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Business Standard
14-07-2025
- Health
- Business Standard
Over 9 million animal bites and 5,700 rabies deaths in India yearly: ICMR
A nationwide study by the Indian Council of Medical Research –National Institute of Epidemiology (ICMR-NIE) has revealed that India continues to lose over 5,700 lives annually to rabies, despite high levels of awareness and vaccine uptake. The survey, conducted across 60 districts and 15 states, found that nearly 9.1 million animal bites occur each year, with children under 14 and the elderly most frequently affected. Even though 80 per cent of dog bite victims received at least one dose of the anti-rabies vaccine, the report raises alarm over the lack of access to complete post-exposure prophylaxis (PEP), especially rabies immunoglobulin (RIG), which can be life-saving in severe exposures. What is rabies? Rabies is a lethal viral infection that attacks the central nervous system and is nearly always fatal once symptoms appear. Dogs are responsible for most human cases. After exposure, whether a bite or a minor scratch, a medical emergency emerges. Rabies remains lethal and severely underreported: ICMR The ICMR study, which used household-level data, estimates that 5,726 human rabies deaths occur in India every year. The highest incidence of dog bites was found among: Children aged 0–14 years Elderly above 60 years Males Despite India's ambitious goal to eliminate rabies by 2030 under the National Action Plan for Rabies Elimination (NAPRE), these findings expose serious gaps in access, awareness, and post-bite care. Rabies immunoglobulin is the missing link: ICMR While vaccines are widely promoted, RIG remains severely underused and unavailable, particularly in public health settings. The ICMR study found that most dog bite victims received incomplete treatment, and few received RIG—a crucial biological that offers immediate protection before the vaccine takes effect. Experts emphasise that without RIG, even vaccinated individuals can succumb to rabies, especially in deep bite wounds or Category III exposures. While rabies vaccine is available for free of cost at most government hospitals and urban primary health centres (UPHCs), RIG is usually available only in tertiary care government hospitals, such as Aiims, Delhi, Guru Teg Bahadur Hospital, Delhi, Sion Hospital (Lokmanya Tilak), Mumbai, CMC Vellore, Tamil Nadu, Rajiv Gandhi Government General Hospital, Chennai. How vaccine and RIG work together Rabies vaccine contains inactivated virus that prompts your immune system to develop protective antibodies. It is part of two protocols: Pre-exposure prophylaxis (PrEP): for high-risk individuals (such as veterinarians and travellers to high-risk areas) Post-exposure prophylaxis (PEP): for those bitten or scratched, delivered on Days 0, 3, 7, and 14 (plus Day 28 for immunocompromised individuals) However, it requires about 7–14 days to build immunity, leaving a dangerous window if not supplemented. Rabies immunoglobulin provides immediate, passive immunity by introducing ready-made antibodies directly to the wound site. It is essential for Category III exposures—deep bites or contact with mucous membranes—as recommended by the World Health Organisation and other health experts. According to experts, RIG should be administered within seven days of the first vaccine dose. Without RIG, the rabies virus might reach the central nervous system before the vaccine can fully protect you—an almost certain path to fatality if the infection takes hold. Current government response The Ministry of Health and Family Welfare (MoHFW), along with the National Centre for Disease Control (NCDC), is implementing the National Rabies Control Programme (NRCP) to address these challenges through: Free provision of anti-rabies vaccine and RIG Mass dog vaccination campaigns Model anti-rabies clinics Awareness and training programmes Intersectoral coordination under a 'One Health' approach However, according to the Marching Towards Rabies-Free India report by MoHFW, availability of RIG still varies drastically between states, and only 20 states have declared human rabies a notifiable disease, leading to chronic underreporting and delayed interventions. According to ICMR, rabies is 100 per cent fatal once symptoms begin—but also 100 per cent preventable with timely and complete treatment. Vaccination alone is not enough in severe cases and RIG must be administered within seven days of the first vaccine dose. According to MoHFW, the first line of defence is always immediate wound washing, followed by full PEP. Despite targets, India's rabies strategy faces major barriers Uneven access to vaccine and immunoglobulin Weak surveillance and underreporting Lack of lab-confirmed diagnoses Public misconceptions about treatment Fragmented coordination across health sectors What are the common signs a dog may have rabies? Sudden, unprovoked aggression Attacking people or animals without reason Restlessness, snapping, biting at objects or air Excessive salivation or foaming at the mouth (due to paralysis of the jaw and throat muscles) Thick, sticky saliva may drip constantly Unusual behaviour or personality changes Friendly dogs becoming hostile Active dogs becoming lethargic or withdrawn Difficulty swallowing or hydrophobia (fear of water) Dogs may refuse to drink despite appearing thirsty Attempts to drink may trigger spasms or panic Staggering or paralysis Hind leg weakness Seizures or paralysis, especially near the end stage High-pitched growling or strange vocalisations Bark may sound distorted or unusual Whining, howling, or guttural noises Steps to take after a dog bite Immediate wound care Gently wash the affected area with soap and running water for at least 15 minutes, then sanitise with an iodine or 70 per cent alcohol solution. Seek medical attention Go to the nearest large government hospital or a known tertiary medical college hospital. Health professionals will classify the injury. There are three WHO-defined categories of rabies exposure: Category I (Touching or feeding animals, or being licked on intact skin): No PEP required, but wash hands for hygiene and observe the animal. Category II (Minor scratches or nibbles): Vaccine is required. Category III (Deep wounds or mucosal exposure): Both vaccine and RIG are required. For RIG, specifically ask if it's available at the anti-rabies clinic or emergency room you visited. According to ICMR, MoHFW, and global medical experts, when it comes to rabies, it's always better to act fast than to take chances—because once symptoms appear, it's already too late.
Time of India
13-07-2025
- Health
- Time of India
India in grip of silent salt consumption epidemic: ICMR-NIE
Representative image NEW DELHI: Excessive salt consumption is fuelling a silent epidemic in India with people at increased risk of hypertension, stroke, heart disease, and kidney disorders, according to scientists from ICMR's National Institute of Epidemiology. The scientists have initiated a community-led salt reduction study to address the issue and are focusing on low-sodium salt substitutes. While the World Health Organisation recommends less than 5 grams of salt per person per day, studies show that urban Indians consume around 9.2 grams/day, and even in rural areas, it is around 5.6 grams/day - both higher than recommended. One promising tool in this effort is low-sodium salt substitutes -- blends where part of the sodium chloride is replaced with potassium or magnesium salts, Dr Sharan Murali, a senior scientist at National Institute of Epidemiology (NIE) and principal investigator of the study, said. "Lesser sodium consumption helps reduce blood pressure and improves overall heart health, making low-sodium alternatives a meaningful switch, especially for those with hypertension," Dr Murali stated. "Just switching to low-sodium salt can lower blood pressure by 7/4 mmHg on average, a small change with a big impact," Dr Murali said. To tackle the issue of high salt consumption, the NIE has launched a three-year intervention project in Punjab and Telangana, supported by the Indian Council of Medical Research. The goal is to evaluate the effectiveness of structured salt reduction counselling in reducing blood pressure and sodium intake among individuals with hypertension, senior scientist at NIE, Dr Ganesh Kumar, who is also a part of the study, said.
The Hindu
13-07-2025
- Health
- The Hindu
ICMR says Indians taking too much salt, launches study to address issue
Excessive salt consumption is fuelling a silent epidemic in India with people at increased risk of hypertension, stroke, heart disease, and kidney disorders, according to scientists from ICMR's National Institute of Epidemiology. The scientists have initiated a community-led salt reduction study to address the issue and are focusing on low sodium salt substitutes. Higher levels of salt consumption than recommended While the World Health Organisation (WHO) recommends less than 5 grams of salt per person per day, studies show that urban Indians consume around 9.2 grams/day, and even in rural areas it is around 5.6 grams/day - both higher than recommended. One promising tool in this effort is low-sodium salt substitutes -- blends where part of the sodium chloride is replaced with potassium or magnesium salts, Sharan Murali, a senior scientist at National Institute of Epidemiology (NIE) and principal investigator of the study, said. "Lesser sodium consumption helps reduce blood pressure and improves overall heart health, making low-sodium alternatives a meaningful switch, especially for those with hypertension," Dr Murali stated. "Just switching to low-sodium salt can lower blood pressure by 7/4 mmHg on average'a small change with a big impact," Dr Murali said. Salt consumption reduction projects To tackle the issue of high salt consumption, the NIE has launched a three-year intervention project in Punjab and Telangana, supported by the Indian Council of Medical Research (ICMR). The goal is to evaluate the effectiveness of structured salt reduction counselling, delivered by health workers at Health and Wellness Centres (HWCs), in reducing blood pressure and sodium intake among individuals with hypertension, senior scientist at NIE, Dr Ganesh Kumar, who is also a part of the study, said.. "We are currently in the first year of the project, focused on baseline assessments and field preparations," Dr Kumar said. "Counselling materials are not yet finalised; rather, we aim to co-create the intervention package with the community health workers, drawing on their experiences and incorporating their suggestions. It's not just about delivering health education - it's about listening, understanding, and building together," Dr Murali said. To ensure interventions are grounded in reality, the NIE conducted a market survey across 300 retail outlets in Chennai to assess the availability and pricing of low-sodium salt (LSS). They found that LSS was available in only 28 per cent of retail outlets. It was seen in 52 per cent of supermarkets, but a dismal 4 per cent in small grocery shops. The price of LSS averaged Rs 5.6 per 100g, more than twice the price of normal iodised salt (Rs 2.7 per 100g). These findings highlight a critical supply-demand disconnect, Dr Murali said. "The lower demand for low sodium salt might be leading to its lower availability - it's a proxy indicator of awareness and access," noted Dr. Murali. To spark a public conversation around salt reduction, the NIE has also recently launched the #PinchForAChange campaign on Twitter and LinkedIn through ICMR-NIE. Using infographics, facts, and simple messages, the campaign aims to raise awareness about hidden salt sources, promote low-sodium alternatives, and empower individuals to make heart-healthy choices. "If successful, this project could lead to the integration of sustainable dietary counselling models into the existing public health system. It can bridge the gap between knowledge and action, improve health literacy, and ultimately reduce the burden of hypertension-related diseases. "This is not just about reducing salt. It's about restoring balance in our diets, our systems, and our hearts. Together, one pinch at a time, we can create lasting change," Dr Murali added.
Time of India
13-07-2025
- Health
- Time of India
ICMR says Indians taking too much salt, launches study to address issue
New Delhi: Excessive salt consumption is fuelling a silent epidemic in India with people at increased risk of hypertension , stroke, heart disease , and kidney disorders, according to scientists from ICMR 's National Institute of Epidemiology . The scientists have initiated a community-led salt reduction study to address the issue and are focusing on low sodium salt substitutes . While the World Health Organisation (WHO) recommends less than 5 grams of salt per person per day, studies show that urban Indians consume around 9.2 grams/day, and even in rural areas it is around 5.6 grams/day - both higher than recommended. One promising tool in this effort is low-sodium salt substitutes -- blends where part of the sodium chloride is replaced with potassium or magnesium salts, Dr Sharan Murali, a senior scientist at National Institute of Epidemiology (NIE) and principal investigator of the study, said. "Lesser sodium consumption helps reduce blood pressure and improves overall heart health, making low-sodium alternatives a meaningful switch, especially for those with hypertension," Dr Murali stated. "Just switching to low-sodium salt can lower blood pressure by 7/4 mmHg on average' a small change with a big impact," Dr Murali said. To tackle the issue of high salt consumption, the NIE has launched a three-year intervention project in Punjab and Telangana, supported by the Indian Council of Medical Research (ICMR). The goal is to evaluate the effectiveness of structured salt reduction counselling, delivered by health workers at Health and Wellness Centres (HWCs), in reducing blood pressure and sodium intake among individuals with hypertension, senior scientist at NIE, Dr Ganesh Kumar, who is also a part of the study, said.. "We are currently in the first year of the project, focused on baseline assessments and field preparations," Dr Kumar said. "Counselling materials are not yet finalised; rather, we aim to co-create the intervention package with the community health workers, drawing on their experiences and incorporating their suggestions. It's not just about delivering health education - it's about listening, understanding, and building together," Dr Murali said. To ensure interventions are grounded in reality, the NIE conducted a market survey across 300 retail outlets in Chennai to assess the availability and pricing of low-sodium salt (LSS). They found that LSS was available in only 28 per cent of retail outlets. It was seen in 52 per cent of supermarkets, but a dismal 4 per cent in small grocery shops. The price of LSS averaged Rs 5.6 per 100g, more than twice the price of normal iodised salt (Rs 2.7 per 100g). These findings highlight a critical supply-demand disconnect, Dr Murali said. "The lower demand for low sodium salt might be leading to its lower availability - it's a proxy indicator of awareness and access," noted Dr. Murali. To spark a public conversation around salt reduction, the NIE has also recently launched the #PinchForAChange campaign on Twitter and LinkedIn through ICMR-NIE. Using infographics, facts, and simple messages, the campaign aims to raise awareness about hidden salt sources, promote low-sodium alternatives, and empower individuals to make heart-healthy choices. "If successful, this project could lead to the integration of sustainable dietary counselling models into the existing public health system. It can bridge the gap between knowledge and action, improve health literacy, and ultimately reduce the burden of hypertension-related diseases. "This is not just about reducing salt. It's about restoring balance in our diets, our systems, and our hearts. Together, one pinch at a time, we can create lasting change," Dr Murali added. PTI
The Hindu
13-07-2025
- Health
- The Hindu
Facial, speech problems among after-effects of mucormycosis post recovery: ICMR study
People who suffered from mucormycosis and recovered continue to battle long-term health effects of the fungal infection, such as facial disfigurement and speech difficulty, found an ICMR study. There was an uptick in cases of mucormycosis, a rare infection also known as 'Black Fungus', during the COVID-19 pandemic. Published last month in Clinical Microbiology and Infection, a leading microbiology journal, the study found that 14.7 per cent of 686 hospitalised mucormycosis patients died within a year, with most deaths occurring during initial hospitalisation. Critical predictors of poor survival included involvement of the brain or eyes, intensive care admission, poor glycaemic control, and comorbid conditions. Conversely, patients who received both surgical treatment and combination antifungal therapy (particularly Amphotericin-B formulations with Posaconazole) had significantly higher survival rates, said Dr Rizwan Suliankatchi Abdulkader, from ICMR's National Institute of Epidemiology (NIE), the lead author of the study. "But survivors often faced disfigurement and psychological distress, with more than 70 per cent reporting at least one clinical sequela (complication or disability) and a substantial proportion experiencing loss of employment," Rizwan said. 'These are not abstract complications. Facial disfigurement, impaired speech, anxiety, and loss of livelihood are lived realities for many survivors. It is time for India to move beyond life-saving interventions and focus on life-restoring systems of care, including mental health support and rehabilitation,' he said. Led by Rizwan and the All-India Mucormycosis Consortium, the study assessed survival, treatment outcomes, and post-recovery quality of life among hospitalised patients in India. This large-scale study, covering 686 patients from 26 tertiary hospitals across the country, is the first of its kind to offer long-term, prospective data on this critical public health concern. As a part of the study, 686 patients who had contracted mucormycosis between March and July 2021 were followed up for one year. Of the 686, 80 per cent (549) also had COVID-19. The prevalence of mucormycosis varies significantly, from 0.01 to 2 cases per million in developed countries to 140 cases per million in India and similar nations, with incidence approximately 80 times higher in India. Despite advances in medical care, mucormycosis remains a highly lethal and debilitating condition. 'This study reinforces the pressing need to ensure access to timely diagnosis, surgical interventions, and combination antifungal therapy in all parts of India," said Dr Manoj Murhekar, Director of Chennai-based ICMR-NIE. "We cannot overstate how essential high-quality, multidisciplinary care is for patients battling mucormycosis, especially given the irreversible complications they face if treatment is delayed," said Murhekar, a senior author of the study. Spanning the length and breadth of India, the study involved institutions from nearly every region, capturing a diverse and realistic picture of mucormycosis management in both urban and rural populations. Rizwan stressed, 'This is not just a story of numbers. Behind every data point is a person who struggled with pain, disfigurement, and long-term disability. Our duty as clinicians and public health professionals is to reduce not just mortality but also the suffering that comes with survival. "India has a disproportionately high burden of this disease. Our health systems must be better prepared.' The research comes at a time when India is still grappling with the long-term fallout of the COVID-19 pandemic, during which mucormycosis surged dramatically. As the global community turns its attention to pandemic preparedness and health system resilience, the study serves as a sobering reminder of the challenges posed by neglected fungal diseases. 'We hope our findings will serve as a call to action for policymakers, hospital administrators, and clinicians. Mucormycosis is not just a complication of COVID-19. It is a disease that demands long-term clinical attention, public health surveillance, and above all, compassion in care," Rizwan said.
