Mismatch in data on rabies deaths poses major challenge

Health Ministry’s surveillance programme reported 50 deaths in 2023, while Registrar-General recorded 271 fatalities the same year; however, ICMR study says 5,726 people die of rabies annually

Updated - October 04, 2026 10:49 pm IST - NEW DELHI

ICMR for its study surveyed 3,37,808 people in 78,807 households across 60 districts in 15 States and estimated that India sees about 9.1 million animal bites every year, including about 5.6 million dog bites. Image for representation | Photo Credit: Getty Images/iStockphoto

In 2025, India recorded 55 deaths by malaria, 131 deaths by dengue, and 27 deaths by kala-azar (visceral leishmaniasis or black fever), according to Union Health Ministry data, whereas there is no single comparable and comprehensive national measure of its annual human rabies mortality, even as the country looks to eliminate dog-mediated human rabies by the year 2030.

While a community-based study led by researchers from the Indian Council of Medical Research-National Institute of Epidemiology (ICMR-NIE) and published in The Lancet Infectious Diseases recently estimated that 5,726 people die of rabies in India every year, the Health Ministry’s Integrated Disease Surveillance Programme-Integrated Health Information Platform (IDSP-IHIP) system reported 21 deaths by rabies in 2022, 50 in 2023, and 54 in 2024.

In contrast, the Registrar General of India’s Medical Certification of Cause of Death (MCCD) system recorded 66 medically certified rabies deaths in 2022, and 271 in 2023. The MCCD system, however, covers only medically certified deaths and does not capture all registered deaths.

These figures are not directly comparable — the IDSP-IHIP is a disease surveillance system, while the MCCD captures medically certified causes through civil registration. At the national level, the MCCD covered 22.3% of registered deaths in 2022, and 22.0% in 2023. Neither system, therefore, provides a complete national count — underscoring the gaps in India’s rabies mortality surveillance.

The government table, sourced to IDSP-IHIP, had recorded one death in January 2025 but did not provide a figure for all of 2025. The government’s published table, labelled ‘Human Rabies cases (Death)’, gives the source as IDSP-IHIP.

ICMR for its study surveyed 3,37,808 people in 78,807 households across 60 districts in 15 States and estimated that India sees about 9.1 million animal bites every year, including about 5.6 million dog bites.

The researchers used the community survey, laboratory data, and a probability decision-tree model to estimate the number of people who progress from an animal bite to rabies and die. The 5,726 figure is therefore a modelled estimate of annual deaths, and not a count of deaths recorded in hospitals or by government surveillance.

The difference between the two datasets is substantial. The 54 deaths reported through government surveillance in 2024 is less than 1% of the study’s estimated annual toll of 5,726.

“The two figures, however, are generated through different methods and should not be treated as directly equivalent. The figures therefore highlight a large gap between reported surveillance deaths and estimated mortality,” a senior Health Ministry official said.

“Lack of consolidated data is a challenge in rabies eradication. Very often cases and deaths occur in areas of the country where they are not measurable. Vaccination of stray dogs, stringent post-exposure vaccination for humans, and disruption of the rabies chain is essential to curb the problem,” Nirmal Kumar Ganguly, medical scientist, public health expert, and former ICMR chief, speaking exclusively to The Hindu, said.

The National Centre for Disease Control itself says efforts are continuing to make human rabies a notifiable disease across India, and that all States have been asked to notify the disease under the relevant State legislation.

The Health Ministry has also acknowledged the surveillance challenge, with deaths occurring outside the formal health system posing an additional difficulty in capturing the full burden of disease.

Meanwhile, the Lancet study found important gaps even after animal bites. About one in five dog-bite victims had not received the anti-rabies vaccine, while only 66.2% had received at least three doses. Among those who received only one dose, nearly half did not complete the vaccination course. Only about one in 10 eligible victims received passive immunisation.

Rabies is a vaccine-preventable viral disease that attacks the central nervous system and is almost invariably fatal once symptoms appear, with infected dog bites causing most human transmission.