Dog bites, Kerala experts urge children to get vaccinated before

The Indian Academy of Pediatrics (IAP) and the Kerala Government Medical Officers Association (KGMOA) have jointly advocated for the integration of rabies pre-exposure prophylaxis (PrEP) into child healthcare guidelines for all children under the age of 14. This recommendation is prompted by the increasing incidence of rabies infections among children, particularly in Kerala. The state has experienced a notable surge in reported dog bite incidents, escalating from 60,000 in 2013 to over 316,000 in 2024. Concurrently, there has been an increase in human fatalities, with 14 rabies-related deaths reported thus far this year, and an annual mortality rate of 20-25 deaths in recent years, disproportionately affecting school-aged children. Globally, rabies is responsible for approximately 59,000 deaths each year, with India accounting for 18,000-20,000 of these fatalities. Children represent nearly 40% of these cases. Both the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) recommend PrEP for rabies. Authorities suggest that the provision of general immunity against rabies can reduce mortality and the necessity for post-exposure treatment, specifically the costly rabies immune globulin (RIG), which is administered in conjunction with the standard post-bite vaccination. Specifically, children of school age are affected. Despite the inclusion of PrEP in Kerala’s immunization strategy, governmental opposition stems from a perceived lack of recognition of rabies as a significant public health concern warranting extensive implementation by the National Immunization Technical Advisory Group (NITAG).