On the trail of rabies cases in Kerala

The death of a 12-year-old girl in Pathanamthitta has sharpened the focus on the rising number of rabies cases and the growing population of stray dogs in Kerala. With the Supreme Court expected to pass an interim order on the issue next week, K.S. Sudhi talks to public health experts as well as petitioners to map the situation   

September 24, 2022 12:25 am | Updated 11:14 am IST

A dog trapper deployed by the Kottayam Municipality captures a stray for administering anti-rabies vaccine.

A dog trapper deployed by the Kottayam Municipality captures a stray for administering anti-rabies vaccine. | Photo Credit: Vishnu Prathap

Twelve-year-old Abhirami, of Mannappuzha in Perinad Panchayat of Pathanamthitta, was returning home early in the morning on August 13 after collecting milk bottles from a nearby house, when a German Shepherd pounced on her. A karate champion with three titles under her belt, Abhirami bravely fought the dog and tried to escape from its clutches. By the time she succeeded in freeing herself, the dog had inflicted deep wounds on her right cheek just below the eye and on her limbs. Though she was administered three doses of the anti-rabies vaccine, on September 5 she succumbed to the deadly virus while undergoing treatment at the Government Medical College, Kottayam.

“She might have been destined to live up to the age of 12. Had she received proper primary care at the hospital where she was initially admitted, she would have survived. Nothing can fill the void caused by her death,” says Abhirami’s mother, Rajani Hareesh, her calm demeanour cloaking the grief that has engulfed her.

Also read | Many weak links in anti-rabies vaccine administration: experts

Abhiraj, one of her classmates, had rushed to the scene upon hearing her wailing, and miraculously escaped unhurt. “No one could save her from the animal as all were helpless and scared of going near it. Eventually, she succeeded in freeing herself from the beast by pushing it away with her legs,” recalls Rajani. 

Watch | How is Rabies prevented?

The tragic death of the young girl drew a wave of protests across Kerala, forcing the State government to constitute a high-level committee to look into issues related to stray dogs. Till the third week of September, 21 rabies deaths have been reported from the State this year. Reports of stray dogs attacking pedestrians as well as motorists pour in regularly from different parts of the State.

According to data available with the State Health Department, the number of dog bite cases reported in the State has been going up considerably — from over 60,000 in 2013 to 1.37 lakh in 2016; and while around 2.2 lakh cases were reported in 2021, this year, the figure had already crossed 2 lakh by August.

Canine count

The canine population in Kerala has gone up significantly since the 19th Livestock Census held in 2012. The number of dogs has been estimated at 11.2 lakh during the 20th Livestock Census, 2019, against 7.88 lakh a decade ago. The latest census has put the stray dog population at 2.89 lakh. The 8.36 lakh pet dogs too add to the State’s canine population, according to the latest headcount.

While the highest number of street dogs were reported from Kollam (50,869), the State capital, Thiruvananthapuram, accounted for the highest number of pet dogs, 1.25 lakh, according to the data generated during the 20th Livestock Census, which was made available by the Directorate of Animal Husbandry (DAH), Kerala.

“The last two years have witnessed the canine population going up significantly as the Animal Birth Control (ABC) programme for dogs was disrupted during the COVID-19 years,” says K. Sindhu, Additional Director, DAH. “A large number of people purchased pet dogs to fight the COVID-induced monotony in life when a ban on travel and social gatherings was in force. Higher the number of dogs in a community means higher the possibility of dog bites too.”

Statistics available with the State Institute for Animal Diseases, Kerala, also indicate an upward trend in the number of rabies-positive cases during the last four years.

“There has been an increase in the number of rabies-positive cases in dogs over the past few years. While 97 cases tested positive in 261 samples analysed in 2018, it was 153 cases in 372 samples in 2019, and 221 cases in 573 samples in 2021 analysed at the five centres of the State Institute of Animal Diseases, Kerala,” says Swapna Susan Abraham, Deputy Director of the institute. The department is in the process of compiling the data for the current year.

While the rising number of rabies-positive cases could also be due to an increase in the number of samples tested each year, the numbers are nonetheless an indicator of the spread of the disease to humans from animals. Fully vaccinating dogs in a locality and achieving herd immunity is the only way to protect both animals and human beings from the deadly disease, Abraham says.

Also read | Tests confirm efficacy of rabies vaccine

Kerala Health Minister Veena George has announced an action plan to make Kerala free of rabies deaths by 2025, which would see the departments of health, local self-government, and animal husbandry coming together to implementing the ABC programme and vaccination of dogs. Under the ABC programme, dogs are picked up from streets for vaccination and sterilisation, and are kept under observation for a few days before being returned to the same place.

Scope for research

Some medical experts have called for a scientific study into a possible mutation of the rabies virus. T. Jayakrishnan, a professor of community medicine at KMCT Medical College, Mukkam, Kozhikode, says there could be a change in its virulence and transmission, which needs to be looked into. “The virus gets transmitted to dogs from wild animals, especially fox. In recent times, such wild animals are widely seen in human habitations. There is a possibility of fox mingling with dogs, which could have led to the spread of the virus,” he says.

Stray dogs, says Abraham of the State Institute of Animal Diseases, also need to be vaccinated for developing herd immunity in the dog population, which is a major challenge. Oral bait vaccine, a vaccine which is administered to dogs through food, is an option which, it is hoped, will be approved for use in the near future, she says.

Of the 21 official rabies deaths so far this year, 15 persons were not vaccinated even after being bitten by dogs. The State government has sought a quality test on one batch of the anti-rabies vaccine at the Central Drugs Laboratory at Kasauli, Himachal Pradesh, after doubts were raised about the efficacy of the vaccine. Reports that a few persons who had taken the vaccine had died of rabies triggered questions about the effectiveness of the vaccine, forcing the authorities to undertake a quality analysis of the vaccine.

K.K. Purushothaman, Professor in the Department of Paediatrics, MES Medical College in Perinthalmanna, Malappuram, suggests pre-exposure vaccination or immunisation of the vulnerable population, such as children. “Almost 40% to 50% of those bitten by dogs are children, as it is easy for the animals to reach their face and neck. As such attacks could be fatal, children could be considered for pre-exposure vaccination,” he says.

Legal battle

With the rabies deaths causing panic and reports of residents killing stray dogs through poisoning and strangulation, there is a blame game over the rising canine population and rabies cases. Some legal experts blame it on conflicts in the Prevention of Cruelty to Animals Act, 1960 and the Animal Birth Control (Dogs) Rules, 2001; others point to the flawed implementation of birth control measures.

Canine culling campaigners and advocates of animal rights are also engaged in a protracted legal battle over the issue in the Supreme Court. V.K. Biju, a lawyer of the Supreme Court, who brought the issue of the “stray dog menace” before the apex court, contends that the root cause is the enactment of the Rules, which according to him, were passed in contravention of the parent Act, the Prevention of Cruelty to Animals Act.

Biju says that while the Act stands for the “destruction” of stray dogs, the rules are against the “destruction” of stray dogs, including the rabies-affected ones, besides providing specific protection of stray dogs. In his submission before the Supreme Court, he argues that the existence of stray dogs has adversely affected the fundamental rights of citizens, i.e. the right to life and free movement.

In his writ petition filed before the apex court, Biju has sought orders for the strict implementation of the Act and the quashing of the Rules to make India free of stray dogs.

In the light of this, animal rights campaigners are apprehensive over the campaign to cull dogs to check rabies. Vivek K. Viswanath, managing trustee of Thrissur-based Walking Eye Foundation for Animal Advocacy, says that the rising canine population and number of rabies deaths in the State are on account of the flawed implementation of animal birth control measures and the vaccination drive.

“The failure of the State government to implement the ABC Rules, Prevention of Cruelty to Animals (Dog Breeding and Marketing) Rules, 2017 and the Prevention of Cruelty to Animals (Pet Shop) Rules 2019 shall be blamed for the present crisis and the panic that has gripped the State,” he says.

In its intervention petition, the Walking Eye Foundation for Animal Advocacy says the ABC programme in the State came to a grinding halt some two years ago when the government decided to entrust it with the Kudumbashree Mission, a women’s self-help group. It was assigned the job in Wayanad, Thrissur, Ernakulam, Kottayam, Pathanamthitta and Idukki districts. Some local bodies in a few districts too initiated the programme on their own. However, the Kudumbashree is not an animal welfare organisation. The petition adds that none of the ABC centres in Kerala had proper monitoring committees as mandated under Rule 4 of the ABC rules.

Viswanath says that culling of dogs is not the solution for controlling the stray dog population and that strict implementation of birth control measures can bring down the number, and vaccination drives can stop the spread of rabies. Authorities should initiate remedial measures before slaying animals, he argues, pointing out that neighbouring States have successfully implemented both birth control and vaccination drives, with visible results.

S. Ratheesh, State Assistant Programme Officer, Kudumbashree, says the mission has carried out around 80,000 ABC programmes across the State since 2017. The organisation was prevented by the Kerala High Court from carrying out the drive in December 2021. Though the mission had applied for recognition from the Animal Welfare Board of India for carrying out the ABC programme, the board declined permission citing infrastructure inadequacies at the centres at Ernakulam and Thrissur, he adds.

With the court restraining Kudumbashree from the programme, a Thiruvananthapuram-based organisation is the only player left in the field. However, there is no ban on local bodies directly implementing the programme by engaging veterinarians and other required personnel. Considering the gravity of the situation, State authorities have decided to immediately set up 30 ABC centres across Kerala and carry out the vaccination drive through the Directorate, says Sindhu of the Directorate of Animal Husbandry.

Volunteers catch strays for administering anti-rabies vaccine at the Ernakulam Junction railway station.

Volunteers catch strays for administering anti-rabies vaccine at the Ernakulam Junction railway station. | Photo Credit: Thulasi Kakkat

Problem of waste management

Veterinarians and animal health experts say the dumping of edible food waste on streets and the functioning of unlicensed abattoirs where meat waste is available for dogs to feed on are sustaining the canine population, and making them more aggressive in nature. Sindhu says an effective waste management system needs to be implemented.

Jayakrishnan, of KMCT Medical College, adds that during the two years of the COVID-19 pandemic, eating from food packets has become common. After consumption, the packets are carelessly thrown on the streets. He argues that the issue should be approached from a social perspective.

“In Kerala, we used to have one or two native dogs in the community, which roamed around houses, near eateries and hotels and consumed the leftover food. Over a period of time, people have stopped attending to the needs of the animals. Many people are mistakenly referring to even native dogs as stray dogs. Thus, those who adopt pet dogs are reluctant to have native dogs and prefer only foreign breeds. This has pushed the dogs to the streets, and [they form] packs, and fend for themselves,” he says.

Justice S. Siri Jagan, a retired judge of Kerala High Court who heads the Supreme Court-appointed committee to decide on the compensation to be paid to dog bite victims, feels that the whole issue revolves around the legal conflict between the Dog Rules and the Prevention of Cruelty to Animals Act. Till the enactment of the Rules in 2001, the local authorities used to keep the stray dog population under control by physically reducing their numbers in areas where their presence posed a threat to the safety of people. With the Rules coming into force, the local authorities stopped the population control measures. Yet, there had not been any concerted effort to address the issue and to solve the legal conflict, he says.

In its report submitted to the Supreme Court, the Siri Jagan committee had noted that there is no evidence that the ABC procedures could reduce the ferocity in dogs, as claimed by animal rights campaigners. The ABC procedures, said the panel, cannot be a solution to the immediate problem faced by the people considering the huge dog population in the State. After birth control intervention and vaccination, according to the ABC procedures, the dogs have to be let loose at the place from where they were caught. People have no way of knowing whether the dog that has bitten them has been vaccinated or not, compelling them to take an anti-rabies vaccine.

Also read | Pre-exposure prophylaxis for rabies is worth a shot 

The panel observed that ABC procedures can only help in reducing the dog population in the long run, which may take at least three to four years to show results on the ground. The violent process of catching dogs for the procedure also causes severe trauma to the animals. Once released back in the locality after the surgery is completed, they can view passersby with suspicion. These animals are likely to be more dangerous, said the panel in one of its reports to the apex court. The panel also observed that the ABC programme in Kerala has not delivered the desired results.

The Supreme Court has sought a fresh report on the situation in Kerala from the panel, and is expected to pass an interim order on the issue on September 28.

(With inputs from A.S. Jayanth in Kozhikode)

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