World Rabies Day 2025 – You, Me, and Community

World Rabies Day 2025 -You, Me, and CommunityRabies, a fatal but vaccine-preventable viral zoonotic disease, causes approximately 59,000 human deaths globally each year, mostly because of dog bites.Rabies is an endemic disease in India.It is prevalent in all the states and union territories of the country except Andaman & Nicobar and Lakshadweep Islands.India accounts for 35% of the global burden of rabies.In India, 174 million animal bites occur annually, resulting in 20,565 human rabies deaths and is responsible for economic loss of 8.6 billion USD and 3.7 million disability-adjusted life years (DALYs) across the globe annually.The disease is almost fatal after the onset of clinical symptoms and results in painful deaths due to acute progressive encephalitis.Most of the cases occur in underserved population in Africa and Asia with approximately 40% of cases in children below 15 years of age.More than 95% of human cases across the globe are caused due to dog bites.Rabies deaths in human are 100% preventable through prompt and appropriate medical care.A multicentric community survey on animal bites done in seven states in 2017 demonstrated an antirabies vaccination (ARV) coverage of 796%.An evaluation of the human rabies surveillance system indicated a substantial under-reporting of the number of bites and human rabies death burden.The last nationwide survey to estimate human rabies deaths and animal-bite burden was done in 2003, and this type of up-to-date country-specific data are necessary for reliable global estimates.A study conducted in 2010 through probability decision tree approach by Partners for Rabies Prevention (PRP) estimated 16,450 rabies deaths in the country.An enhanced verbal autopsy survey within Million Death Study (MDS) projected 12,700 symptomatically identifiable rabies deaths in India in 2005 and further reported that 91% of these deaths occur in rural areas, 62% in males, and 50% in children below 15 years of age.The overall mortality was estimated to be 1.1 deaths per 1,00,000 population with one-third of these deaths in the state of Uttar Pradesh and three-fourths in 7 central and south-eastern states.The World Health Organization (WHO), World Organization for Animal Health (OIE), Food and Agriculture Organization of the United Nations (FAO) and the Global Alliance for Rabies Control (GARC) has set a goal of zero dog-mediated rabies deaths by 2030 and joined forces as the United Against Rabies collaboration.The WHO through its Strategic Advisory Group of Experts (SAGE) has recognized the importance of the programmatic experiences and evidences on rabies control from India towards achieving this goal as India contributes to one-third of the global rabies deaths.Generation of evidence-based guidance and high-quality data to measure impact and inform policy decisions has been coined as an important objective under this Global Strategic Plan 'to end human deaths from dog-mediated rabies by 2030'.The WHO categorizes risk exposure for animal bites into category I (no exposure), category II (exposure) and category III (severe exposure).The disease can be prevented by timely administration of postexposure prophylaxis (PEP) to the bite victims.This includes wound management as per recommendations; and administration of rabies vaccines through intramuscular (IM) or intradermal (ID) routes under different schedules in category II and III exposures and rabies immunoglobulins in previously nonvaccinated category III exposures.The incidence of rabies has remained stagnant and grossly under-reported in India since a decade.There is serious need to improve reporting systems to address the issue of lack of accurate data and its verification in a number of regions in the country as the true burden of the disease is not reflected in the hospital data .There is a dearth in the availability of quality literature in the country on dog bites and dog-mediated rabies and most of the studies are regional studies, based on records and secondary data analysis from hospital/clinic settings on animal bites without differentiation into dog bites.The studies reporting estimates at the national level are mostly derived from modeling study and not on primary data analysis.Understanding the burden of dog bites and rabies in the country will help policymakers in effective decision-making, proper allocation of scarce resources and funding and, thereby, formulation and implementation of best suited interventions at programmatic level.United Against Rabies, an alliance of partners from international agencies, has made a global call to end human deaths from dogmediated rabies by 2030 (Zero by 2030).To achieve this goal, India has laid a roadmap through its National Action Plan for Dog-mediated Rabies Elimination (NAPRE) from India by 2030.NAPRE envisages a one-health approach, involving human and veterinary health sectors, the agriculture ministry, municipal corporations, and Panchayati Raj Institutions to achieve 75% dog-vaccination coverage by 2025, and 75% reduction in human rabies deaths by 2030.The key component of the action plan includes mass dog vaccination, ensuring availability of rabies biologicals free of cost at all levels of the health system and strengthening linkages between rabies surveillance in humans and animals.In India, the sudden spike in the number of cases of rabies is a major public health concern.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.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.Unfortunately, the neighboring 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.Awareness about first aid measures after an animal bite in the country is inadequate.In a survey in six Indian states, only 38% of victims of animal bites reported washing wounds after biting with soap and water.Effective mass media campaigns are required to educate the public about rabies, first aid measures, and the importance of seeking timely care.In summary, there is a need for integrated and comprehensive management of street dogs and bite management.