Inconsistency in data on rabies deaths is a major challenge

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

While a community-based study led by researchers at 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 each year, the Integrated Disease Surveillance Program-Integrated Health Information System (IDSP-2IHIP) of the Indian Ministry of Health reported. 50 in 2023 and 54 in 2024.

In contrast, the Indian Registrar’s Medical Certificate of Death (MCCD) system recorded 66 medically confirmed rabies deaths in 2022 and 271 in 2023. However, the MCCD system only covers medically confirmed deaths and does not capture all registered deaths.

These numbers are not directly comparable — IDSP-IHIP is a disease surveillance system, while MCCD captures medically verified causes through civil registration. Nationally, MCCD covered 22.3% of registered deaths in 2022 and 22.0% in 2023. Therefore, neither system provides a complete national count – underscoring gaps in India’s rabies mortality surveillance.

A government table sourced from IDSP-IHIP recorded one death in January 2025, but did not provide a figure for the full year 2025. A government table titled “Rabies Cases (Death)” lists the source as IDSP-IHIP.

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

The researchers used a community survey, laboratory data and a probability tree model to estimate the number of people who will go from being bitten by an animal to rabies and dying. The number of 5,726 is therefore a modeled estimate of annual deaths, not the number of deaths recorded in hospitals or by government surveillance.

The difference between the two datasets is significant. The 54 deaths reported through government surveillance in 2024 are less than 1% of the estimated annual number of 5,726, according to the study.

“However, the two numbers are generated by different methods and should not be considered directly equivalent. The numbers therefore highlight the wide gap between reported follow-up deaths and estimated mortality,” said a senior health ministry official.

“Lack of consolidated data is a challenge for rabies eradication. Very often, cases and deaths occur in areas of the country where it is not measurable. Vaccination of stray dogs, rigorous post-exposure vaccination for humans and disruption of the rabies chain are essential to curtail the problem,” said Nirmal Kumar Ganguly, exclusive senior physician, former physician and public health expert at HinduIC.

The National Center for Disease Control itself says that efforts are ongoing to make human rabies a notifiable disease across India, and that all states have been asked to report the disease under their respective state laws.

The Ministry of Health also recognized the challenge of surveillance, where deaths occurring outside the formal health system present additional difficulties in capturing the full burden of disease.

Meanwhile, the Lancet study found important gaps even after animal bites. About one in five dog bite victims did not receive the rabies vaccine, while only 66.2% received at least three doses. Among those who received only one dose, almost half did not complete the vaccination cycle. Only about one in 10 eligible victims was passively immunized.

Rabies is a vaccine-preventable viral disease that attacks the central nervous system and is almost always fatal once symptoms appear, with most transmission to humans through the bite of an infected dog.

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 each year, with more than 95% of deaths occurring in Africa and Asia.

WHO estimates that India accounts for 35% of rabies deaths worldwide and 59.9% of rabies deaths in Asia, underscoring the country’s significant contribution to the global burden. Children are particularly vulnerable. The WHO reports that 40% of people bitten by animals suspected of rabies are children under 15 years of age. Rabies is completely preventable with timely vaccination of dogs and prompt post-exposure care.

An ICMR-funded study says that although there has been a substantial decline in human rabies deaths over the past two decades, India needs to accelerate its steps to eliminate dog rabies by 2030 by adopting a targeted ‘One Health’ approach – integrating human and animal surveillance, ensuring timely administration of a full course of post-exposure prophylaxis and vaccination of dogs across the country.

Published – 04 Oct 2026 19:57 IST