Rabies claims life of interior Sindh farmer admitted to JPMC

A 35-year old man from interior Sindh died at the Intensive Care Unit of the Jinnah Postgraduate Medical Center (JPMC) on Sunday after contracting rabies, which is a 99.9 per cent fatal disease if the victim is not given vaccine immediately after an infected dog’s bite, health officials said.

“Muhammad Javed, a 35-year old male from Tando Allahyar, was brought to JPMC on Saturday from a private hospital in Karachi in critical condition. He had full-blown rabies and died on Sunday afternoon,” JPMC Executive Director Dr Seemin Jamali told The News on Sunday.

According to experts, rabies is a vaccine-preventable viral disease which occurs in more than 150 countries and territories. Infected dog bites are the main source of human rabies deaths, contributing up to 99 per cent of all rabies transmissions to humans.

“If a rabid dog bites a person, the rabies virus is transmitted to the affected person through the animal’s saliva,” said Jamali. “If a person comes with a dog bite, we treat him or her with the rabies vaccine – post-exposure prophylaxis (PEP). The vaccine is always successful if it’s given immediately after exposure.”

She added: “The affected person gets one dose of fast-acting rabies immunoglobulin, which prevents them from getting infected by the virus. The patient will get four rabies vaccine shots over the next 14 days.”

According to the World Health Organization, an average of 60,000 people die from rabies annually, and more than 15 million people receive post-exposure prophylaxis every year. Dr Jamali said the ill-fated patient Javed was a farmer from Tando Allah Yar who was bitten by a rabid dog but he could not get anti-rabies vaccine on time and the virus infected his central nervous system.

“He was taken to a private hospital in Karachi from where he was shifted to JPMC for palliative care as nothing could be done for him in the last moments of the disease,” she said, adding this was the third such death due to rabies at JPMC this year.

Due to the increased population of stray dogs in Karachi and the rest of Sindh, around 6,000 people, including women and children are brought to JPMC alone with dog bite cases, she said. She added that all these people are given anti-rabies vaccine and immunoglobulin to prevent them from getting infected.

Last month, a female doctor of the JPMC itself was bitten by a stray dog, which managed to enter the hospital facility, compelling hospital authorities to call for their elimination from the hospital premises.

Experts say the rabies virus replicates in the bitten muscle and gains access to motor endplates and motor axons to reach the central nervous system. The virus then travels to the central nervous system, where a majority of the clinical symptoms manifest as an acute encephalitis or meningoencephalitis. The incubation period averages 2 to 3 months and death occurs within 2 weeks after the appearance of clinical symptoms if intensive care is not sought.

In more than 99 per cent of all cases of human rabies, the virus is transmitted via dogs; half of the global population lives in canine rabies-endemic areas and is considered at risk for contracting rabies. Although all age groups are susceptible, rabies is most common in people younger than 15 years. Four out of every 10 deaths due to rabies are in children younger than 15 years.