{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:47:07Z","timestamp":1785937627009,"version":"3.56.0"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>Rabies is a zoonotic disease that is almost always fatal but can be prevented; it disproportionately affects areas of Asia and Africa with limited resources. Post-exposure prophylaxis (PEP) failures continue to cause avoidable deaths despite advancements in vaccination techniques. Two rabies deaths in which vaccination was not enough to prevent death are reported in the current study: one in an adult bitten by a wolf and another in a child bitten on the face by a stray dog. Critical shortcomings in comprehensive care, such as improper wound suturing, poor wound management, and a failure to administer rabies immunoglobulin (RIG), are highlighted in both cases. Both patients\u2019 rabies infections were verified using histopathological and molecular analyses. These incidents underscore the crucial importance of a comprehensive \u201crabies care bundle\u201d that encompasses active vaccination, passive immunization with RIG, and thorough wound care. To avoid similar results and preserve public trust in rabies vaccination programs, it is crucial to increase clinician awareness, ensure that all PEP components are accessible, and adhere to WHO guidelines.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0649","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:36:42Z","timestamp":1781635002000},"page":"383-386","source":"Crossref","is-referenced-by-count":0,"title":["The Critical Need for a Comprehensive Post-Exposure Care Bundle following Rabies Exposure: A Report of Two Cases"],"prefix":"10.4269","volume":"115","author":[{"given":"Jayanthi","family":"Yadav","sequence":"first","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhopal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul S.","family":"Keche","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhopal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lonika","family":"Lodha","sequence":"additional","affiliation":[{"name":"Department of Neurovirology, National Institute of Mental Health and Neurosciences, Bengalaru, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shipra","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Neurovirology, National Institute of Mental Health and Neurosciences, Bengalaru, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangita","family":"Moirangthem","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhopal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sashikanta","family":"Sahoo","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhopal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashvini Kumar","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Namdeo","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashwati","family":"Nema","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Bhopal, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arneet","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debasis","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Bhopal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","article-title":"Rabies.","year":"2023"},{"key":"b2","article-title":"Rabies: Epidemiology and Burden.","year":"2025"},{"issue":"4","key":"b3","series-title":"PLoS Negl Trop Dis","first-page":"e0003709","article-title":"Estimating the global burden of endemic canine rabies","volume":"9","author":"Hampson","year":"2015"},{"key":"b4","article-title":"National Guidelines on Rabies Prophylaxis.","year":"2015"},{"key":"b5","article-title":"Rabies Post-Exposure Prophylaxis Guidance.","year":"2025"},{"issue":"5","key":"b6","series-title":"Lancet Infect Dis","first-page":"e167","article-title":"Human rabies despite post-exposure prophylaxis: A systematic review of fatal breakthrough infections after zoonotic exposures","volume":"23","author":"Whitehouse","year":"2023"},{"key":"b7","series-title":"Lancet Reg Health Southeast Asia","first-page":"100109","article-title":"Emergence of rabies among vaccinated humans in India: A public health concern","volume":"9","author":"Goel","year":"2023"},{"key":"b8","series-title":"BMJ Case Rep","first-page":"bcr2014206191","article-title":"Rabies encephalitis in a child: A failure of rabies post exposure prophylaxis?","volume":"2015","author":"Tinsa","year":"2015"},{"key":"b9","article-title":"WHO Expert Consultation on Rabies: Third Report. WHO Technical Report Series No. 1012.","year":"2018"},{"issue":"RR-3","key":"b10","series-title":"MMWR Recomm Rep","first-page":"1","article-title":"Human rabies prevention\u2013United States, 2008: Recommendations of the Advisory Committee on Immunization Practices","volume":"57","author":"Manning","year":"2008"},{"key":"b11","series-title":"Comp Immunol Microbiol Infect Dis","first-page":"102287","article-title":"Integrating one health strategies for rabies control: Insights from Jackal-mediated human rabies in Northeast India","volume":"116","author":"Dutta","year":"2025"},{"issue":"16","key":"b12","series-title":"Vet Rec","first-page":"409","article-title":"Role of dog sterilisation and vaccination in rabies control programmes","volume":"175","author":"Rowan","year":"2014"},{"issue":"3","key":"b13","series-title":"Trop Med Infect Dis","first-page":"118","article-title":"Development of a non-meat-based, mass producible and effective bait for oral vaccination of dogs against rabies in Goa State, India","volume":"4","author":"Gibson","year":"2019"},{"issue":"40","key":"b14","series-title":"Vaccine","first-page":"4792","article-title":"Feasibility and efficacy of oral rabies vaccine SAG2 in endangered Ethiopian wolves","volume":"34","author":"Sillero-Zubiri","year":"2016"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/2\/article-p383.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/2\/article-p383.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/115\/2\/article-p383.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T13:10:28Z","timestamp":1785935428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/115\/2\/article-p383.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,5]]},"references-count":14,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0649","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,5]]}}}