Rabies: A Primitive Disease Killing Thousands of Indians Annually

India accounts for over 21,000 deaths each year, making it the country with the highest global incidence of rabies.

India accounts for more than 25 thousand rabies deaths each year, giving it the highest incidence of rabies globally. 

(Photo: iStockphoto)

Three lakh dogs in Goa have been vaccinated in the past three years under the Mission Rabies programme, said Dr Santosh Desai. He is the Director of Animal Husbandry and Veterinary Services of Goa.

He said that the mission had helped reduce the number of rabies cases significantly in Goa since 2015. They were now testing new methods of surveillance and vaccination processes to control rabies in the state.

World over, over 59,000 people die from rabies every year; the majority of them from Asia and Africa.

According to the US National Library of Medicine, about 15 million people are bitten by animals, mostly dogs, every year in India. India accounts for more than 25,000 deaths each year, making it the country with the highest incidence of rabies globally.

The rabies ward at Isolation Hospital in Bengaluru. (Photo: FIT/Parul Agrawal)

At the isolation hospital in Bengaluru, Dr Ansar Ahmed has seen hundreds of rabies deaths in last 12 years of his posting.

My worst memory of a rabies patient is of a 6-year-old girl, who was brought to me some ten years ago. The child was howling and jumping and the mother was just clinging on to her. She knew that she would lose her child within the next two- three days. I blew air on the child’s face and she panicked as if I had thrown acid on her. That is Aerophobia– the most prominent rabies symptom. The mother kept repeating how the girl was simply playing with a dog. The dog was licking her. She had a scratch on her hand, which is how she contracted the infection.

Dr Ansar Ahmed

Rabies in India

India has the fastest growing dog population in the world. Over 15 percent of these dogs are never vaccinated.

Each year, 17.4 million cases of dog bite are reported from India. A number of these lead to awful, painful deaths. While most deaths are reported from rural areas, rabies does not discriminate. Among those who die are lawyers, doctors, officers– people from affluent families.

Most deaths in India occur due to incomplete or faulty vaccination. Even doctors are not aware of dos & don’ts. It is worse in rural areas, where post-animal bite aftercare– such as the fact that wounds should not be packed with dressing or stitched– is unheard off.

Dr Murli, Chinmaya Mission Hospital, Bengaluru

India has only one laboratory for diagnosing rabies in animals, located in Bangalore at the Veterinary College of the Karnataka. (Photo: Reuters)

Rabies is a primitive disease but remains a silent killer in India.

For a population of over one billion with alarming death statistics, India has only one laboratory to diagnose rabies in animals. Located in Bangalore, it tests brains of rabid animals for diagnostic and research purposes. With a staff of less than four people, the overworked, understaffed team is unable to meet the demands placed on it in time.

We receive samples from all over the country. Anybody who suspects that an animal is rabid can send samples for diagnosis. It allows doctors to decide what treatment is needed. Monitoring of rabies rates in animals as well as humans is vital to control rabies in India. We definitely need more such labs.

Professor Yethiraj, Dean Veterinary College, Bengaluru

Treatment

The five step guide to treat animal bites and prevent rabies.(Photo: FIT)

Rabies spreads through the saliva of a rabid animal’s bite, a dog, a bat, a monkey, wild cats, wolf or bear. The virus multiplies at the wound site and attacks the central nervous system. In humans, symptoms appear within a few days to several months.

Once the symptoms develop, the clock starts ticking. The patient deteriorates by the hour. Patients are sent to isolation centres or kept away from others as they exhibit violent tendencies. Its difficult to know which dog is infected and which is vaccinated so getting preventive treatment is the only way for humans to prevent the disease. 

Dr Anil Kumar, Victoria Hospital, Bengaluru

Shortage of Vaccines

Due to lower prices, quite a few Pharma companies now feel that it is no longer profitable to produce these drugs. (Photo: Reuters)

The shortage of vaccines is another cause for crisis. In a bid to control the price of the rabies vaccine, Immunoglobulin, the government has put a cap on pricing. Also, to ensure the availability of vaccines at all state-run dispensaries and hospitals, government often buy it in bulk.

As a result, demand is higher than supply. Pharma companies are unwilling to make the drug because it is not profitable and private hospitals find it difficult to procure these vaccines.

Due to lower prices, quite a few pharma companies now feel that it is no longer profitable to produce these drugs. Also, we need to remember that lot of people in India prefer receiving treatment at private hospitals and clinics. After the animal bite, the clock starts ticking and patients find themselves running around to find the vaccine.

Dr Murli, Chinmaya Mission Hospital, Bengaluru 

Culling dogs is illegal in India and is an ineffective practice anyway, since more than 50 percent of all reported dog bite cases in India are from pet dogs.

Under various drives, dogs are caught, sterilised, vaccinated and released by the civic agencies and NGOs from time to time. However, the reality is that large areas in India do not benefit from such drives.

In order to eradicate rabies, we need to extensively map and monitor animal birth control drives and attempt a door-to-door coverage of areas that remain neglected by government and NGO drives.

Till that happens, the next time you come across a ‘dog-bite’, think before taking it lightly.

53-year-old Satya Reddy was playing with a puppy in front of his house when it bit him on his finger. I meet him two months later, at an isolation hospital in Bengaluru. His condition is heartrending.

When the patient came here, he was salivating. He is already hydrophobic. Convulsions give him extreme pain. He is close to his death; today evening or tomorrow morning maybe.

Dr Ansar Ahmed, District Surgeon, Isolation Hospital

Reddy’s wife is inconsolable. His daughter is reluctant to speak on camera. She opens up as I sit besides her, while we wait to meet the medical superintendent.

He went to an Ayurvedic doctor who asked him to apply a medicinal powder for a month. The wound healed. He did not get any injections. We never knew vaccination was so important. It was just a small puppy. We found out later that it was rabid. 

Satya Reddy’s daughter

The rabies ward at Isolation Hospital in Bengaluru. (Photo: The Quint/Parul Agrawal)

World over, over 59,000 people die from rabies every year; the majority of them from Asia and Africa. India alone accounts for more than 21,000 deaths each year, making it the country with the highest incidence of rabies globally.

At the isolation hospital in Bengaluru, Dr Ansar Ahmed has seen hundreds of rabies deaths in last 12 years of his posting.

My worst memory of a rabies patient is of a 6-year-old girl, who was brought to me some ten years ago. The child was howling and jumping and the mother was just clinging on to her. She knew that she would lose her child within the next two- three days. I blew air on the child’s face and she panicked as if I had thrown acid on her. That is Aerophobia– the most prominent rabies symptom. The mother kept repeating how the girl was simply playing with a dog. The dog was licking her. She had a scratch on her hand, which is how she contracted the infection.

Dr Ansar Ahmed

Post animal-bite, leave the wound open– use a simple dressing, but don’t try to stitch it as this could expose the nerve endings to the rabies virus. (Photo: iStockphoto)

India has the fastest growing dog population in the world. Over 15 percent of these dogs are never vaccinated.

Each year, 17.4 million cases of dog bite are reported from India. A number of these lead to awful, painful deaths. While most deaths are reported from rural areas, rabies does not discriminate. Among those who die are lawyers, doctors, officers– people from affluent families.

Most deaths in India occur due to incomplete or faulty vaccination. Even doctors are not aware of dos & don’ts. It is worse in rural areas, where post-animal bite aftercare– such as the fact that wounds should not be packed with dressing or stitched– is unheard off.

Dr Murli, Chinmaya Mission Hospital, Bengaluru

India has only one laboratory for diagnosing rabies in animals, located in Bangalore at the Veterinary College of the Karnataka. (Photo: Reuters)

Rabies is a primitive disease but remains a silent killer in India.

For a population of over one billion with alarming death statistics, India has only one laboratory to diagnose rabies in animals. Located in Bangalore, it tests brains of rabid animals for diagnostic and research purposes. With a staff of less than four people, the overworked, understaffed team is unable to meet the demands placed on it in time.

We receive samples from all over the country. Anybody who suspects that an animal is rabid can send samples for diagnosis. It allows doctors to decide what treatment is needed. Monitoring of rabies rates in animals as well as humans is vital to control rabies in India. We definitely need more such labs.

Professor Yethiraj, Dean Veterinary College, Bengaluru

The five step guide to treat animal bites and prevent rabies. (Photo: The Quint)

Rabies spreads through the saliva of a rabid animal’s bite, a dog, a bat, a monkey, wild cats, wolf or bear. The virus multiplies at the wound site and attacks the central nervous system. In humans, symptoms appear within a few days to several months.

Once the symptoms develop, the clock starts ticking. The patient deteriorates by the hour. Patients are sent to isolation centres or kept away from others as they exhibit violent tendencies. Its difficult to know which dog is infected and which is vaccinated so getting preventive treatment is the only way for humans to prevent the disease. 

Dr Anil Kumar, Victoria Hospital, Bengaluru

Due to lower prices, quite a few Pharma companies now feel that it is no longer profitable to produce these drugs. (Photo: Reuters)

The shortage of vaccines is another cause for crisis. In a bid to control the price of the rabies vaccine, Immunoglobulin, the government has put a cap on pricing. Also, to ensure the availability of vaccines at all state-run dispensaries and hospitals, government often buy it in bulk.

As a result, demand is higher than supply. Pharma companies are unwilling to make the drug because it is not profitable and private hospitals find it difficult to procure these vaccines.

Due to lower prices, quite a few pharma companies now feel that it is no longer profitable to produce these drugs. Also, we need to remember that lot of people in India prefer receiving treatment at private hospitals and clinics. After the animal bite, the clock starts ticking and patients find themselves running around to find the vaccine.

Dr Murli, Chinmaya Mission Hospital, Bengaluru 

Culling dogs is illegal in India and is an ineffective practice anyway, since more than 50 percent of all reported dog bite cases in India are from pet dogs.

Under various drives, dogs are caught, sterilised, vaccinated and released by the civic agencies and NGOs from time to time. However, the reality is that large areas in India do not benefit from such drives.

In order to eradicate rabies, we need to extensively map and monitor animal birth control drives and attempt a door-to-door coverage of areas that remain neglected by government and NGO drives.

Till that happens, the next time you come across a ‘dog-bite’, think before taking it lightly.

(The names of the rabies patients in the story have been changed on request)