A woman from Ammapettai, Tamil Nadu died of rabies yesterday, about two weeks after being bitten by a puppy. The Press Trust of India reports the 45-year-old victim initially neglected the bite wound and later sought care after getting symptoms of the lethal viral disease.

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She was treated in the Pasteur Institute of India in Coonoor, but it was too late. Her family received rabies prophylaxis.

Rabies, a zoonotic disease, continues to remain a neglected but major public health problem in India. In fact, rabies deaths are no stranger to India, which according to a recent study, India reports 20,000 human rabies deaths annually.

According to the Control of Communicable Diseases Manual, all mammals are susceptible to rabies. Raccoons, skunks, foxes, bats, dogs, coyotes and cats are the likely suspects. Other animals like otters and ferrets are also high risk. Mammals like rabbits, squirrels, rodents and opossums are rarely infected.

Rabies infected animals can appear very aggressive, attacking for no reason. Some may act very tame. They may look like they are foaming at the mouth or drooling because they cannot swallow their saliva.Sometimesthe animal may stagger (this can also be seen in distemper). Not long after this point they will die. Most animals can transmit rabies days before showing symptoms.

Initially, like in many diseases, the symptoms of rabies are non-specific; fever, headache and malaise. This may last several days. At the site of the bite, there may be some pain and discomfort. Symptomsthen progress to more severe: confusion, delirium, abnormal behavior and hallucinations. If it gets this far, the disease is nearly 100% fatal.

With the exception of Antarctica, rabies is endemic on all continents. Worldwide, it is estimated that there are more than 59,000 deaths due to rabies annually, with 95% in Africa and Asia.