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Business Standard
6 days ago
- Health
- Business Standard
Over 9 million animal bites and 5,700 rabies deaths in India yearly: ICMR
A nationwide study by the Indian Council of Medical Research –National Institute of Epidemiology (ICMR-NIE) has revealed that India continues to lose over 5,700 lives annually to rabies, despite high levels of awareness and vaccine uptake. The survey, conducted across 60 districts and 15 states, found that nearly 9.1 million animal bites occur each year, with children under 14 and the elderly most frequently affected. Even though 80 per cent of dog bite victims received at least one dose of the anti-rabies vaccine, the report raises alarm over the lack of access to complete post-exposure prophylaxis (PEP), especially rabies immunoglobulin (RIG), which can be life-saving in severe exposures. What is rabies? Rabies is a lethal viral infection that attacks the central nervous system and is nearly always fatal once symptoms appear. Dogs are responsible for most human cases. After exposure, whether a bite or a minor scratch, a medical emergency emerges. Rabies remains lethal and severely underreported: ICMR The ICMR study, which used household-level data, estimates that 5,726 human rabies deaths occur in India every year. The highest incidence of dog bites was found among: Children aged 0–14 years Elderly above 60 years Males Despite India's ambitious goal to eliminate rabies by 2030 under the National Action Plan for Rabies Elimination (NAPRE), these findings expose serious gaps in access, awareness, and post-bite care. Rabies immunoglobulin is the missing link: ICMR While vaccines are widely promoted, RIG remains severely underused and unavailable, particularly in public health settings. The ICMR study found that most dog bite victims received incomplete treatment, and few received RIG—a crucial biological that offers immediate protection before the vaccine takes effect. Experts emphasise that without RIG, even vaccinated individuals can succumb to rabies, especially in deep bite wounds or Category III exposures. While rabies vaccine is available for free of cost at most government hospitals and urban primary health centres (UPHCs), RIG is usually available only in tertiary care government hospitals, such as Aiims, Delhi, Guru Teg Bahadur Hospital, Delhi, Sion Hospital (Lokmanya Tilak), Mumbai, CMC Vellore, Tamil Nadu, Rajiv Gandhi Government General Hospital, Chennai. How vaccine and RIG work together Rabies vaccine contains inactivated virus that prompts your immune system to develop protective antibodies. It is part of two protocols: Pre-exposure prophylaxis (PrEP): for high-risk individuals (such as veterinarians and travellers to high-risk areas) Post-exposure prophylaxis (PEP): for those bitten or scratched, delivered on Days 0, 3, 7, and 14 (plus Day 28 for immunocompromised individuals) However, it requires about 7–14 days to build immunity, leaving a dangerous window if not supplemented. Rabies immunoglobulin provides immediate, passive immunity by introducing ready-made antibodies directly to the wound site. It is essential for Category III exposures—deep bites or contact with mucous membranes—as recommended by the World Health Organisation and other health experts. According to experts, RIG should be administered within seven days of the first vaccine dose. Without RIG, the rabies virus might reach the central nervous system before the vaccine can fully protect you—an almost certain path to fatality if the infection takes hold. Current government response The Ministry of Health and Family Welfare (MoHFW), along with the National Centre for Disease Control (NCDC), is implementing the National Rabies Control Programme (NRCP) to address these challenges through: Free provision of anti-rabies vaccine and RIG Mass dog vaccination campaigns Model anti-rabies clinics Awareness and training programmes Intersectoral coordination under a 'One Health' approach However, according to the Marching Towards Rabies-Free India report by MoHFW, availability of RIG still varies drastically between states, and only 20 states have declared human rabies a notifiable disease, leading to chronic underreporting and delayed interventions. According to ICMR, rabies is 100 per cent fatal once symptoms begin—but also 100 per cent preventable with timely and complete treatment. Vaccination alone is not enough in severe cases and RIG must be administered within seven days of the first vaccine dose. According to MoHFW, the first line of defence is always immediate wound washing, followed by full PEP. Despite targets, India's rabies strategy faces major barriers Uneven access to vaccine and immunoglobulin Weak surveillance and underreporting Lack of lab-confirmed diagnoses Public misconceptions about treatment Fragmented coordination across health sectors What are the common signs a dog may have rabies? Sudden, unprovoked aggression Attacking people or animals without reason Restlessness, snapping, biting at objects or air Excessive salivation or foaming at the mouth (due to paralysis of the jaw and throat muscles) Thick, sticky saliva may drip constantly Unusual behaviour or personality changes Friendly dogs becoming hostile Active dogs becoming lethargic or withdrawn Difficulty swallowing or hydrophobia (fear of water) Dogs may refuse to drink despite appearing thirsty Attempts to drink may trigger spasms or panic Staggering or paralysis Hind leg weakness Seizures or paralysis, especially near the end stage High-pitched growling or strange vocalisations Bark may sound distorted or unusual Whining, howling, or guttural noises Steps to take after a dog bite Immediate wound care Gently wash the affected area with soap and running water for at least 15 minutes, then sanitise with an iodine or 70 per cent alcohol solution. Seek medical attention Go to the nearest large government hospital or a known tertiary medical college hospital. Health professionals will classify the injury. There are three WHO-defined categories of rabies exposure: Category I (Touching or feeding animals, or being licked on intact skin): No PEP required, but wash hands for hygiene and observe the animal. Category II (Minor scratches or nibbles): Vaccine is required. Category III (Deep wounds or mucosal exposure): Both vaccine and RIG are required. For RIG, specifically ask if it's available at the anti-rabies clinic or emergency room you visited. According to ICMR, MoHFW, and global medical experts, when it comes to rabies, it's always better to act fast than to take chances—because once symptoms appear, it's already too late.
The Hindu
30-06-2025
- Health
- The Hindu
Kerala yet to submit rabies elimination plan, says Union Minister Rajiv Ranjan Singh
The Kerala government has not finalised and submitted the State Action Plan for Rabies Elimination (SAPRE), Union Minister of Fisheries, Animal Husbandry and Dairying Rajiv Ranjan Singh informed in a letter to Kodikunnil Suresh, MP. 'The National Action Plan for Dog-Mediated Rabies Elimination (NAPRE) has been launched, under which States are required to prepare and implement their respective SAPREs. However, the Government of Kerala is yet to finalise and submit its SAPRE. It is necessary that this process be expedited to ensure effective coordination and eligibility for Central support under the plan,' Mr. Singh said. The Union Minister said the Animal Welfare Board of India (AWBI) has extended support to Kerala in managing the stray population by recognising Animal Birth Control (ABC) centres in Kannur, Kollam, Thrissur, Ernakulam, Alappuzha and Wayanad. 'Approval has also been granted for conducting ABC programmes through mobile units and by government veterinary hospitals using trained veterinarians,' he said. Mr. Singh further noted that AWBI has recently published an animal birth control module to guide the implementation of the programme and has issued a series of advisories to promote humane management of stray animals, encourage vaccination and reduce human-animal conflict. He emphasised that the continued support and proactive intervention of the State government in implementing the ABC Rules and preparing the SAPRE would be crucial in preventing rabies deaths. The SAPRE in Kerala is being prepared jointly by the Health, Animal Husbandry and Local Self Government departments, with the Health department acting as the nodal agency. 'The preparation of SAPRE is nearing completion. Since it is a joint action plan, we need to consolidate the inputs from all three departments. Once that is done, we will submit it to the Union Ministry for vetting,' said a Health department official. MP slams Kerala govt Meanwhile, Mr. Suresh criticised the Kerala government for the delay in submitting the action plan. 'The submission of SAPRE is a mandatory requirement. The delay has now been flagged by the Union government. Despite repeated reminders and formal communications issued by the Ministry and the AWBI, the State government has failed to act. The ABC Rules, 2023, remain largely unimplemented across Kerala in the absence of SAPRE. This is not merely an administrative delay, but an outright failure of governance,' the Mavelikara MP said.
