World Rabies Day: Awareness must to prevent disease, reduce deaths

Islamabad: Rabies is one of the most neglected diseases in Pakistan though its incidence is very high with an estimated 2,000 to 5,000 cases every year meaning the disease claimed 2,000 to 5,000 lives every year as it is 100 per cent fatal after developing symptoms however the concerned government authorities seem to have done little both for its prevention and treatment.

Rabies, one of the oldest and deadliest diseases known to mankind is said to be the mother of all infectious diseases and it is believed that nothing can be more painful and horrific than rabies. Known as the poor man’s disease, rabies also known as “Hydrophobia” (fear of water), is an acute infectious zoonotic disease of the central nervous system, which can affect almost all mammals, including humans and is transmitted to other animals and humans through close contact with saliva of infected animals through bites, scratches, licks on broken skin and mucous membranes. After appearance, it causes convulsions, inability to move and strange behaviour developing hydrophobia (an extremely intense aversion to water, especially the fear of drinking water or other liquids) in the victim resulting in ultimate death.

High mortality rate of the disease in Pakistan is mainly because of the lack of awareness about vaccination of domestic animals and pre exposure vaccination of at risk population, the dog bite cases.

Additional Medical Superintendent at Holy Family Hospital Dr. Tariq Masood Niazi expressed this while talking to ‘The News’ on Friday in connection with World Rabies Day which is observed around the globe on September 28 every year. The theme of World Rabies Day this year is ‘Zero by 30’ in honor of the goal of zero human deaths from canine rabies by 2030.

If a stray dog bites a person and disappears or dies or is killed, the victim must report to the nearest healthcare facility and get anti-rabies tissue culture vaccine (TCV) that is given in at least five doses intramuscular schedule of 1ml on Day 0, 3, 7, 14 and 28. A booster dose on 90thday is also advised in the deltoid muscle while anti-rabies immunoglobulin (RIG) should also be administered in severe biting cases of suspect animal, said Dr. Tariq.

The disease period from the entrance of virus into the body till the appearance of symptoms is between 3 to 12 weeks normally and in rare cases can exceed up to six months or many years. The common carriers of the disease are dogs, the commonest ones, in Pakistan, he said.

He added the HFH like other public sector hospitals of the country provides TCV to dog-bite cases however the government does not provide RIG as it is much costly. He said people must vaccinate pet animals including dogs and cats against rabies. It is important to mention here that a vial of 2ml of RIG costs from Rs6,800 to 10000 and an adult victim of dog bite needs four to five vials depending on his or her body weight.

It is important that till 2013-14, the public sector hospitals in Pakistan were following 14-injections therapy for dog-bite cases in which sheep brain Anti-Rabies Vaccine was administered into the abdomen for 14 days on daily basis though the World Health Organization had declared sheep brain ARV obsolete in 1992 and recommended tissue culture vaccine (TCV) for the treatment and it shows how much the disease has ever been neglected.

Now the situation has improved and almost all public sector hospitals in all provinces are providing TCV free of cost to dog-bite victims, said a senior official at National Institute of Health Dr. Shahab Akhtar Qazi.  

Dr. Qazi whi has served as National Coordinator of Rabies Prevention Program at NIH for years said the most important thing to reduce deaths by rabies is to create awareness among public on importance of administration of TCV in case of dog bite.