Delhi to Mandate Reporting of Human Rabies Cases

Delhi to Mandate Reporting of Human Rabies Cases

Why in News? 

To eliminate deaths from dog-mediated rabies, the Delhi government is set to declare human rabies a notifiable disease under the Epidemic Diseases Act. This mandate aims to streamline medical responses and track rabies trends to achieve a rabies-free city.

Highlights of Delhi Government’s Rabies Notifiable Disease Initiative

• The Delhi government has formally notified to make human rabies a notifiable disease under the Epidemic Diseases Act, 1897. This means that all suspected, probable, or confirmed cases must be reported to health authorities without delay.
• Under the Epidemic Diseases Act, the state has the legal power to mandate disease reporting if it poses a public health risk. Making rabies notifiable will require all government and private hospitals, medical colleges, and individual practitioners to immediately report every case of human rabies to designated authorities.
• To support this notification system, Delhi has scaled up its prevention and treatment infrastructure. As of early 2026, anti-rabies vaccine (ARV) is available at 59 health facilities across all 11 districts of the National Capital Territory. In addition, rabies immunoglobulin (RIG) is provided at 33 designated centres and hospitals.
• Beyond notification, Delhi is finalising a State Action Plan for Rabies Elimination (SAPRE). This plan involves coordination with local bodies, animal husbandry departments, and other stakeholders. The initiative aims to address the root causes by improving dog vaccination coverage and enhancing community awareness.

What is Rabies?

• • Definition: Rabies is a viral disease that affects the nervous system of mammals, including humans. It is caused by the Rabies virus, which belongs to the Lyssavirus genus. The virus primarily spreads through the saliva of infected animals. 

• Transmission Routes: The most common mode of rabies transmission is through dog bites, which account for over 95% of human rabies cases in India. The virus can also spread through bites from other mammals such as bats, cats, foxes, and monkeys. 

• Incubation Period: The incubation period of rabies typically ranges from 1 to 3 months, depending on the location of the bite and the viral load. In some cases, symptoms can appear as early as one week or as late as one year after exposure.

• Clinical Symptoms: Initial rabies symptoms resemble common illnesses, such as fever, headache, fatigue, and general weakness. As the disease progresses, patients develop neurological symptoms including anxiety, agitation, confusion, and hallucinations. Characteristic signs include hydrophobia (fear of water) and aerophobia (fear of air currents). 

• Diagnosis: Rabies diagnosis is challenging because symptoms resemble other neurological disorders in early stages. Post-mortem diagnosis relies on brain tissue examination using the direct fluorescent antibody test, which is considered the gold standard.
• Treatment: There is no effective treatment once rabies symptoms appear. However, post-exposure prophylaxis (PEP) is highly effective. It involves thorough wound cleansing, anti-rabies vaccine administration, and rabies immunoglobulin (RIG).

Reasons Behind Delhi Government’s Decision

• Persistent Human Deaths Despite Preventability: Rabies remains one of the most fatal yet preventable diseases. Once symptoms appear death is almost certain. India reports an estimated 18,000 to 20,000 rabies deaths every year according to national health estimates. According to the World Health Organization (WHO), the country accounts for up to 36% of rabies deaths worldwide. This reality pushed the government to act decisively.

• Underreporting of Rabies Cases: Human rabies cases often go unreported due to lack of mandatory reporting. Many deaths occur at home or in private facilities. Official records fail to reflect real numbers. An RTI revealed that at least 18 people died from rabies in Delhi between 2022 and 2024, despite a government claim of “zero deaths” for the same period. This underlines the need for accurate, systematic reporting.

• Alignment with National Rabies Elimination Target: India has committed to the global goal of zero human deaths from dog mediated rabies by 2030. This target aligns with the WHO global framework adopted in 2018. Delhi’s decision supports this national and international commitment through stronger surveillance.

• High Dog Bite Burden in Urban Areas: In 2025, Delhi’s MCD reported 49 rabies cases alongside a significant number of animal bites (over 35,000), highlighting a serious public health challenge. Urban density increases human animal contact. Street dog populations remain significant despite sterilisation drives. Mandatory reporting helps map high risk zones and plan targeted interventions.

• Delay in Post Exposure Treatment: Rabies prevention depends on early post exposure prophylaxis. Many victims delay treatment due to lack of awareness or access. Rabies control needs coordination between health departments, municipal bodies and animal husbandry services. Notification helps authorities trace cases early.

• Protection of Vulnerable Populations: Children account for nearly 40 percent of rabies deaths in India as per WHO data. Urban poor communities face higher exposure risk. Rabies is a zoonotic disease. Strengthening its surveillance builds capacity for other zoonotic threats.

Current Status of Rabies Prevention Efforts in India

• The National Rabies Control Programme (NRCP) operates under the Ministry of Health and Family Welfare. Its activities include awareness campaigns, first aid guidance, wound care education and tracking of vaccination services. 
• The NRCP also supports a dedicated rabies helpline (15400) to offer information on nearby facilities with anti-rabies vaccine (ARV) and rabies immunoglobulin (RIG) availability to the public in participating states including Delhi. 
• Over the past two decades rabies treatment has improved significantly in India. Modern rabies post-exposure prophylaxis (PEP) using WHO-approved vaccines is now available in most major hospitals and many primary health centres.
• Many urban local bodies conduct regular drives to vaccinate stray and owned dogs against rabies. Municipal authorities, animal husbandry departments and veterinary teams collaborate to implement catch-neuter-vaccinate-release (CNVR) programmes. Some cities like Trichy have sterilised and provided booster doses to thousands of stray dogs as part of sustained efforts. 
• Awareness campaigns are conducted regularly, often around World Rabies Day (28 September), to educate citizens on bite prevention wound care and the importance of immediate medical treatment after exposures.

Core Benefits of Mandatory Notification

• Rapid Response System: Human rabies notification will create a real time early warning mechanism for health authorities. Every suspected or confirmed case will reach surveillance units without delay. This allows faster medical follow up and field investigation. 

• Accurate Disease Assessment: Mandatory notification will generate reliable and complete data on human rabies cases. Accurate numbers help governments understand the real disease burden. This supports better policy planning and budget allocation. Data driven decisions improve vaccine procurement and staffing.

• Integration with Technology: Surveillance now leverages digital platforms like the Integrated Health Information Platform (IHIP) to provide real-time updates and maps of rabies incidence.
• Policy Prioritization: By making rabies notifiable, the disease moves from a “neglected” status to a high-priority public health threat, which triggers greater political commitment and funding allocations.  
• One Health Coordination: Mandatory notification bridges the gap between human and animal health systems, allowing veterinary services to prioritize animal control and vaccination based on human case reports. 
• Improved Accountability Across Health Institutions: Once rabies becomes notifiable all public and private health facilities must report cases. This creates uniform responsibility across the health sector. It reduces silent handling of cases and undocumented deaths.