The number of rabies deaths has been increasing in Kerala reportedly at an alarming rate over the past four-five years. A girl from Malappuram succumbing to the infection at the Government Medical College Hospital, Kozhikode, on April 29, is the latest on the list.
According to the Health department, while two rabies deaths were reported in 2016, it rose to three the next year. There were nine deaths in 2018, and eight in 2019. In the pandemic year of 2020, the figure came down to five. In 2021, the number more than doubled to 11. There were 15 deaths in 2022, 17 in 2023, and 22 in 2024. This year, there has been 12 deaths so far.
K.K. Purushothaman, public health expert, points out that though steps such as curbing of rabid dogs and animal birth control are being discussed over the past few years, there is no solution in sight as yet.
“Debates are kicked up when an unfortunate incident happens. Thereafter, they lose their news value and the issue is buried. Rabies deaths, meanwhile, are seeing an upward curve despite post-exposure vaccination and the administration of immunoglobulin serum on the affected patients. We can’t wait any more for the control of dogs,” he says.
Immunoglobulin serum is a drug directly given on the wound site to neutralise the virus and provide passive immunity till vaccine-induced antibodies are produced in the body.
In this context, the demand for pre-exposure prophylaxis vaccination, or the rabies vaccination ahead of possible animal exposure or bite, has been raised again. At present, veterinarians and animal handlers, who are at risk of animal bites, alone are getting it. Public health experts say that the risk of death due to a random animal bite can be reduced if this vaccination is implemented among a larger population.
When there is severe exposure to rabid animals, termed by the World Health Organization as ‘Category III’ bites, the affected people will have to be administered four to five doses of the vaccine and the immunoglobulin serum. In pre-exposure prophylaxis vaccination, just two shots of the vaccine are enough to generate an immune response. If those getting this vaccine sustain an animal bite, they need to take only two booster shots and the immunoglobulin serum will not be required.
Dr. Purushothaman says that the financial feasibility of this vaccination, at least for those who can afford it, should be looked into in Kerala in the present context. “It may not be an excess expenditure if we compare the amount of money that has to be spent on human rabies immunoglobulin serum, which is very expensive,” he adds.
Published – April 29, 2025 07:04 pm IST