Health experts flag need for immediate wound care, medication to fight rabies

Public health experts have called for more awareness creation among the public regarding the importance of immediate wound care and post-exposure prophylaxis (PEP) against rabies in the event of an animal exposure and addressing the systemic gaps in care, as Keralam strives to achieve the goal of rabies elimination and zero human rabies deaths by 2030.While much of the media attention has been focussed on the human rabies deaths that occurred in the State despite PEP, the actual focus should be on the proportion of the people in the State who do not take PEP after animal exposure, either due to their ignorance or because they were not aware that they were at risk of rabies, S. Harikumar, State Programme Officer, National Rabies Control Programme, said.He was narrating Keralam’s rabies story on Wednesday at a workshop organised as part of World Rabies Day observance by the Health, Animal Husbandry and Local Self-government departments and the School of Public Health at the Kerala University of Health Sciences.“It is a sad state of affairs that despite the wide availability of anti-rabies vaccination in all public hospitals, of the 15 human rabies deaths reported in 2026 so far, all except one did not take PEP. While the majority of these deaths were following dog bites, in the case of five deaths, the cause of rabies exposure was “unknown”,” Dr. Harikumar saidNew cause of concernIn Keralam, apart from dogs or cats, exposure to wild animals leading to human rabies death were a new and emerging cause for concern. In the last two or three years, human rabies following exposure to leopard, wild cat, fox, jackal and mongoose, have also been reported in the State.Of the total animal bites reported, close to 50% were dog bites. Stray dogs accounted for roughly 30% of the dog bites, which meant that systematic vaccination of domestic dogs and steps such as mandatory pet licensing can make a huge difference in the rabies burden, it was pointed out.Last year, there were six human rabies deaths despite PEP, while the number has dropped to one this year so far. The quality of the vaccine and cold chain maintenance have all been repeatedly validated at Union government institutions.Wounds on face, neckThe rabies deaths despite PEP have consistently pointed to laxity in immediate wound washing and the fact that these wounds were on the face or neck or highly innervated areas such as hands, which aided the virus’s rapid entry into the nervous system before the rabies immunoglobulin or vaccine could work.“The laxity in wound washing is something we have to address. People rush to the hospital with the bite victim instead of spending time on this important step. At the health-care institution, people often say casually that they have washed the wound, so that step is missed at the hospital also. Wound washing for at least 10-15 minutes should be repeated as a standard protocol at hospitals when animal bite cases are brought in. We also need to re-examine and re-train staff on the proper technique of administering immunoglobulin serum in wounds, especially around the eyes. Addressing these basic gaps can add to the effectiveness of PEP,” Dr. Harikumar pointed out.The workshop was also the occasion for the dissemination of the WHO-funded Integrated Bite Case Management (IBCM) project implemented in the State. IBCM is an integrated human and animal surveillance approach to rabies surveillance on the One Health platform, with stress on community involvement and mass dog vaccination as a cost-effective approach to rabies control. Published - September 30, 2026 08:41 pm IST