Peer-reviewed article

Distinguishing dog-bite and rabies vulnerability in children to strengthen global elimination efforts.

Tiwari HK · 1 Sept 2026

Abstract

Dog-mediated rabies remains a preventable cause of mortality in children, particularly in low- and middle-income countries where free-roaming dogs are common. While the WHO-led "Zero by 30" strategy emphasises mass dog vaccination and access to post-exposure prophylaxis (PEP), less attention has been paid to the behavioural and communication pathways that shape children's vulnerability. This Viewpoint proposes a conceptual distinction between vulnerability to dog bites and vulnerability to rabies following exposure. Conflating these risks may contribute to diffuse messaging and missed prevention opportunities. This Viewpoint argues for a differentiated child-facing and adult-facing interventions, with schools positioned as adaptable platforms for integrating safe behaviour, disclosure, and timely care-seeking within existing systems. Aligning behavioural, educational, and biomedical components more explicitly may strengthen implementation of global rabies elimination strategies and reduce paediatric deaths.