RABIES-IND

RABIES Human rabies deaths and animal bite burden in India: A cross-sectional survey

~9.1 Million

Annual Animal Bite Cases

49.1%

Incomplete Vaccination

5,726

Annual Rabies Deaths

Overview

The project “Human rabies deaths and animal bite burden in India: Cross-sectional survey” was funded by ICMR-NIE and led by Dr. Vijay V Yeldandi. Conducted from July 2022 to August 2023, it aimed to estimate the burden of animal bites and human rabies deaths in India, assess post-exposure prophylaxis (PEP) coverage, and describe the anti-rabies vaccine (ARV) supply chain, and estimate the costs associated with animal bites. The study used a cross-sectional survey design with three components:

Community-based survey – Conducted across four districts in Telangana (Kamareddy, Mahabubabad, Hyderabad, and Narayanpet), surveying 5,300–6,400 households to identify animal bite cases.
Facility-based survey – Conducted in 36 health facilities (PHCs, district hospitals, medical colleges, and private hospitals) to assess reporting systems, vaccine supply chains, and costs.
Modeling approach – Interviews with state and district rabies program officers to understand program management and estimate human rabies deaths using a decision-tree model.

Aim

To estimate the burden of human rabies deaths and animal bites in India and understand related post-exposure management and costs.

Objectives

Primary objectives

Estimate the incidence of animal bite
Estimate human rabies deaths by decision tree model

Secondary objectives

Estimate the proportion of animal bite cases received post exposure prophylaxis
Describe anti rabies vaccine supply chain at different levels of health care system
Estimate direct and indirect costs associated with animal bite cases

Project Update

Rabies study implemented across Kamareddy, Narayanpet, Mahbubabad, and Hyderabad districts in Telangana state.
Community surveys: Completed in all 4 clusters, covering 5,300 households.
Facility surveys: Out of 36 targeted facilities, 20 completed and 16 under survey.
Data collected: Animal bite cases, rabies deaths, ARV usage, cold chain maintenance, and costs incurred due to animal bites.
Entire project data submitted to ICMR-NIE by October 2023.

Results

Survey Coverage: 78,807 households (337,808 individuals) across 60 districts in 15 states.
Animal bite incidence: 6.6 per 1,000 population (≈9.1 million bites annually), with dog bites at 5.6 per 1,000.
Vaccination uptake: 20.5% of dog-bite victims received no ARV; 66.2% received ≥3 doses, but 49.1% did not complete the course.
Estimated annual human rabies deaths: 5,726 (95% UI 3,967–7,350).

Conclusion / Outcomes

India has shown a decline in rabies deaths over two decades, but efforts must be accelerated to meet the 2030 elimination target.
Key measures required:
Integrated one-health surveillance
Full post-exposure prophylaxis coverage
Mass dog vaccination campaigns
The study successfully captured comprehensive data on animal bites, rabies deaths, vaccination coverage, supply chain, and economic impact, submitted timely to NIE, and contributed to manuscript preparation for publication.