In a key step towards achieving zero human deaths, the Delhi government is set to declare human rabies a notifiable disease under the Epidemic Diseases Act to strengthen disease surveillance, speed up reporting and facilitate quick public health action, helping prevent rabies deaths, according to an official government release.
A notifiable disease is required by law to be reported to government authorities. The significant move will ensure no case goes unreported as all healthcare institutions – be it government or private, including medical colleges and individual medical practitioners, will be by law required to inform authorities about suspected, probable, or confirmed cases of human rabies.
The data provided by the hospitals will help the government to tackle the growing crisis of rabies. The official release also said efforts were underway to further strengthen rabies vaccination facilities for humans as well as dogs and other animals.
Delhi Health Minister Pankaj Kumar Singh “this is an important step toward our goal of zero human deaths from rabies in Delhi.”
“Rabies is a preventable disease, and no death due to rabies is acceptable. Declaring human rabies as a notifiable disease will strengthen surveillance, improve early detection, and ensure timely treatment,” said Delhi Health Minister Pankaj Kumar Singh.
What makes rabies deadly, but a highly preventable disease
Rabies is a viral zoonotic disease that causes tens of thousands of deaths annually. India accounts for 36% of worldwide rabies deaths, with approximately 18,000–20,000 fatalities every year, as per the World Health Organisation (WHO). A review published in the National Institutes of Health (NIH), estimates around 17.4 million dog bites per year in India.
Mostly caused by dog bites or scratches, death due to human rabies cases can be prevented by stopping the virus from reaching the central nervous system.
Once the virus infects the central nervous system and symptoms appear, rabies kills in 100% of cases.
According to the WHO, rabies deaths are preventable with prompt post-exposure prophylaxis (PEP) by stopping the virus from reaching the central nervous system. PEP involves thorough wound washing, administration of a course of human rabies vaccine and, when indicated, rabies immunoglobulins (RIG).
20 states have declared human rabies a notifiable disease, as per the official website of the Ministry of Health & Family Welfare’s National Rabies Control Program.
How does rabies spread
Rabies spreads to people as well as animals through saliva in the form of bite, scratches, or direct contact with the infected animal’s eyes, mouth, or open wounds. Up to 99% of human rabies case are spread by dogs, and the most common targets are children aged between 5-14 years.
How rabies symptoms progress from harmless to deadly
One should never take dog bites or scratches lightly and must head to the nearest health centre immediately. Symptoms get serious, and eventually deadly once the virus reaches the nervous system.
It may start as fever, pain, unexplained tingling, pricking, or burning sensations at the wound site. As the virus moves to the central nervous system, progressive and fatal inflammation of the brain and spinal cord develops.
Rabies is broadly divided into two categories – furious rabies and paralytic rabies. In the first type, symptoms include hyperactivity, excitable behaviour, hallucinations, lack of coordination, hydrophobia (fear of water) and aerophobia (fear of drafts or of fresh air), as per the World Health Organisation. Death occurs after a few days due to cardio-respiratory arrest.
The paralytic rabies, accounting for about 20% of the total human cases, runs a less dramatic but longer course and is often misdiagnosed due to its slow onset. In this case, muscles gradually become paralysed, starting from the wound site. After coma, eventually death occurs.
In 2021, the Delhi government made vector-borne diseases like dengue, malaria, and chikungunya notifiable diseases under the Epidemic Diseases Act.
Making rabies a notifiable disease is the need of the hour. Health experts have been demanding the crucial step for quicker public health responses and better data-driven interventions. Early reporting of rabies can go a long way in preventing the spread of the disease.
“The decision to make human rabies a notifiable disease is a crucial and welcome public health intervention. Rabies is a vaccine-preventable, zoonotic viral disease, but once clinical symptoms appear, it is nearly 100% fatal, as there is no curative treatment. It is, however, entirely preventable through timely post-exposure prophylaxis (PEP) with rabies vaccination, which remains the only effective life-saving intervention,” Dr J Kirtana, Associate Consultant Infectious Diseases, Fortis Hospital, Shalimar Bagh told Financial Express.com.
“Equally important is preventing rabies at its source. Mass dog vaccination remains the most cost-effective and sustainable strategy for preventing rabies in people. In parallel, sustained public education—especially for school-going children—is essential to promote safe behaviour around stray animals, improve awareness about immediate wound care, ensure knowledge of rabies vaccine availability, and reinforce the urgency of seeking prompt medical attention after any animal bite or scratch,” Dr Kirtana.
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