ഇന്ത്യയിലെ പേവിഷബാധ മരണങ്ങൾ: ഔദ്യോഗിക കണക്കുകളും പഠന റിപ്പോർട്ടുകളും തമ്മിൽ വലിയ അന്തരം

In 2025, India recorded 55 deaths by malaria, 131 deaths by dengue, and 27 deaths by kala-azar (visceral leishmaniasis or black fever), according to Union Health Ministry data, whereas there is no single comparable and comprehensive national measure of its annual human rabies mortality, even as the country looks to eliminate dog-mediated human rabies by the year 2030.

While a community-based study led by researchers from the Indian Council of Medical Research-National Institute of Epidemiology (ICMR-NIE) and published in The Lancet Infectious Diseases recently estimated that 5,726 people die of rabies in India every year, the Health Ministry's Integrated Disease Surveillance Programme-Integrated Health Information Platform (IDSP-IHIP) system reported 21 deaths by rabies in 2022, 50 in 2023, and 54 in 2024.

In contrast, the Registrar General of India's Medical Certification of Cause of Death (MCCD) system recorded 66 medically certified rabies deaths in 2022, and 271 in 2023. The MCCD system, however, covers only medically certified deaths and does not capture all registered deaths.

Dog vaccination could save more lives than routine child PrEP in Keralam, says study

These figures are not directly comparable -- the IDSP-IHIP is a disease surveillance system, while the MCCD captures medically certified causes through civil registration. At the national level, the MCCD covered 22.3% of registered deaths in 2022, and 22.0% in 2023. Neither system, therefore, provides a complete national count -- underscoring the gaps in India's rabies mortality surveillance.

The government table, sourced to IDSP-IHIP, had recorded one death in January 2025 but did not provide a figure for all of 2025. The government's published table, labelled 'Human Rabies cases (Death)', gives the source as IDSP-IHIP.

ICMR for its study surveyed 3,37,808 people in 78,807 households across 60 districts in 15 States and estimated that India sees about 9.1 million animal bites every year, including about 5.6 million dog bites.

All about the counterfeit 'Abhayrab' rabies vaccine batch under investigation

The researchers used the community survey, laboratory data, and a probability decision-tree model to estimate the number of people who progress from an animal bite to rabies and die. The 5,726 figure is therefore a modelled estimate of annual deaths, and not a count of deaths recorded in hospitals or by government surveillance.

The difference between the two datasets is substantial. The 54 deaths reported through government surveillance in 2024 is less than 1% of the study's estimated annual toll of 5,726.

"The two figures, however, are generated through different methods and should not be treated as directly equivalent. The figures therefore highlight a large gap between reported surveillance deaths and estimated mortality," a senior Health Ministry official said.

Bhutan leads South-East Asia in eliminating rabies as public health problem

"Lack of consolidated data is a challenge in rabies eradication. Very often cases and deaths occur in areas of the country where they are not measurable. Vaccination of stray dogs, stringent post-exposure vaccination for humans, and disruption of the rabies chain is essential to curb the problem," Nirmal Kumar Ganguly, medical scientist, public health expert, and former ICMR chief, speaking exclusively to The Hindu, said.

The National Centre for Disease Control itself says efforts are continuing to make human rabies a notifiable disease across India, and that all States have been asked to notify the disease under the relevant State legislation.

The Health Ministry has also acknowledged the surveillance challenge, with deaths occurring outside the formal health system posing an additional difficulty in capturing the full burden of disease.

Tamil Nadu failing at animal birth control programme

Meanwhile, the Lancet study found important gaps even after animal bites. About one in five dog-bite victims had not received the anti-rabies vaccine, while only 66.2% had received at least three doses. Among those who received only one dose, nearly half did not complete the vaccination course. Only about one in 10 eligible victims received passive immunisation.

Rabies is a vaccine-preventable viral disease that attacks the central nervous system and is almost invariably fatal once symptoms appear, with infected dog bites causing most human transmission.

The World Health Organization (WHO) estimates that domestic dogs are responsible for up to 99% of human rabies transmission. Globally, rabies causes an estimated 59,000 human deaths every year, with more than 95% of deaths occurring in Africa and Asia.

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

The WHO estimates that India accounts for 35% of rabies deaths globally and 59.9% of rabies deaths in Asia, underlining the country's significant contribution to the global burden. Children are particularly vulnerable. The WHO says 40% of people bitten by suspected rabid animals are children under 15 years. Rabies is entirely preventable through timely vaccination of dogs and prompt post-exposure care.

The ICMR-funded study states that although there has been a substantial decline in human rabies deaths over the past two decades, India needs to fast-track its actions to eliminate dog-mediated human rabies by 2030 by adopting a focused 'One Health' approach -- integrating human and animal surveillance, ensuring timely administration of the full course of post-exposure prophylaxis, and accelerating dog vaccination across the country.