Intended for healthcare professionals


Man bites dog: India’s progress in tackling rabies

BMJ 2020; 368 doi: (Published 21 January 2020) Cite this as: BMJ 2020;368:l6979
  1. Kamala Thiagarajan, freelance journalist
  1. Madurai, South India
  1. kamala.thiagarajan{at}

With millions of stray dogs in India, controlling rabies in the subcontinent has proven a challenge. Kamala Thiagarajan says that building awareness, increasing vaccinations, better organisation, and an initial boost from a UK charity have led to improvements

Gowri Yale, a veterinarian with a PhD in rabies epidemiology, was manning a 24 hour rabies hotline in Goa. A man called, saying that his 10 year old son had been bitten by a street dog. Members of Mission Rabies, a charity started as part of the UK based Worldwide Veterinary Service,1 had spoken at the boy’s school, and he had a pamphlet with the hotline number.

The father was unsure about the information—did his son really need five injections? Yale urged the man to get his son the injections from a private or government run hospital, which is not necessarily an easy thing to do. Rabies treatment in India consists of four vaccines taken over a period of 14 days. A fast acting shot of the rabies immunoglobulin is also advised as soon as possible.

These injections are free at government run hospitals, but stocks are often low, and long queues can result in tedious hours spent waiting. At private hospitals, the entire course of injections could cost as much as Rs4000 (£42; €51; $56). “It’s very important that he gets all five injections,” she said repeatedly.

The next morning, after reports that the dog had bitten another person, Mission Rabies officials picked it up and euthanised it. A necropsy confirmed rabies.

Widespread problem

Charities like Mission Rabies are waging a concerted fight against rabies in India that is beginning to show some success. Other infectious diseases might get more attention, but rabies kills 59 000 people globally every year.2 The World Health Organization reports that dog bites are responsible for up …

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