Dog bite cases remain a concern in Tamil Nadu

Government hospitals in Chennai treat 5,500-6,000 persons for dog bites annually. A recent article discusses strategies for rabies elimination & prevention in Tamil Nadu.

In 2023, two of the major government hospitals in the city – Government Stanley Medical College Hospital and Rajiv Gandhi Government General Hospital (RGGGH) – treated at least 5,500 to 6,000 persons for dog bites. The numbers have been quite consistent over the last few years, say doctors.

While the figures pertain to only two large centres in the city, a recent article published in Tamil Nadu Journal of Public Health and Medical Research – “Rabies Elimination in Tamil Nadu - Where Do We Stand?” — has given a State-wide picture. There were a total of 8.83 lakh dog bites in Tamil Nadu in 2022 and 121 deaths caused by rabies from 2018 to 2022 — the article noted that the State is showing a declining trend in the deaths due to rabies but was nowhere closer to the goal of zero deaths due to rabies.

The article’s authors – T.S. Selvavinayagam, Director of Public Health and Preventive Medicine, and Sudharshini Subramaniam, Institute of Community Medicine, Madras Medical College – have discussed the various strategies adopted for achieving rabies eradication, challenges, roadblocks, and the way ahead. It has put forward a number of critical points – inadequacies in dog bite management, miscategorisation of bites, need for stronger surveillance for notifying bites and rabies incidence, possibility of rabies being under-reported and mis- and under-diagnosed since the diagnosis is based on clinical findings with a history of dog bite.

The authors noted that counting the canine population is a crucial step towards prioritising areas for intensive intervention measures, such as mass canine vaccination and animal birth control. They called for a holistic strategy for addressing various aspects of rabies prevention and control.

The Anti Rabies Vaccine (ARV) census of RGGGH and Government Stanley Medical College Hospital sheds light on the extent of the menace in the city. From January to November 2023, 2,219 persons were treated for dog bites at RGGGH.

At Stanley, S. Chandrasekar, professor and head, Department of Medicine, said since 2021, he had been seeing a similar pattern in relation to dog bites. “Every month, we administer 1,400 to 1,600 doses of ARV. This means that we see at least 300 to 400 persons with dog bites a month; the number of doses vary according to the bites,” he said.

The feeding areas are different for each hospital, he said, adding that for Stanley, patients primarily came from Royapuram, Vyasarpadi, Korukkupet, Kaladipet, Washermanpet, and M.K.B. Nagar, where there are plenty of stray dogs. “We do not see a surge in the number of cases, but the numbers are consistent. The Greater Chennai Corporation (GCC) is taking measures to control the stray dog population and vaccination against rabies. Dogs that bite without being provoked should be identified,” he said.