Hyderabad: At a time when Telangana is reporting around 350 dog bite cases daily, the majority of govt health centres in the state don’t have enough an essential rabies drug — rabies immunoglobulin (RIG).While in Hyderabad the drug is available only at Fever Hospital, Nallakunta, sources say that in the districts — even though area hospitals are mandated to stock RIG — supply remains a major concern. A life-saving injection, RIG must be administered to dog-bite victims with severe and deep wounds within seven days of receiving the initial anti-rabies vaccine (ARV).A recent study revealed that only 1.8% of primary health centres (PHCs) across India have RIG in stock. Published in the medical journal ‘The Lancet’, the study also highlights the situation in districts of Telangana, such as Rangareddy, Medak, and Nalgonda.The study further noted that due to the unavailability of RIG at nearby urban primary health centres (UPHCs), many patients receive incomplete treatment.P Suresh, a resident of Nalgonda, brought his 10-year-old son to Fever Hospital in Hyderabad after the child suffered a severe dog bite. “My son was bitten by a dog while playing outside. It left a deep wound near his knee. Doctors gave him the basic vaccine doses but said the hospital did not have RIG. We were sent to a nearby area hospital, which also didn’t have it. Finally, we had to come to Fever Hospital in Hyderabad. They told us to reach here within five to six days to avoid the risk of rabies. For poor families like ours, travelling and staying in Hyderabad is very difficult. But what else can we do?” Suresh said.Patients from rural areas are frequently forced to travel long distances to district hospitals or to Hyderabad in search of the rabies drug. Of the approximately 350 dog bite cases handled daily by Fever Hospital and the Institute of Preventive Medicine (IPM), Narayanaguda, around half a dozen are considered serious. About 200 RIG vials are used each day.Health experts warn that the lack of RIG in PHCs and area hospitals can lead to delayed or incomplete treatment, increasing the risk of rabies — a fatal disease once symptoms appear. Unlike the rabies vaccine, which takes seven to 14 days to generate antibodies in the body, RIG acts immediately by neutralising the rabies virus at the wound site. Without this immediate protection, the virus can reach the nervous system and cause rabies.“RIG is the only protective measure that provides instant antibodies. It should ideally be available at govt area hospitals too, but the supply is irregular and poorly distributed,” said Dr K Bhanu Prasad, assistant professor of preventive medicine at the Nizam Institute of Medical Sciences (NIMS). He added that while private hospitals often have RIG, the cost runs into thousands of rupees, making it unaffordable for many. “If RIG is made available at the PHC level, especially in areas where dog bite cases are more common, it can save many lives,” he said.Another doctor from IPM echoed similar concerns, pointing out that the shortage contributes to overcrowding in major hospitals. “It would help if a few doses of RIG were stored at PHCs, as it is the first injection needed after a severe bite, along with the basic vaccine,” the doctor said.He also highlighted that one of the main reasons RIG is not stored at PHCs is the lack of adequate refrigeration facilities. “RIG must be stored at a consistent temperature between 2°C and 8°C. However, many PHCs lack power backup, trained staff, and sufficient funding. Improving this infrastructure would not only help store RIG, but also other essential life-saving medicines,” he said.GFX:When should RIG be administered?• In cases of deep or multiple dog bites or scratches that break the skin• If a dog licks broken skin, or if saliva enters the eyes, nose, or mouth• If there is exposure to saliva or nervous tissue from a rabid or suspected rabid animal• If the person has never previously received a rabies vaccine
