Why are children still dying of rabies in India? | OPEN Magazine Special

In early April 2025, in quiet Kunnicode in Kerala’s Kollam district, seven-year-old Niya Faisal was bitten by a stray. Her parents did not delay. The bite was washed. The hospital visit was swift. The full course of post-exposure prophylaxis—five anti-rabies vaccine doses and immunoglobulin—was administered. And still, 22 days later, Niya died. In the final hours, as hydrophobia set in and convulsions took hold, the SAT Hospital in Thiruvananthapuram could only confirm what the virus had already declared.

Niya’s death was the eleventh rabies fatality reported in Kerala in just four months of 2025. Three of those were children. All had received the vaccine. It was not supposed to happen. Rabies is one of the few viral diseases where medicine knows the answer. There is a vaccine. There is a window—short but definite—in which to administer it. And there is a playbook, written in thousands of papers and guidelines, on what to do next. But what happens when the protocol is followed and still the child dies? That is the question now being whispered in Kerala’s hospitals and demanded in its assembly.

Doctors in the state are calling for what was once considered excessive: pre-exposure rabies vaccination, especially for children in high-risk zones. “We cannot wait for the bite anymore,” says Dr Sundar Krishna, a paediatric infectious diseases specialist in Bengaluru. “If this trend continues, we need to flip our approach.”

This shift—from reactive to preemptive immunisation—is no small thing. It means acknowledging that the infrastructure to manage India’s stray dog population is no longer just inadequate. It is dangerous. And that the state cannot outpace the virus with catch-up medicine alone.

India has seen a more than 2.5-times jump in rabies deaths since 2022, with over four people dying each month in 2024. The numbers are still far below historic estimates—studies such as the Lancet Infectious Diseases paper peg the actual number at around 5,700 deaths annually, many of them unreported in rural districts. But even the government’s conservative figures suggest that something is wrong.

Excerpts from “Why Are Children Still Dying of Rabies in India?” by V Shoba, published in OPEN Magazine on May 11.

Read the full article here: https://openthemagazine.com/special/why-are-children-still-dying-of-rabies-in-india/