Tamil Nadu Issues Guidelines After Rabies Deaths in Vaccinated Children
Chennai: Following the recent deaths of two children in Kerala from rabies despite receiving anti-rabies vaccinations, the Tamil Nadu Directorate of Public Health and Preventive Medicine has issued a strong advisory to healthcare workers across the state.
The advisory stresses the urgent need for proper training in classifying dog bites and ensuring timely, correct administration of post-exposure prophylaxis (PEP), including rabies immunoglobulin (RIG) and anti-rabies vaccine (ARV).
“Rabies PEP is life-saving only if administered correctly and promptly,” said Dr. T.S. Selvavinayagam, Director of Public Health, in a communication to district and city health officials.
The Kerala deaths involved two boys bitten by stray dogs who had received vaccinations. However, the fatalities are believed to have resulted from delays in starting PEP, failure to give RIG in category III cases, improper wound cleaning, missed or delayed vaccine doses, or problems with vaccine storage and administration.
The advisory highlights that RIG is essential to neutralize the virus at the site of deep or bleeding wounds before the vaccine’s immune response kicks in. Without RIG, the virus can still reach the nervous system despite vaccination.
Proper wound washing with soap and water for at least 15 minutes is emphasized as the most important first step after a dog bite.
The circular also notes that wounds on the face or head require immediate and aggressive treatment, as any delay can reduce vaccine effectiveness. Children are at higher risk due to weaker immunity and the chance they may not report bites accurately.
The health department reiterated the classification of dog bite categories for treatment:
Category I: Touching/feeding animals or licks on intact skin - no PEP needed.
Category II: Minor scratches or abrasions without bleeding - ARV required.
Category III: Bites or scratches with bleeding or licks on broken skin - ARV and RIG mandatory.
All healthcare providers have been directed to strictly follow these guidelines to prevent further rabies deaths.
Jyoti Kumari joined Medical Dialogues in 2025 as a Journalism Intern. She holds a Bachelor's degree in Mass Communication from the Delhi School of Journalism, University of Delhi. She is passionate about news reporting, content creation, social media, and emerging media trends.