OSSSC Nursing Disease Guide

Communicable · High priority

Rabies

Core disease facts with the linked government programme, prevention and treatment or cure reality.

TypeViral disease — caused by rabies virus, a lyssavirus.

Image-based identification

Annotated brain histology showing Negri bodies in rabies
What to identifyNegri bodies are eosinophilic intracytoplasmic inclusions in neurons—a classic rabies pathology clue.Image credit: CDC image with CC0 annotation — public domain/CC0

Government programmes, schemes and services

  • Programme: National Rabies Control Programme: Strengthens wound-care awareness, rabies vaccination and immunoglobulin access, case surveillance, training and laboratory support for human rabies prevention.
  • Action plan: National Action Plan for Dog-Mediated Rabies Elimination: Uses a One Health approach linking human post-exposure care, dog vaccination, surveillance and community awareness to end dog-mediated human rabies by 2030.
  • Service: National rabies helpline 15400: Guides bite victims to nearby facilities that provide rabies vaccination and immunoglobulin services.

Prevention

  • Prevent: Dog vaccination, bite prevention, 15-minute wound washing, prompt vaccine and rabies immunoglobulin when indicated

Treatment and cure reality

  • Treat: Exposure is preventable with correct post-exposure prophylaxis; after clinical symptoms begin there is no reliable cure and disease is almost invariably fatal.

Must remember

  • Main source in India: Infected dog bite or saliva exposure; cats and other mammals can also transmit.
  • Once clinical symptoms appear: Rabies is almost invariably fatal; prevention after exposure is therefore critical.
  • Immediate wound care: Wash and flush thoroughly with soap and running water for about 15 minutes; apply an appropriate antiseptic.
  • Avoid: Irritants such as chilli/turmeric, tight suturing, and unnecessary wound closure.
  • Category I: Touching/feeding an animal or lick on intact skin—no prophylaxis if history is reliable.
  • Category II: Nibbling uncovered skin or minor scratches without bleeding—wound care plus vaccine.
  • Category III: Transdermal bite/scratch, lick on broken skin, or mucosal exposure—wound care, vaccine, and rabies immunoglobulin.
  • Rabies immunoglobulin: Infiltrate into and around all wounds as far as anatomically possible; give as soon as possible and not later than 7 days after the first vaccine dose.
  • Modern vaccine: Cell-culture vaccine; nerve-tissue vaccine is obsolete.
  • Do not observe instead of treating: Start indicated post-exposure prophylaxis immediately; observation of a dog/cat can inform later management under protocol.
  • Elimination target: Dog-mediated human rabies by 2030 under the national action plan.
  • Helpline: National Rabies Control Programme helpline 15400.