Rabies death toll in Sindh hits 12 as Sanghar woman dies at JPMC

A 50-year-old woman from District Sanghar, who was being provided hospice care at the Dog Bite Centre of the Jinnah Postgraduate Medical Centre (JPMC) after confirmation that she was suffering from Rabies Encephalitis (full-blown rabies), died at the health facility on Wednesday night.

“Mishra Birbal, 50, a resident of Sanghar district of Sindh, was bitten by a stray dog on her left hand almost two months back, and they left the wound unattended. She died tonight at the hospital. The dog that bit her was rabid and she developed Rabies Encephalitis, a viral disease which is not treatable once it is developed if the victims are not given anti-rabies vaccine (ARV) and immunoglobulin,” said Dr Seemin Jamali, the Executive Director of the JPMC, while talking to The News on Wednesday.

Mishra Birbal was the 12th victim of full-blown Rabies and second from Sanghar district of Sindh, health officials said, adding that the number of deaths due to Rabies Encephalitis could be much higher in the province, where over 85,000 people have so far been bitten by stray dogs during the first six months of the current year.

Dr Seemin Jamali said they provided hospice care — which focuses on the palliation of a chronically or terminally ill patient’s pain and symptoms — to the victim and counselling to her family members, adding that the lady had developed hydrophobia and was in immense pain and misery.

“Nothing can be done for such patients and we help them to have maximum peace and comfort in the last days of their life. That is why it is immensely important that people are prevented from dog bite and if somebody is bitten by a stray or even a pet dog, he or she must be given ARV and immunoglobulin,” Dr Seemin said.

A 12-year-old boy from Thatta district of Sindh was the 11th victim of Rabies Encephalitis who died at the JPMC last month, officials of the Sindh Health Department said, adding that six children have died due to full-blown rabies at the JPMC, while five people who were mostly children succumbed to the lethal viral illness at Indus Hospital this year.

What is Rabies Encephalitis?

Rabies Encephalitis is a dog-borne viral illness caused mostly by the biting of stray dogs, and if ARV is not administered to the affected person along with immunoglobulin, the patient suffers a miserable death due to hydrophobia and other complications of the disease.

Ironically, Pakistan is facing an acute shortage of ARV after Indian companies reduced its supply to Pakistan, citing growing global demand and lesser production, while the number of dog bite cases is on the rise due to some NGOs’ opposition to killing stray dogs.

Dr Seemin Jamali maintained that it was the sixth death due to Rabies Encephalitis at the JPMC in 2019, while so far 6,000 people have been brought to the hospital this year who were bitten by stray dogs and were given ARV and immunoglobulin at the hospital’s dog bite centre.

On the other hand, five persons also died due to Rabies Encephalitis at the Indus Hospital Karachi, while the hospital received over 7,000 people with dog bite cases who were given treatment along with ARV and immunoglobulin shots at the hospital, informed Dr Naseem Salahuddin, Head of Infectious Diseases at the Indus Hospital.

Over 85,000 dog-bite cases in Sindh have been recorded in the first five months. As many as 85,000 people, most of them children, have been bitten by stray dogs in the first five months of the current year in the entire Sindh so far, said Director General Health Sindh Dr Masood Solangi while talking to The News.

As many as 70,000 people were bitten by stray dogs in five divisions of Sindh, excluding Karachi, until May 2019. There are reports of 15,000 to 17,000 dog-bite cases reported at three tertiary-care hospitals of Karachi during this period, Dr Solangi said, adding that dog-bite cases were on the rise as compared to last year, due to growing number of stray dogs in the province.

According to the data of the dog-bite cases, the highest number of dog-bite cases was reported from the Larkana division, where 22,822 people were bitten by stray dogs in the first five months of the year, followed by Hyderabad division, where over 21,099 people fell victim to stray dogs.

Over 12,215 people were attacked and injured by stray dogs in Nawabshah division in the same period, while over 6,000 dog-bite incidents were reported from Sukkur and Mirpurkhas divisions.

Sindh Health Department officials say that between 15,000 and 17,000 people became victims of stray dogs in Karachi’s six districts, adding that the number of dog-bite cases could be much higher, as many people go to private hospitals and smaller health facilities that do not report these cases to the authorities.

“The commissioners have repeatedly been urged to start killing stray dogs after growing incidents of dog-bite cases in Sindh, including Karachi,” Dr Solangi said, adding that he has written to the commissioners of the six districts to six divisions to launch strong and efficient campaigns in their areas to get rid of stray dogs so that people could be saved from being bitten by the canines.

“I have written to the commissioners of all six divisions of Sindh to start efficient campaigns against stray dogs and get people rid of them, as we have difficulty in acquiring ARV, which is essential for preventing people from developing Rabies Encephalitis and meeting a miserable death,” said Dr Solangi.