Rabies Gives No Second Chance, But It Can Be Prevented

I am a pet parent, and my dog Bolt is my naughtiest kid. But being a pet parent also comes with responsibility, especially at a time when we regularly hear reports of serious dog bites and incidents involving both pet and stray dogs.

Beyond the debate around dogs, there is a much bigger public-health issue we need to talk about, and that is rabies. This weekend on NDTV Lifeline, we dedicated the show to a disease that presents us with a disturbing contradiction. Rabies is almost always fatal once clinical symptoms appear, and yet deaths from rabies are preventable if the right action is taken quickly after an exposure.

India continues to see a substantial burden of animal bites and rabies. WHO estimates had put India's toll, at 18,000 to 20,000 deaths a year, and estimated that India accounted for 36% of global rabies deaths. Children remain particularly vulnerable. WHO says 40% of people bitten globally by animals suspected of having rabies are under the age of 15.

We spoke to Dr Simmi Tiwari, Officer-in-Charge, Centre for One Health and Programme Officer for the National Rabies Control Programme at the National Centre for Disease Control. One of the most important messages from the conversation was that rabies prevention cannot be reduced to simply "getting an injection". What happens immediately after a bite or scratch matters. And this is where awareness can make the difference between life and death. "Wash the wound immediately and thoroughly with soap and running water for at least 15 minutes and seek medical attention. Post-exposure prophylaxis can include wound washing, rabies vaccination and, for severe Category III exposures, rabies immunoglobulin", said Dr Tiwari.

Another important message is specifically for parents, "Never dismiss a scratch or bite because it looks small as children may not always tell their parents they have been bitten or scratched. They may be frightened or simply not realise its significance. That makes awareness at home crucial", shared Dr Tiwari.

Something many people do after a dog bite is use home remedies. "Home remedies are not the answer, please do not make the mistake of applying turmeric, chilli as that worsens the situation and cannot replace proper wound washing and medical assessment," adds Dr Tiwari.

The exposure itself is what should trigger immediate action. A bite or scratch from a potentially infected animal should never be ignored while waiting for symptoms to develop. Once rabies progresses, neurological signs can include unusual sensations around the wound, hydrophobia or fear of water, agitation and eventually paralysis. But the critical message is not to wait for these signs before seeking treatment. Once clinical symptoms appear, rabies is virtually always fatal.

There is another misconception we need to put behind us, which is the frightening memory of multiple painful injections in the stomach. Modern rabies vaccines are different from the old nerve-tissue vaccines. For adults, intramuscular rabies vaccination is administered in the upper arm or deltoid, while the anterolateral thigh can be used in young children. For severe Category III exposures, rabies immunoglobulin provides passive antibodies at the beginning of post-exposure treatment while the vaccine generates the body's immune response.

Rabies attacks the central nervous system. Once the virus reaches that stage and clinical symptoms appear, the disease is virtually always fatal. That sounds terrifying, but the more important message is that, we can stop the disease before it gets there. This is precisely why awareness about wound washing, timely vaccination and appropriate post-exposure treatment matters.

And perhaps we also need to change the way we talk about rabies. Because it can't become humans versus dogs. Every time there is a serious dog-bite incident, the conversation understandably becomes emotional. People are frightened. Pet owners become defensive. Animal lovers worry about what will happen to community dogs.

But rabies prevention cannot be reduced to choosing between human safety and animal welfare. Geeta Seshamani, Vice President, Friendicoes SECA raised an important point during our conversation, "if we choose to feed and care for community dogs, that responsibility shouldn't end with putting out food. We also need to be conscious of their sterilisation and vaccination."

Dog vaccination, responsible pet ownership, sterilisation, awareness about animal behaviour, access to post-exposure treatment, surveillance and education all have a role. All of us need to know what to do after a bite. Wash the wound for 15 minutes. Seek medical attention immediately. Take the prescribed post-exposure treatment seriously. And don't assume that because a wound has healed, the danger has passed.

Ahead of World Rabies Day on September 28, we must remember that Rabies is one of those diseases where the outcome can be devastating, but prevention can be remarkably straightforward. We don't need fear around rabies, we need more awareness, faster action and greater responsibility. Because once rabies symptoms appear, there is almost no second chance.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.