Chennai, September 18, 2025 – Several urban health centres in Chennai continue to redirect dog-bite victims to larger government hospitals for anti-rabies vaccine (ARV), despite repeated instructions from the state health department not to deny treatment.

A recent field visit by The New Indian Express to three Urban Primary Health Centres (UPHCs) and one Urban Health and Wellness Centre under the Greater Chennai Corporation (GCC) revealed that staff commonly advise patients to seek the vaccine at bigger facilities such as Rajiv Gandhi Government General Hospital, Government Peripheral Hospital at Periyar Nagar, or Government Stanley Medical College Hospital.

Staff at these centres confirmed that they usually administer tetanus injections and advise wound cleaning, but avoid giving ARV due to concerns about vaccine wastage. Each vial contains five doses and must be used within 24 hours of opening. With fewer dog-bite cases reported at smaller centres, health workers fear being questioned if unused doses go to waste.

The practice continues even though Health Minister Ma Subramanian and senior health officials have instructed medical staff not to refuse ARV to any dog-bite victim. This redirection affects patients seeking care at primary health outposts in Perambur (Bharathi Road), Periyar Nagar, Stanley, and other suburbs served by the Chennai Corporation’s smaller health units. GCC Joint Commissioner (Health) VP Jeyaseelan stated that steps will be taken to prevent further redirection of patients.

The issue has gained urgency following the recent death of a 47-year-old man from rabies in Chennai. According to The Times of India, the man developed symptoms a month after a stray dog bite and succumbed to the disease despite receiving vaccination. Experts suggest that delays in proper wound care and possible gaps in the vaccination schedule may have contributed to the outcome.

Rabies remains a significant public health concern in Tamil Nadu. A report by The New Indian Express in August highlighted that one in four rabies deaths in the state is linked to bites from pet dogs, not just strays. In response to increasing cases, the city is also planning shelters for aggressive and suspected rabid dogs, as reported by Mathrubhumi.

Rabies is almost always fatal once symptoms appear, but timely and complete post-exposure prophylaxis (PEP) can prevent the disease. PEP includes thorough wound washing, administration of rabies vaccine, and in severe cases, rabies immunoglobulin. The World Health Organization emphasizes that no patient should be denied access to these life-saving interventions.

Public health experts warn that redirecting patients could lead to delays in treatment and increase the risk of preventable deaths.

In the study “Delayed or Missed Anti-Rabies Vaccine: A Barrier in Eradication of Rabies” by Singh et al. (2024), researchers highlighted that while most patients received the first anti-rabies vaccine dose on the day of the animal bite, many failed to complete the full vaccination schedule on time.

Among those presenting within 3–6 days, 88.2% had taken two doses, while in patients who came 7–27 days post-bite, only 8.8% had completed all four doses, though 75% had taken three. The second and third doses were the most commonly delayed, undermining effective post-exposure prophylaxis and posing a serious public health challenge. ¹

Reference

1. Singh, Mitasha, Anita Khokhar, Srishti Goel, and Urvashi Babbar. “Delayed or Missed Anti-Rabies Vaccine: A Barrier in Eradication of Rabies.” Epidemiology International 9, no. 2 (2024): 41–46. Advanced Research Publications. Accessed September 18, 2025. https://medical.advancedresearchpublications.com/index.php/EpidemInternational/article/view/3712.

(Rh/Eth/ARC/MSM)