According to the World Health Organization (WHO), India accounts for over one-third of all rabies deaths worldwide. Every year, approximately 18,000-20,000 people tragically lose their lives to rabies in India. WHO and Indian public health sources have consistently identified India as bearing a disproportionately high rabies burden, with children under 15 years contributing substantially to exposure-related deaths.¹ ² An estimated 30-60% of these deaths occur in children below 15 years of age.
Once the symptoms of rabies appear, it leads to death in almost 100% of cases. But the good news is that rabies is completely preventable by getting the right medical attention within the first 24 hours of a dog bite.
Rabies is a viral disease that belongs to the Lyssavirus genus, a family of rhabdoviruses. It infects the brain and central nervous system.
Rabies usually spreads when an infected animal bites or scratches you. The virus is present in the saliva of the infected animal. It can also spread if an infected animal licks your eyes, mouth, cut, or open wounds. You can get rabies from organ transplantation, but that is very rare.
The virus usually enters the body after the bite. From there, it travels along the peripheral nerves to the spinal cord and then enters the brain. This process can take weeks to months, and once the virus gets to the brain and spinal cord, rabies is almost always deadly. That's why it's so important to get treatment right away.
Dogs account for the vast majority of human rabies exposures and deaths, particularly in India, where dog-mediated rabies remains the principal source of transmission.¹ ² According to the National Rabies Surveillance System (2022)1, many animals can carry and transmit rabies, including:
Bats
Monkeys
Foxes
Raccoons
Skunks
Mongooses
No, not every dog bite causes rabies. If the dog is vaccinated against rabies, the risk of transmission of the disease is very low. However, a history of vaccination does not completely eliminate the risk, considering vaccine efficacy may vary in animals.
In a rabies-endemic country like India, it is important to seek medical care and receive post-exposure prophylaxis (PEP) after any dog bite, regardless of the dog’s vaccination status.
Do not ignore minor dog bites or scratches; start vaccination immediately, even if there are no symptoms. Timely action is the only prevention for rabies.
Dr. Surender Kumar Saunkhya, Senior Pediatrician, Rajasthan
A dog bite can cause panic, which may delay critical early care needed to prevent infection. Instead of panicking, it is important to act quickly and follow the right steps to prevent infection and promote healing.
The purpose of immediate care and the rabies vaccine is to prevent the virus from reaching the brain and causing infection. This is known as post-exposure prophylaxis (PEP). The vaccination schedule depends on the type of wound and level of exposure.
Rinse the wound immediately – Wash the bite wound thoroughly for at least 15 minutes under running water with soap.
Apply gentle pressure – This can temporarily reduce bleeding.
Apply an antiseptic – Once the bleeding has reduced, apply an antibiotic solution or ointment.
Cover the wound – Covering the area with a clean cloth protects the wound from contamination.
Visit the doctor immediately – Immediate medical attention is essential, even if the wound appears minor.
Do not apply oil, chilli powder, turmeric, or toothpaste on the wound, as this can irritate and increase the risk of infection.
Do not cover the wound tightly.
Do not try to prick, squeeze, or probe the wound; it could further increase the infection.
Do not apply excessive ointment to the wound, and never use harsh chemicals like hydrogen peroxide, as they can delay healing.
According to Dr. Surender Kumar Saunkhya, it is important to observe the dog for at least 10-12 days after a bite and monitor any changes in its behavior. If the dog shows unusual behavior like aggression, fear of water, excessive drooling, foaming, or dies, you should inform your doctor immediately. Even if the dog remains healthy, you should still inform your doctor so they may review the situation and adjust the vaccination plan accordingly.
Doctors classify rabies exposure to determine whether vaccination is needed, using the WHO wound grading system.
Category III exposures require urgent medical attention and should not be delayed.³
According to the WHO and the National Rabies Control Program (NRCP), if you are exposed to rabies, the treatment should start immediately, even before any symptoms appear, because once the symptoms develop, rabies almost always causes death.
If the person has not been vaccinated before, the doctor will start the rabies vaccine. One commonly used intramuscular regimen is the Essen schedule, with doses given on days 0, 3, 7 and 14. Some national or institutional protocols may include additional schedules depending on clinical circumstances. Intradermal regimens are also used in many settings and may differ, so vaccination should always follow current local or national guidance. ³ ⁴
If the wound is deep or there are multiple bite wounds, the doctor may also administer rabies immunoglobulin (RIG). They inject it around the wound to provide immediate protection, along with the rabies vaccine.
If the person is on medicines like corticosteroids, chloroquine, or hydroxychloroquine or is undergoing cancer treatment, the doctor may give rabies immunoglobulin (RIG) for most types of dog bites, except when there is no real exposure (Category I) and will adjust the vaccination schedule accordingly.
If you have completed the rabies vaccination recently, your doctor may modify the vaccination schedule based on your history.
To prevent any infection in the wound, the doctor may prescribe a tetanus vaccine and antibiotics.
Note: It is important to complete the full course of vaccination, even if the wound appears to heal.
Disclaimer: Regardless of the size of the bite wound or whether it is bleeding or not, you should visit a doctor immediately.
Due to the high number of dog bite cases among children under 14 years, we connected with Dr. Surender Kumar Saunkhya, a senior paediatrician from Jaipur, to understand why such cases are often not reported immediately. He said that people usually do not take minor scratches or wounds licked by stray dogs seriously.
He also shared that in many cases, children are brought to the doctor 3–6 days after a dog bite, often after someone from the neighbourhood or extended family advises them to seek care. In such situations, even if the person has no symptoms, doctors still start rabies vaccination and consider it as Day 0. The vaccination schedule is then planned based on the type of exposure and the person’s vaccination history.
He further mentioned that many people do not complete the vaccination regimen because they do not see any symptoms. He emphasized that it is important to complete the full course of vaccination, even if there are no symptoms, as rabies is fatal and has no cure once symptoms appear.
He also recommends that people consider pre-exposure rabies vaccination (pre-exposure prophylaxis) if they have a pet dog or work in areas with a high risk of contact with potentially rabid animals.
Seek urgent medical attention without delay if any of the following apply:
Bite on the face, head, or neck
Deep puncture wounds
A child has been bitten
Multiple bite wounds
Bite from an unknown stray dog or animal behaving abnormally
The person bitten is immunocompromised or receiving cancer treatment
These situations may carry higher risk and often require urgent wound care, rabies prophylaxis assessment, and possible immunoglobulin.
Dr. Surender Saunkhya explained that after the dog bite, the rabies virus enters the body and travels from the site of the bite to the brain to produce symptoms. The time gap between the dog bite and the appearance of symptoms is known as the incubation period.
The incubation period of rabies can range from weeks to months, and occasionally longer depending on factors such as bite location and viral inoculum.³ So even if you do not have any symptoms after a dog bite, it doesn’t mean you are safe.
The early symptoms of rabies are flu-like, such as
Fever
weakness
Headache
Discomfort
Tingling, itching and burning sensations at the bite site.
The illness will progress quickly, leading to serious neurological symptoms such as
Feeling anxious or unusually restless
Difficulty sleeping (insomnia)
Confusion or trouble thinking clearly
Increased irritability or agitation
Severe mental disturbance (delirium)
Seeing or hearing things that are not there (hallucinations)
Hydrophobia (fear of water or difficulty swallowing)
Excessive saliva or drooling
Fits or seizures
These symptoms usually appear in the later stages and indicate a medical emergency.
Dr. Lokesh Kumar Sharma, Joint Director, State Disease diagnostic Centre, Dept. of Animal Husbandry, Rajasthan, gives us a few tips on how to prevent rabies:
1. Vaccinate your dog: schedule and legal requirements in India
Vaccinate your dog from the puppy stage, as even young dogs can carry rabies. Keep up with yearly rabies vaccinations for adult dogs to protect your pet, your family, and the community.
Skipping dog vaccinations can put your pet's health and public safety at unnecessary risk.
Mass vaccination of community dogs, including puppies, is an effective way to control and prevent rabies.
2. How to avoid dog bites: safety tips for children and adults
Educate people about your pet dog's behaviour and temperament to help prevent bites and avoid emergencies.
Public awareness is important for both adults and children. Understanding the normal dog behaviours, their protective instincts can prevent bites and scratches. Knowing how to manage a dog bite wound immediately can help reduce the risk of rabies after exposure.
3. Rabies symptoms in dogs: how to identify an infected animal
Rabid dogs usually exhibit fever, aggression, excessive drooling, and fear of water or difficulty swallowing.
They may hide in the dark and quiet places and become unusually aggressive.
Some dogs may also show neurological symptoms such as difficulty walking, seizures, and paralysis.
Disclaimer: If you come across a dog showing these signs, your main goal is to stay safe, keep distance from the dog and contact a nearby veterinarian or animal support service immediately to handle the situation safely.
Dr. Lokesh Kumar Sharma also shared expert guide what to do if a stray dog behaves strangely:
Maintain a safe distance from the dog and do not try to comfort or touch it. If the dog approaches you, stay still and avoid sudden movements. Slowly back away without turning your back.
Observe the dog from a distance for signs such as aggression, disorientation, fear, or unusual behaviour.
Contact local animal control, a nearby animal rescue group, NGO, shelter, or the police for assistance and keep an eye on the dog until help arrives.
If you are bitten or scratched, wash the wound immediately under running water with soap and seek medical attention as soon as possible.
The Government of India is actively working to control rabies through the National Rabies Control Programme (NRCP), which is implemented across the country. The main focus of this programme is to prevent deaths due to rabies in humans and progressively achieve the global target of reducing it to “Zero by the year 2030” by:
Proper management and treatment of animal bite cases
Promoting timely use of post-exposure prophylaxis (PEP), including vaccination
Strengthening surveillance and reporting of rabies and animal bites
Training healthcare professionals to handle dog bite cases effectively
Increasing public awareness and supporting coordination between health and veterinary sectors
Under the NRCP, rabies vaccination for humans is provided free of cost at many government healthcare facilities to encourage timely treatment after dog bites.
You can also check the anti-rabies centre in your district for dog bite suppo0rt by clicking on the link below
https://rabiesfreeindia.mohfw.gov.in/vaccination_dose?tab=nhf
Who should not take the rabies vaccine?
There is no contraindication of rabies vaccination. Even pregnant women, children, elderly individuals, people with poor immunity or people on medication should receive the vaccine, as rabies is deadly if left untreated. (NRCP)
How much does the rabies vaccine cost?
In the government hospitals, rabies vaccines are available free of cost under the rabies control program. In the private clinics and hospitals, the cost may range from ₹200 - ₹500 per dose. If rabies immunoglobulin (RIG) is required, the cost may increase further.
Is a tetanus (TT) injection necessary after a dog bite?
Yes, a tetanus injection may be needed after a dog bite to prevent bacterial infection, especially if the wound is deep or contaminated. A doctor will decide based on your vaccination history.
Can rabies be prevented after a dog bite?
Yes, rabies can be prevented after a dog bite if proper wound care and post-exposure prophylaxis (PEP) are started on time. Immediate action, especially within the first 24 hours, is critical to prevent infection.
Is 3 days too late for rabies vaccine?
No, 3 days is not too late. You should start rabies vaccination as soon as possible after a dog bite, even if a few days have passed. However, earlier treatment, especially within the first 24 hours, is always more effective.
When is it too late for the rabies vaccination?
It is never too late for the rabies vaccination as long as the symptoms have not appeared. You can start the vaccination immediately. However, once the symptoms appear the rabies is almost always fatal and vaccination is no longer effective.
Who should not take the rabies vaccine?
There is no contraindication of rabies vaccination. Even pregnant women, children, elderly individuals, people with poor immunity or people on medication should receive the vaccine, as rabies is deadly if left untreated. (NRCP)
World Health Organization. Rabies Fact Sheet. Geneva: WHO, updated 2024. https://www.who.int/news-room/fact-sheets/detail/rabies
National Centre for Disease Control, Ministry of Health and Family Welfare, Government of India. National Rabies Control Programme. New Delhi: NCDC. https://rabiesfreeindia.mohfw.gov.in
World Health Organization. WHO Expert Consultation on Rabies: Third Report. Geneva: World Health Organization, 2018. https://www.who.int/publications/i/item/9789241210218
Swinkels HM, Koury R, Warrington SJ. Rabies. [Updated 2025 Mar 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448076/
Nadal, D., Bote, K., Masthi, R., Narayana, A., Ross, Y., Wallace, R., & Abela, B. (2023). Rabies post-exposure prophylaxis delivery to ensure treatment efficacy and increase compliance. IJID One Health, 1, 100006 https://doi.org/10.1016/j.ijidoh.2023.100006
