Rabies Prevention : Frequently Asked Questions
▪️ What is rabies ?
Rabies is a viral infection transmitted mainly through the saliva of an infected animal, usually through a bite or scratch. Once clinical symptoms appear, rabies is almost invariably fatal—but it is preventable with prompt post-exposure prophylaxis (PEP). Dogs account for up to 99% of human rabies transmission worldwide.
▪️Which animals can transmit rabies in India?
Rabies can occur in mammals. In India, dogs are by far the most important source. Other animals that can transmit rabies include:
Cats
Monkeys
Mongooses
Foxes, jackals and wolves
Cattle and buffaloes
Sheep and goats
Occasionally, other mammals such as horses and donkeys
Any bite or saliva exposure from a potentially rabid mammal should be medically assessed.
▪️Which animals generally do NOT transmit rabies in India?
According to Indian national guidance, domestic rats/rodents, squirrels, hares and rabbits ordinarily do not require rabies PEP. However, unusual exposures—particularly bites from wild rodents—should be assessed individually.
Birds, reptiles, amphibians and fish do not transmit rabies, as rabies is a disease of mammals.
▪️What about a bat bite?
Bat-mediated rabies has not been conclusively demonstrated in India, and Indian national guidance states that routine PEP is not warranted following bat exposure in India. However, unusual or uncertain exposures should be discussed with a rabies specialist. This differs from some other countries where bat exposure is an important rabies risk.
▪️My child was bitten by a vaccinated pet dog. Is rabies vaccine still required?
Yes, if the exposure is a Category II or III exposure, the child's PEP assessment should not be skipped simply because the dog is vaccinated.
A history of animal vaccination does not guarantee protection because vaccine failure can occur. Indian national guidelines therefore recommend PEP irrespective of the biting dog's vaccination status.
A healthy dog or cat should also be observed for 10 days under appropriate veterinary/public-health supervision. The 10-day observation rule applies specifically to dogs and cats.
▪️What should I do immediately after a bite or scratch?
Wash the wound immediately with soap and running water for at least 15 minutes.
After thorough washing, an appropriate iodine-containing antiseptic may be applied. Then seek medical assessment as soon as possible.
▪️When is rabies vaccination needed?
Category I:
Touching/feeding an animal or a lick on intact skin → No rabies vaccine or RIG.
Category II:
Minor scratches/abrasions without bleeding or nibbling of uncovered skin → Rabies vaccine.
Category III:
Any transdermal bite or scratch, saliva on broken skin or mucosa → Rabies vaccine + rabies immunoglobulin/appropriate monoclonal antibody when indicated.
▪️What is RIG?
Rabies immunoglobulin (RIG) provides immediate passive protection at the wound site. It is used for Category III exposures in previously unvaccinated individuals and should be infiltrated into and around the wound as early as possible.
▪️What if the person has already completed rabies vaccination?
If a person has documented, complete previous PrEP or PEP, a subsequent exposure generally requires only a 2-dose vaccine regimen on days 0 and 3, without RIG.
However, if the repeat exposure occurs within 3 months of completing PEP, IAP guidance states that only proper wound care is required—no vaccine and no RIG.
▪️Can rabies vaccination be given to infants, children or pregnant women?
Yes. Age, infancy, pregnancy and lactation are not contraindications to life-saving rabies PEP when indicated.
▪️Can I wait and see if symptoms develop?
No. Do not wait for symptoms. Once clinical rabies develops, it is almost invariably fatal. PEP works by preventing the virus from reaching the central nervous system and should be started promptly when indicated.
▪️Can rabies spread from one person to another?
Ordinary human-to-human transmission through bites or saliva has not been confirmed. Extremely rare transmission through infected organs/tissues, particularly transplantation, has been documented.
The most important rule
Animal bite/scratch → Wash for 15 minutes → Seek medical assessment promptly → Start PEP when indicated.
Never rely only on the appearance of the wound, the fact that the bite was provoked, or the animal's vaccination history to decide that rabies prevention is unnecessary.
Dr Neerupam Gupta
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