Timely rabies vaccine administration key: Experts

Rabies, a fatal viral disease mainly from dog bites, sees rising cases in Delhi. Vaccination is vital, but delays and concerns over vaccine quality persist.

New Delhi

Not all dog bites cause rabies; to do so, the dog would have to be infected (and those that are die within a week). (Getty Images/iStockphoto)

Rabies is a viral disease with 100% mortality. It is a zoonotic disease transmitted from animals to humans, and the majority of human deaths caused by rabies are attributed to dog bites, accounting for over 96% of fatalities, according to studies.

According to data provided by the ministry of fisheries, animal husbandry and dairy in Parliament on April 1, Delhi recorded 6,691 dog bite cases in 2022, 17,874 cases in 2023, 25,210 cases in 2024 and 3,196 in January 2025 alone. Delhi, however, has not recorded a single rabies death since 2022, according to the data. To be sure, there are other data sources that cite higher numbers.

Not all dog bites cause rabies; to do so, the dog would have to be infected (and those that are die within a week).

Experts say that the only way to prevent getting the disease is by getting vaccinated against it after being bitten (although there is also a pre-bite vaccine recommended for those working with animals). In recent years, the quality of rabies vaccine has come under the scanner as several deaths from Kerala were reported among vaccinated persons—the latest being the death of three children in April, who died despite having taken the rabies vaccine.

“It’s a standard recommendation these days to prescribe immune globulin along with the vaccine as vaccine takes a couple of days to work while the immune globulin or monoclonal anti-bodied that are given these days work faster. One cannot take a chance irrespective of the degree of wound,” said Dr Suranjit Chatterji, senior internal medicine specialist, Indraprastha Apollo Hospital.

All government hospitals in Delhi that have a functional neurology department are equipped to deal with rabies cases. While hospitals do not face a shortage of vaccines, specific supply numbers were not available, according to government officials aware of the matter.

The National Center for Disease Control runs a helpline for rabies, which can be contacted at 15400.

Does the vaccine work?

An inquiry into the earlier Kerala deaths suggests delayed treatment as the key cause for deaths.

A 2023 study titled “Emergence of rabies among vaccinated humans in India: a public health concern” that was published in The Lancet Regional Health Southeast Asia underlined that death due to rabies among vaccinated persons was a matter of concern, especially citing deaths reported from the southern state.

“Deaths due to rabies among vaccinated and unvaccinated individuals, especially in the State of Kerala, have caused great public concern… Among 300 samples taken from dogs, 168 samples (56%) were found to be positive for rabies, compared to 32% in a similar study conducted in 2016. The state has reported more than 200,000 dog bite cases and 21 deaths (12 deaths were laboratory confirmed), which is almost double the deaths reported during the last year. Six of the victims, including a 12-year-old child, died despite receiving anti-rabies immunoglobulin (RIG) and vaccine,” read the paper.

“Due to a severe shortage of vaccines resulting from an increase in rabies cases, 250 anti-rabies vaccines were allegedly administered without being subjected to the required quality tests. However, the authorities later obtained a letter from the manufacturing company alerting them of the completion of quality inspections and the certificate from Central Drugs Laboratory (India). Antibodies against rabies were later detected in one of the six victims. Till now, the expert panel constituted to investigate deaths has not reported any concern regarding the effectiveness or potency of biologicals or the emergence of rabies virus strains that evade the protective effects of vaccine.”

The authors in the Lancet study said that the current rabies crisis in many countries, including India, was not controlled because stray dogs and other rabid animals roam freely and attack people. “Stray menace is a huge problem but more than the vaccine quality, it is likely the delay in taking the shot that caused the disease,” said an expert, requesting anonymity.