":"2001","journal-title":"Int J Infect Dis"},{"key":"R9-20260817","doi-asserted-by":"crossref","first-page":"178","DOI":"10.4103\/0255-0857.81786","article-title":"Fatal rabies despite post-exposure prophylaxis","volume":"29","author":"Deshmukh","year":"2011","journal-title":"Indian J Med Microbiol"},{"key":"R10-20260817","doi-asserted-by":"crossref","first-page":"A45","DOI":"10.1016\/j.vaccine.2018.08.086","article-title":"The need to improve access to rabies post-exposure vaccines: Lessons from Tanzania","volume":"37","author":"Changalucha","year":"2019","journal-title":"Vaccine"},{"key":"R12-20260817","doi-asserted-by":"crossref","first-page":"7605","DOI":"10.1016\/j.vaccine.2007.08.054","article-title":"Failures of post-exposure rabies prophylaxis","volume":"25","author":"Wilde","year":"2007","journal-title":"Vaccine"},{"key":"R13-20260817","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.ijid.2005.10.007","article-title":"Assessing the burden of human rabies in India: Results of a national multi-center epidemiological survey","volume":"11","author":"Sudarshan","year":"2007","journal-title":"Int J Infect Dis"},{"key":"R14-20260817","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1080\/21645515.2016.1255834","article-title":"Injecting rabies immunoglobulin (RIG) into wounds only: A significant saving of lives and costly RIG","volume":"13","author":"Bharti","year":"2017","journal-title":"Hum Vaccin Immunother"},{"key":"R15-20260817","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.4161\/hv.25431","article-title":"Feasibility of reducing rabies immunoglobulin dosage for passive immunization against rabies: Results of in vitro and in vivo studies","volume":"9","author":"Madhusudana","year":"2013","journal-title":"Hum Vaccin Immunother"},{"key":"R16-20260817","doi-asserted-by":"crossref","first-page":"2410","DOI":"10.1038\/s41598-020-59109-w","article-title":"Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006\u20132018","volume":"10","author":"Ghosh","year":"2020","journal-title":"Sci Rep"},{"key":"R17-20260817","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.vaccine.2015.11.036","article-title":"Worldwide rabies deaths prevention--A focus on the current inadequacies in postexposure prophylaxis of animal bite victims","volume":"34","author":"Wilde","year":"2016","journal-title":"Vaccine"},{"key":"R18-20260817","doi-asserted-by":"crossref","first-page":"bcr2014206191","DOI":"10.1136\/bcr-2014-206191","article-title":"Rabies encephalitis in a child: A failure of rabies post exposure prophylaxis?","volume":"2015","author":"Tinsa","year":"2015","journal-title":"BMJ Case Rep"},{"key":"R19-20260817","doi-asserted-by":"crossref","first-page":"17091","DOI":"10.1038\/nrdp.2017.91","article-title":"Rabies","volume":"3","author":"Fooks","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"R20-20260817","doi-asserted-by":"crossref","first-page":"165","DOI":"10.4269\/ajtmh.18-0711","article-title":"Case report: Survival from rabies: Case series from India","volume":"100","author":"Mani","year":"2019","journal-title":"Am J Trop Med Hyg"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_658_20","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:01:30Z","timestamp":1786986090000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_658_20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8]]},"references-count":19,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_658_20","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8]]},"assertion":[{"value":"2020-04-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-25","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}