Skipping first aid, costly immunoglobulins, delayed treatment: India amidst a dog bite crisis

A study shows that almost 80 per cent of healthcare facilities store rabies vaccines, only 20 per cent keep a stock of immunoglobulins.

India is battling a silent epidemic of dog bites, with over 47.48 attacks recorded in 2025. Rabies requires prompt medical aid, failing which can lead to death of the affected person.

Delaying immediate care, the disease becomes unmanageable to treat and turns fatal in no time.

However, there is little to no awareness around the urgency in the treatment the condition demands.

Rabies virus attacks the nervous system, and rushes to the brain in a little time. While there are effective vaccines against it, the timeliness often gets compromised, leading to mortality even in cases of delayed vaccination. 

Lack of first aid, high cost of immunoglobulin injection and poor timing are a few hurdles in the management of the disease in the country.

Wound cleaning is oversimplified 

When an animal attacks, scratches or bites a person, the immediate response is to run to a clinic or a hospital. Some might even skip the care if it's a minor scratch.

However, as per the World Health Organisation (WHO), the affected person must run the wound under clean water and wash it with soap for at least 15 minutes. This action has two protective functions, firstly it can kill the virus on the spot before it enters the skin, secondly, an animal’s saliva has more than one kind of a virus, washing the wound can ensure that only few survive. Then they must rush to the nearest clinic for anti-rabies vaccine.

Avoidance of first aid causes the virus to enter the nerve endings close to the skin by the time the affected person reaches a healthcare facility.

Wound injections are not affordable 

A third grade bite happens when an animal’s saliva reaches inside the broken skin caused by the bite or previous injury. This requires an additional immunoglobulin shot inside the wound alongside the vaccination course that follows.

As per experts, bites near the face, neck and fingertips are rich in nerve supply, attacks in these areas can increase the risk of rabies transmission.

The rabies immunoglobulin provides immediate immunity with its ready-made antibodies as opposed to vaccines that provide long-term immunity. They are usually to be administered soon after the exposure to animal saliva. 

However, these injections are expensive, costing Rs 5,000 and even higher, depending on the brand. These jabs are not easily accessible in primary health centres and are not affordable to all. These injections are needful for those who have not been vaccinated before and those with third grade bites.

There are studies showing that a combination of immunoglobulins and rabies vaccines provide the best protection against the infection, especially in severe exposure. 

An ICMR study shows that almost 80 percent of healthcare facilities store rabies vaccines, only 20 percent keep a stock of immunoglobulins.

Temperature sensitive vaccine

Rabies vaccines are highly temperature sensitive, often stored between the range 2 degree C and 8 degree C. In circumstances where there is lack of storage infrastructure, the stockpile of these vaccines run the risk of becoming ineffective. They cannot be stored at room temperature. 

Rabies vaccines are often given in standard doses, typically on days 0,3, 7, 14 and 28. They are recommended to be administered on the skin of the upper arm (deltoid region).

Where do we stand with the stray dogs?

Last year, the Supreme Court modified its order stating that all stray dogs picked up from streets in the national capital will be sterilised, vaccinated and released back into the area, if they are not found to be rabid or infected with rabies.

This reframing came amid the protests initiated by dog lovers and potential violations of India’s Animal Birth Control Rules, introduced in 2023.