Overview

• Rabies is a viral, zoonotic, neglected tropical disease
• It is entirely preventable but almost always fatal once symptoms appear
• India accounts for nearly one-third of global rabies deaths
• The disease disproportionately affects children and poor communities
• Continued deaths reflect public health system gaps, not scientific limitations

Burden of Rabies in India

•India has the highest rabies burden globally- Around 20,000 rabies deaths annually in India
• Global annual deaths are approximately 59,000
• Rabies is endemic in India
• About 20 million dog bites occur each year
• Nearly 40% of deaths occur in children below 15 years
• Dog bites account for nearly all human cases
• Over 20% of dog-bite victims receive no anti-rabies vaccine.  Nearly half do not complete the full vaccine course
• Rabies immunoglobulin is scarce, costly, and often unavailable
• Rabies deaths are fully preventable with timely care

Key Facts About Rabies

Cause and Nature

• Caused by rabies virus of the Lyssavirus genus
• Neurotropic virus affecting the central nervous system
• Once symptoms appear, the disease is almost 100% fatal

Transmission

• Spread through saliva via bites, scratches, or broken skin
• Human-to-human transmission has not been confirmed

Incubation and Forms

• Incubation period usually 2–3 months
• Can range from one week to one year
• Furious rabies causes hydrophobia, hallucinations, hyperactivity
• Paralytic rabies causes gradual paralysis and is often misdiagnosed

Prevention and Treatment

• Rabies is completely preventable with timely post-exposure prophylaxis
• Immediate wound washing with soap and water is critical
• Full anti-rabies vaccination is required
• Rabies immunoglobulin or monoclonal antibodies are needed for severe exposure
• No cure once clinical symptoms develop

Economic and Social Impact

• Global economic burden estimated at around 8.6 billion US dollars annually
• Treatment costs can be catastrophic for poor households
• Social stigma delays reporting and treatment
• Loss of livelihoods and psychological trauma are common

Most Effective Control Strategy

• Mass dog vaccination is the most effective preventive measure
• Dog culling is ineffective and unsustainable
• Community awareness and responsible pet ownership are essential
• Global target is elimination of dog-mediated human rabies deaths by 2030

India’s Measures for Rabies Control

• National Rabies Control Programme focuses on surveillance and prevention
• Integrated Health Information Platform enables real-time reporting
• National Health Mission supports vaccines, training, and infrastructure
• Free availability of anti-rabies vaccine and immunoglobulin in public facilities
• National Centre for Disease Control supports laboratories and awareness
• National One Health Programme integrates human and animal health systems

Core Challenges

• Delayed access to post-exposure prophylaxis
• Shortage and high cost of rabies immunoglobulin
• Incomplete vaccination adherence
• Weak dog vaccination and population management
• Poor awareness and health-seeking behaviour
• High vulnerability of children and marginalised groups