Tamil Nadu Reports Rising Dog Bite Cases and Rabies Deaths

Tamil Nadu has recorded an alarming increase in dog bite cases this year, with a total of 525,000 incidents reported so far, compared to 480,000 in the previous year. This represents an approximate 9% increase in cases, according to the state’s Directorate of Public Health and Preventive Medicine. Additionally, the number of rabies-related fatalities has reached 28 this year, following 43 deaths in 2022.

The rise in dog bites has prompted officials to call for improved inter-departmental coordination to address the issue effectively. A. Somasundaram, Director of Public Health and Preventive Medicine, emphasized the importance of ensuring that those who suffer from dog bites receive timely and appropriate treatment. He stated, “The Health Department focuses on Anti-Rabies Vaccination (ARV), proper wound cleaning, and ensuring the availability of ARV and Rabies Immunoglobulin (RIG). We are taking steps to ensure that victims complete the four-dose ARV schedule.”

Awareness regarding the importance of vaccination is crucial. Somasundaram highlighted a common misconception that bites from familiar pets are harmless, which can lead to dangerous outcomes. “One must get vaccinated irrespective of whether the bite is from a pet or a stray,” he warned.

The situation is further complicated by the increasing population of stray dogs in the region. Suresh Kumar, a senior consultant in Infectious Diseases at Apollo Hospitals in Chennai, noted that while public awareness about the need for vaccination has improved, knowledge regarding RIG remains limited. He explained, “Many still assume RIG is unnecessary. It is important to remember that vaccines take at least 15 days to produce antibodies against the virus.”

In a study conducted in Coimbatore, Sudharshini S., an associate professor at the Institute of Community Medicine at Madras Medical College, found that compliance with the ARV schedule was alarmingly low. “ARV must be taken on days 0, 3, 7, and 28 of the bite. We found that compliance gradually dips, and very few turn up for the last dose,” she reported.

Animal bites are categorized based on their severity. Sudharshini noted that Category III bites, which involve single or multiple transdermal bites or scratches, require RIG. Unfortunately, adherence to this protocol is often lacking, even among healthcare providers. “When protocols are clear, there should be no doubts,” she stated, underscoring the need for better training of healthcare workers in dog bite management.

To address these challenges, she proposed the use of technology to remind patients of their scheduled doses, similar to childhood immunization systems. “Many forget to take the subsequent doses,” she added, stressing the importance of ensuring RIG availability at primary health settings.

Dr. Suresh Kumar proposed considering pre-exposure vaccination as a preventive strategy. Currently, this vaccine is primarily administered to veterinarians and foreign tourists. “Given the high number of dog bites and rabies deaths, we should consider this strategy. It requires only two doses and eliminates the need for RIG in case of a dog bite,” he said.

As Tamil Nadu continues to grapple with the rising incidence of dog bites and rabies, officials are calling for a multi-faceted approach that includes public education, improved healthcare protocols, and increased availability of vaccines and treatments. This comprehensive strategy aims to protect the population and prevent further tragedies related to rabies in the state.