Kathmandu, 18 Sep: Nepali society can no longer afford to treat a dog bite as “minor,” wash the wound with soap and water and simply “forget about it,” or dismiss it by saying, “Nothing will happen.” Such negligence has contributed to the premature deaths of more than 100 people from rabies infections in Nepal every year. Even more concerning, around 40 percent of those who die from rabies are children under the age of 15, who are often bitten while playing with stray dogs.
The Nepal government has set an ambitious target of bringing human deaths from rabies down to zero by 2030. To achieve this goal, the government has made rabies vaccines available free of charge at hospitals. However, stakeholders say the journey toward achieving the target remains challenging.
Heavy Patient Flow at Teku Hospital
Data from the country’s leading infectious disease hospital, the Sukraraj Tropical and Infectious Disease Hospital (Teku Hospital), indicates that the situation remains serious. According to the hospital, an average of 600 to 700 people visit the hospital every day to receive rabies vaccinations.
Dr. Anup Bastola, director of Teku Hospital, said around 20 people die of rabies at the hospital every year. He explained that it can take one to three months for symptoms to appear after the virus enters the body, but once symptoms develop, it is virtually impossible to save the patient.
Dr. Bastola said the misconception that a small wound can be ignored or that vaccination is unnecessary after several days remains prevalent in society. Although rabies cannot be treated once the disease develops, he said it can be prevented 100 percent if vaccination is administered promptly after a bite.
The Problem Lies in Dog Management
According to the Epidemiology and Disease Control Division, more than 90 percent of rabies infections in Nepal are caused by dog bites. Experts therefore say vaccinating humans alone will not be enough to control the disease.
Public health expert and veterinarian Dr. Sheetalkaji Shrestha said providing vaccines alone is insufficient. He stressed the need for measures ranging from local governments to the federal level to control the stray dog population, ensure regular vaccination of dogs, raise awareness at schools and establish an effective disease surveillance system.
Bhutan’s Success
The World Health Organization recently recognized neighboring Bhutan as the first country in Southeast Asia to eliminate dog-mediated rabies. Since June 2023, no one in Bhutan has died from rabies transmitted through a dog bite.
For more than a decade, Bhutan has followed a “One Health” approach that brings human, animal and environmental health together. The country carried out extensive vaccination of dogs nationwide, strictly controlled the stray dog population and established immediate access to free vaccines and preventive medicines, along with public awareness campaigns emphasizing the importance of washing bite wounds immediately.
Dr. Narendra Kumar Jha, chief of the Health Directorate in Bagmati Province, Hetauda, said reducing rabies would be difficult without cooperation among all relevant agencies.
According to him, people can protect themselves from the risk of rabies by providing immediate first aid after being bitten by a dog or another animal. The wound should be thoroughly washed with soap and running water for at least 15 minutes immediately after the bite. An antiseptic such as Dettol, surgical spirit or povidone-iodine should then be applied, and the person should visit the nearest health facility without delay to begin the recommended course of rabies vaccination.
