- Reported bites are rising: 2.19 million (2022) → 3.05 million (2023) → 3.72 million (2024) across India, per the National Rabies Control Programme (NRCP). (Press Information Bureau)
- Officially recorded rabies deaths are low (54 in 2024), but independent modelling suggests thousands of deaths annually due to under-ascertainment. (Press Information Bureau, PubMed)
- Children bear the brunt of rabies vulnerability; India accounts for roughly a third of global rabies deaths. (World Health Organization)
- PEP works: Immediate wound washing + WHO/NRCP-recommended vaccine schedules (ID preferred) + passive antibodies for Category III wounds prevent virtually all deaths. (World Health Organization)
- What stops fatalities long-term: Vaccinating ≥70% of dogs (plus ABC sterilization and surveillance) and reliable PEP access everywhere. (PMC)
The current picture: dog bites & rabies in India
Reported bite burden (IDSP/IHIP)
Official NRCP data compiled from states/UTs show:
- 2022: 2,189,909 bites
- 2023: 3,052,521 bites
- 2024: 3,717,336 bites
(2025 Jan: 429,664) (Press Information Bureau)
Human rabies deaths: reported vs. estimated
- Reported (“suspected”) rabies deaths in 2024: 54. These are program figures and reflect only cases captured by surveillance. (Press Information Bureau)
- Independent estimates: A 2025 Lancet study modelled ~5,726 human rabies deaths per year (95% UI 3,967–7,350) in India—far higher than reported counts. (PubMed, ScienceDirect)
- WHO context: India is endemic and contributes ~one-third of global rabies deaths; older WHO communications often cite 18,000–20,000 annual deaths, underscoring chronic under-reporting. (World Health Organization)
How many stray dogs?
Peer-reviewed literature notes street-dog estimates up to ~62 million nationwide (definitions and methods differ; many are community-owned/roaming). (PMC)
Medical facts you need to know
Rabies exposure categories (determine PEP i.e Post Exposure Prophylaxis by vaccine)
- Category I: Touching/feeding, licks on intact skin → No PEP.
- Category II: Minor scratches/abrasions without bleeding → Vaccine.
- Category III: Transdermal bites/scratches, licks on broken skin, mucosal exposure → Vaccine + passive antibodies (RIG or monoclonal).
(Per WHO position and India’s NRCP protocol poster.) (WHO)
What to do immediately after a bite (life-saving)
- Wash wounds thoroughly for 15 minutes with running water and soap; apply a virucidal agent (e.g., povidone-iodine).
- Start vaccine promptly. India’s NRCP advocates intradermal (ID) vaccination. Typical schedules:
- ID: days 0, 3, 7, 28 (4 doses).
- IM: days 0, 3, 7, 14, 28 (5 doses).
- Why ID? Equally effective, uses 60–80% less vaccine and eases shortages. (World Health Organization)
- Category III needs passive antibodies ASAP.
- HRIG 20 IU/kg or ERIG 40 IU/kg, infiltrate into all wounds as much as anatomically feasible.
- Monoclonal antibodies (mAbs) such as Rabishield/TwinRab are India-made alternatives supported by growing evidence and used in many centres. (PMC)
Bottom line: Prompt PEP prevents death. Delays, missed doses, lack of passive antibodies for severe exposures, and poor wound care are the usual reasons fatalities still occur.
Why fatalities persist despite vaccines
- Under-recognition & late presentation in rural/peri-urban areas.
- Gaps in passive antibody availability (ERIG/HRIG) and variable adoption of mAbs. (The Lancet)
- Cold-chain and stock-out issues for vaccines in some facilities; ID rollout uneven. (World Health Organization)
- Dog vaccination coverage well below the threshold in many cities, so virus keeps circulating. (PLOS)
Measures that will actually prevent deaths in India
1) Vaccinate dogs, at scale (the single most important long-term step)
- WHO and partners recommend vaccinating at least 70% of dogs to interrupt transmission; sustained campaigns over multiple years are needed. (PMC, PLOS, PNAS)
- Integrate with Animal Birth Control (ABC) for population stabilization; India’s ABC Rules, 2023 provide the legal/operational framework for municipalities. (Animal Welfare Board)
2) Make human PEP easy, fast, and everywhere
- Standardize ID vaccination in all district hospitals/CHCs; train staff and ensure buffer stock. (World Health Organization)
- Guarantee passive antibodies for all Category III exposures—expand procurement of ERIG/HRIG and include mAbs where supply is reliable. (PMC)
- Maintain Model Anti-Rabies Clinics and ensure 24×7 access in high-burden districts. (Press Information Bureau)
3) One Health, surveillance, and accountability
- Align state action plans with NAPRE—India’s National Action Plan for Dog-Mediated Rabies Elimination by 2030. (Press Information Bureau)
- Strengthen IDSP/IHIP reporting so bites and suspected rabies are captured in real time; use data to steer campaigns. (Press Information Bureau)
4) Community-level actions that work
- School-based education on safe dog behaviour and first aid.
- Responsible ownership: leash laws where notified, vaccination and sterilization of pets, no abandonment.
- Community feeder protocols (designated feeding spots, post-feeding cleanup, support for ABC drives) as envisaged under ABC 2023. (Press Information Bureau)
FAQs
Is every bite fatal without treatment?
No—but any Category II/III exposure can transmit rabies. PEP started promptly is virtually 100% protective. (WHO)
Is intradermal vaccination safe for children?
Yes. ID schedules are WHO-endorsed, effective for all ages, and reduce vaccine use by 60–80%. (World Health Organization)
Do we still need immunoglobulin or mAbs if we’ve had the vaccine?
For Category III exposures in previously unvaccinated people, yes—local infiltration of passive antibodies is essential, along with vaccine.
Why do official rabies deaths look so low?
Because many deaths occur outside hospital settings or are not tested/reported. That’s why modelled estimates are much higher than routine counts. (PubMed)
India’s 2024 snapshot (at a glance)
| Indicator (2024) | India |
|---|---|
| Reported dog-bite cases | 3,717,336 (Press Information Bureau) |
| Reported suspected human rabies deaths | 54 (Press Information Bureau) |
| Modelled annual rabies deaths (study estimate) | ~5,726 (95% UI 3,967–7,350) (PubMed) |
| Dog vaccination needed to break transmission | ≥70% coverage (sustained) (PMC) |
Policy & practice checklist for Indian cities/districts
- Annual canine mass vaccination reaching ≥70% of dogs; track coverage by ward. (PLOS)
- Continuous ABC sterilization under ABC Rules, 2023 with transparent dashboards. (Animal Welfare Board)
- Universal ID PEP availability; passive antibodies stocked at all referral centres. (World Health Organization)
- Model Anti-Rabies Clinics + school programmes + public IEC on bite first aid. (Press Information Bureau)
- Align with NAPRE 2030; publish district-level bite and rabies dashboards monthly. (Press Information Bureau)
Sources & further reading
- Press Information Bureau (PIB), NRCP/IDSP data on dog bites and suspected rabies deaths, 2022–2024. (Press Information Bureau)
- Thangaraj JWV et al., Lancet (2025): modelled India rabies mortality (~5,726/year). (PubMed, ScienceDirect)
- WHO India—Rabies overview (India ≈ one-third of global deaths). (World Health Organization)
- NRCP PEP Protocol Poster (2024): categories, ID/IM schedules, HRIG/ERIG dosing.
- WHO PEP recommendations: intradermal benefits (60–80% dose saving). (World Health Organization)
- ABC Rules, 2023 (Government of India). (Animal Welfare Board)
- Evidence for 70% dog vaccination threshold to interrupt transmission. (PMC)
- Street-dog population context in India (up to ~62M). (PMC)
