Amid rising rabies-related deaths in Kerala, KGMOA has called for the immediate implementation of a universal pre-exposure prophylaxis (PrEP) programme. Citing WHO guidelines, KGMOA proposed a three-dose PrEP schedule, starting with children, who make up over 35% of dog-bite cases, and later expanding to high-risk groups.
Published May 09, 2025 | 9:00 AM ⚊ Updated May 09, 2025 | 9:00 AM
On 8 May, Habeera, the mother of the late Niya, shared an emotional Facebook post with a photo, highlighting the persistent dumping of waste near their home.
Synopsis: Despite over 3.17 lakh dog-bite cases reported in Kerala in 2024, four districts, Pathanamthitta, Alappuzha, Idukki, and Wayanad, recorded zero stray dog sterilisations in the 2024–25 financial year, according to the latest data from the Animal Husbandry Department.
At 2 am on Monday, 5 May, Niya Faisal’s dreams were abruptly cut short.
The 7-year-old girl from Kunnikode in Pathanapuram in Kerala’s Kollam district had many dreams, big and small. One among them was to be back with friends at her school in June after the summer vacation.
From the confines of the SAT Hospital in Thiruvananthapuram, she often asked her mother, Habeera, if the textbooks for the coming academic year had arrived.
She wanted to experience the bibliosmia, the aroma of ink, paper and glue, and the letters that would take her to the third standard, and further in life. Even at an early age, she had witnessed the struggle of her single mother, and she wanted to be the topper in her class.
Niya with her brother.
However, the rabies virus had by then affected her brain, gnawing away and slowly shattering her dreams. Habeera watched helplessly, perhaps knowing the inevitable. Niya died on Monday, 5 May.
Habeera was asked to be in quarantine since she had been in contact with her daughter. The protocol did not allow the girl’s body to be taken home. She was laid to rest at the Alenchery Jamaat Mosque.
Back in her one-bedroom home, her brother Ishal is mostly silent, even as Niya’s death sparked a debate in the state. The girl had received three doses of the anti-rabies vaccine, which failed to keep her alive.
Beyond the medical complexities, there is a more immediate and overlooked issue that haunted Niya and her family for years.
On Thursday, 8 May, Habeera took to Facebook and made a poignant and angry post, pointing at a grave issue Kerala has been facing — an issue that had taken away her daughter.
”Even after killing my child, are you sinners continuing to dump waste?” she asked in the post. She had also put up pictures of public apathy, attracting strays.
Habeera’s Facebook post.
Speaking to South First, Kinattinkara ward member Ajayakumar R explained that Niya’s house is located by a paddy field, flanked by rubber plantations on two sides. The area has long been used as a dumping ground.
”The panchayat had issued multiple warnings asking people to stop dumping waste there, but no one listened. Finally, we cleared some vegetation when Niya was hospitalised, hoping it would discourage further dumping of waste,” he said.
Habeera told South First that waste attracted dogs to the area. “The main reason why stray dogs frequent this area is that people dump food waste here. We repeatedly asked people not to throw waste near our home.”
For the people who keep their houses and surroundings clean, it is a convenient spot to dispose of the waste generated. “For us, it’s our everyday surroundings,” Habeera said.
Recalling the fateful day, the mother said the dog that bit Niya had frequented the area. “It attacked while she was feeding our duck. Even after her death, people continue to dump waste here.”
Ajayakumar said the panchayat has an active Haritha Karma Sena to collect and process waste.
Additionally, ₹50,000 to ₹75,000 is allocated annually in the panchayat’s budget for waste disposal and hiring workers to dispose of animal and bird carcasses.
However, Niya’s mother had not filed an official complaint with the panchayat regarding the dumping of waste, he said.
”Currently, there is no separate fund to address the stray dog menace, which is a serious concern here. We are working on a plan to tackle the issue,” he added.
Despite over 3.17 lakh dog-bite cases reported in Kerala in 2024, four districts, Pathanamthitta, Alappuzha, Idukki, and Wayanad, recorded zero stray dog sterilisations in the 2024–25 financial year, according to the latest data from the Animal Husbandry Department.
Minister MB Rajesh
Only 15,767 dogs were sterilised and 88,744 vaccinated in the state last year.
An official from the Local Self Government Department told South First that poor infrastructure, opposition by the members of the public, and rigid central ABC (Animal Birth Control) rules are the key hurdles.
The rules mandate air-conditioned operating theatres, veterinarians with a minimum of seven years’ experience, post-operative care facilities, and release of dogs to their original location — failing which, cases could be registered.
Earlier, Local Self-Government Minister MB Rajesh blamed Union government-imposed restrictions for shutting down nearly 9,000 ABC units.
“We are facing public resistance and legal limitations. Sterilisation is the only solution, but central laws must be amended,” he said. The minister also stated that the surge in the stray dog menace is due to the inability to carry out the ABC programme through Kudumbashree.
Kerala currently has 15 ABC centres. Nine more are planned.
Dr E Sreekumar, Director of the Institute of Advanced Virology, an autonomous institution under Kerala’s Department of Science and Technology, said that the effectiveness of rabies vaccination depends primarily on maintaining the cold chain and the correct administration of the vaccine.
Dr. E Sreekumar.
”Whenever we investigate deaths despite vaccine administration, we must assess whether it’s a vaccine failure or a vaccination failure,” he told South First.
Vaccine failures are linked to issues like poor quality control, lapses in cold chain maintenance, or improper transportation. Vaccination failure refers to issues with timing, technique, or patient-specific factors like immune response.
Dr Sreekumar noted that two years ago, a state-level investigation was conducted following cases of rabies-related deaths despite timely vaccination.
”The committee did not then find evidence of vaccine or vaccination failure,” he said.
Dr Sreekumar emphasised that the severity of a dog bite plays a major role in the risk of contracting rabies.
Rabies deaths in Kerala.
”The most critical factors are how deep the wound is and where the bite has occurred. Bites to the head and neck, known as Category III or third-degree bites, pose the highest risk because they may allow the virus to directly access nerve bundles,” he said.
Unlike superficial bites where antibodies can neutralise the virus at the entry site, deep bites near major nerves, particularly in areas like the face, head, or neck, allow the virus to bypass the immune response.
”In our body, major nerves lie deep, usually near the bone. If the virus enters a nerve bundle, it can move 2–3 millimetres per day toward the brain,” Dr Sreekumar added.
In such cases, even after vaccine-induced antibody production, the immune system cannot intercept the virus once it’s inside the nerve.
”Antibodies are large protein molecules that cannot pass through the microscopic pores of nerves, so the virus becomes protected, like travelling through a tunnel,” he explained.
“The first and most critical step after a bite is to clean the wound immediately with soap and running water. This can flush out the virus before it enters the nerves,” Dr Sreekumar said.
However, he acknowledged practical challenges. ”In certain anatomical areas like the face, or in small children with multiple wounds, thorough cleaning may be difficult.”
When a bite is deep, medical professionals administer rabies immunoglobulin (RIG) at the site, which helps neutralise the virus locally before it can enter nerves.
Dr Sreekumar stressed that immunodeficiency in some individuals may also be a contributing factor, but more studies are needed to confirm this aspect.
Another key issue is the perception of rabid dogs. The media usually shows aggressive dogs when reporting rabies, but not all rabid dogs are aggressive. Rabies can alter behaviour. Normally calm dogs may turn aggressive and vice versa,” he said.
He also pointed out that aggression is heightened when dogs are in packs, further complicating public perception and response.
When contacted, Kerala Medical Services Corporation General Manager Dr Shibu Lal stated that a detailed report on vaccine procurement over the past 10 years had been submitted to the Health Minister’s office.
The Office of Health Minister Veena George provided crucial data on vaccine procurement. It revealed a significant rise in the procurement of both Equine Anti-Rabies Immunoglobulin (EARI) and the Rabies Vaccine for Human IP (Cell Culture – Vero) over the past decade.
The indent quantity for EARI grew steadily from 50,782 vials in 2015–16 to 3,61,580 in 2024–25, with a sharp spike observed in the last two financial years, reflecting an increased focus on post-exposure prophylaxis.
Correspondingly, the indent value surged from ₹1.74 crore to over ₹95.6 crore.
Similarly, the rabies vaccine showed consistent growth in indent quantity from 4.36 lakh to 7.77 lakh doses, with the indent value reaching ₹165.64 crore by 2024–25. Since 2021–22, there has been a substantial increase in both the quantity ordered and received, indicating improved procurement efficiency and heightened public health preparedness.
Amid rising rabies-related deaths in the state, the Kerala Government Medical Officers’ Association (KGMOA) has called for the immediate implementation of a universal pre-exposure prophylaxis (PrEP) programme.
Citing WHO guidelines, KGMOA proposed a three-dose PrEP schedule (days 0, 7, 21/28), starting with children, who make up over 35% of dog bite cases, and later expanding to high-risk groups.
The doctors’ body stressed that PrEP reduces dependence on scarce rabies immunoglobulin. KGMOA President Dr Sunil PK and General Secretary Dr Jobin G Joseph also urged integrating PrEP with existing post-exposure prophylaxis and dog vaccination efforts, and advocated its inclusion in the National Immunisation Programme.
Meanwhile, State Human Rights Commission Chairperson Justice Alexander Thomas ordered a probe led by the Director of Medical Education into recent rabies deaths, asking for verification of vaccine protocol adherence, quality, and storage.
The Additional Chief Secretary of Health must submit a report on vaccine effectiveness and recommend a qualified agency to study the issue. A sitting will be held at 10 am on 9 June.
Incidentally, Niya was the third child to succumb to rabies in a month.
(Edited by Majnu Babu).
