Can India End Rabies Deaths by 2030? Death of Parag Desai in Ahmedabad Brings Up Some Tough Questions

Today, on October 23, Parag Desai, the executive director of the Wagh Bakri tea brand succumbed to a brain haemorrhage. As per news reports, the 49-year old had sustained injuries while trying to escape an attack by stray dogs near his residence in Ahmedabad, Gujarat, last week on October 15.

Desai’s death has called for attention towards the growing concern of stray dogs who allegedly often attack or bite people. Social media is divided over angry people demanding an end to the stray dog ‘menace’ vs animal activists who are pleading mercy towards the animal.

Without getting into the merits of such a debate, here are some facts documented by the World Health Organization (WHO). According to the health agency, dogs are the source of the vast majority of human rabies deaths, contributing up to 99 per cent of all rabies transmissions to humans.

But, rabies is a vaccine-preventable viral disease though it has no known cure. It occurs in more than 150 countries and territories.

Globally, India has the highest incidence of rabies. India is endemic for rabies, and accounts for 36 per cent of the world's rabies deaths. India also accounts for 65 per cent of the deaths due to rabies in the South-East Asia region.

But, all this may be a tip of the iceberg as several dog bites and rabies cases go unreported in the country.

“The true burden of rabies in India is not fully known; although as per available information, it causes 18,000 - 20,000 deaths every year. About 30-60 per cent of reported rabies cases and deaths in India occur in children under the age of 15 years as bites that occur in children often go unrecognised and unreported,” mentions the WHO.

Ranjeet Dixit, the chief health superintendent at the Lucknow-based Bhaurao Devras Civil Hospital told Gaon Connection that it takes 21 days for the symptoms of rabies to surface. This includes fever, irritability, aggression, muscle spasms, anxiety, hallucinations, seizures, excess salivation and loss of appetite.

“If people think that they can be treated for rabies after the symptoms appear, they are greatly mistaken. Death is almost certain in this disease and immediate vaccination after a dog bite is the only solution,” he said.

The vaccine for rabies is available free of cost at all the government health centres across the country.

Also Read: 36% of the world's rabies deaths happen in India. A Kashmiri doctor is trying to change that.

Rabies, a public health concern in India

In India, the sudden spike in the number of cases of rabies is a major public health concern, notes a November 2022 study published in The Lancet. It quotes the National Rabies Control Programme of the Government of India, which reported 6,644 clinically suspected cases and deaths of human rabies between 2012 and 2022 (see map).

Map: Dog-bite cases in the states and Union Territories of India between Jan–Oct 2022, as reported by local media reports.

The Lancet study reports that “deaths due to rabies among vaccinated and unvaccinated individuals, especially in the State of Kerala, have caused great public concern. In Kerala, the number of infected dogs has doubled in the past five years.”

It goes on to note that “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.”

Situation is equally alarming in the neighbouring state of Tamil Nadu, claim the researchers of the study. “The neighbouring state of Tamil Nadu has also reported an alarming number of deaths from rabies. The disease has claimed the lives of 18 people in the last eight months which is of major concern,” reads November 2022 study.

The researchers of The Lancet study state: “In India, an increase in aggression among dogs has been observed post-pandemic, probably resulting from food shortages, abandonment of pets, and a decrease in human–dog interaction.”

Despite the Prevention of Cruelty to Animals Act of 1960, which protects stray animals, and the Animal Birth Control (Dogs) Rules of 2001, which makes it illegal to remove or relocate dogs, mass killing of dogs have been reported, it notes.

Also Read: World Rabies Day: An average of 50 people are killed daily in India due to rabies

Rise in dog bite cases in UP

As per recent media reports, the cases of dog bites have almost doubled in Uttar Pradesh, India’s most populous state.

According to data attributed to the state’s health department, a total of 993,584 cases of dog bites had been registered from January, 2022 to August, 2022. But this year, so far, more than 1.8 million (1,843,160) cases of dog bites have been reported.

Gaon Connection approached health officials in Uttar Pradesh’s rural areas to assess the preparedness in dealing with the cases of rabies.

DK Srivastava, the upper chief medical officer in Sitapur district admitted that the population of stray dogs is on the rise.

“People are more inclined to pet dogs now. That is also a contributing factor when it comes to a rise in the population of stray dogs. However, the community health centre in Sitapur has enough anti-rabies vaccines to check the mortality in rabies patients,” Srivastava told Gaon Connection.

“It is important that a person who has been bitten by a dog is vaccinated within 12 hours. The villagers especially should not believe in superstitions like putting turmeric or chilly powder on the wound,” he added.

Meanwhile, Yogesh Tiwari, a teacher living in the Bhogipur village in the Sitapur district also echoed the health officials opinion on the rise in the population of stray animals.

“The incidents of dog bites have undoubtedly increased. The young children are at a greater risk of attack by stray dogs. Recently, dogs had attacked a young girl in this village because of which the attendance in my school had dipped. Now, students come to school in groups to be able to ward off any attack by stray dogs,” Tiwari told Gaon Connection.

“The Khairabad town of Sitapur is worst affected. In 2018, a total of 18 people were reported as dead due to attacks by stray dogs,” he claimed. Gaon Connection has not independently verified claims made by the school teacher.

Over 360 kilometres from Sitapur, Ghulam Rasool Rizvi, a 55-year-old resident of Mubarakpur village in Azamgarh district, recalled a recent incident of dog bite that he witnessed.

“It was a horrific incident. Ramesh, a father of two children, was bitten by a dog at the petrol pump… He contracted rabies and became aggressive. On September 15 [last month], he was shut inside a room and the police and the health officials were called in to control him,” he recalled.

“After four hours of attempts, the man was tied in ropes and taken to a hospital where he died. Unfortunately, he had ignored the bite and hadn’t taken the teeka [vaccination],”Rizvi added.

Awareness is increasing

Mohammad Akram, a physician who runs a private clinic at the Bhogipur village in Sitapur, said that people were now more aware about rabies than they were a decade ago.

“People rarely neglect a dog bite these days. They know that teeka has to be taken after a dog bite. A total of five shots of vaccine are administered and it costs almost Rs 2,000 at private health clinics,” Akram said.

Villagers also agreed that people were far more aware about dog bites now.

“In my childhood, I used to hear a lot about Rabies deaths but now they are very rare. But people need to know for sure that they cannot delay the vaccination,” Pragya Shukla, a rural resident from Lakhimpur Kheri district told Gaon Connection.

End Rabies by 2030

According to the National Rabies Control Programme of the Union Ministry of Health & Family Welfare, rabies is endemic throughout the country. With the exception of Andaman & Nicobar and Lakshadweep Islands, human cases of rabies are reported from all over the country. The cases occur throughout the year.

About 96 per cent of the mortality and morbidity is associated with dog bites. Cats, wolves, jackal, mongoose and monkeys are other important reservoirs of rabies in India. Bat rabies has not been conclusively reported from the country.

To address the issue of rabies in the country, the National Rabies Control Programme was approved in 2013.

Globally, concerted efforts have been launched to eliminate dog-mediated rabies by 2030. WHO is one of the leading agencies for it, and India has also pledged to end rabies related deaths in the next seven years by 2030.

With inputs from Virendra Singh in Barabanki and Ramji Mishra in Sitapur