Shortage of anti-rabies vaccine causing more cases of the disease in Sindh

Dog-bite patients across Sindh are becoming more prone to rabies due to the shortage of anti rabies vaccines (ARV).

The vaccine, at one point in time, was unavailable in most public hospitals including those working under the Karachi Metropolitan Corporation (KMC). The ARV is available in limited quantity in Jinnah Postgraduate Medical Centre (JPMC), Dr Ruth Pfau Civil Hospital, Indus Hospital and Abbasi Shaheed Hospital, according to various news reports.

The problem of the shortage in ARVs originated after India stopped supply in Pakistan. The demand for ARV vaccines started increasing in India hence the country had to stop its export in Pakistan.

KMC Senior Director Salma Kausal had cited the lack of availability of the vaccine in the market and a shortage of funds from the provincial government.

“Hospitals that operate under KMC are facing difficulties in acquiring ARV due to shortage of funds,” she told an English daily. “Moreover, the vaccine is also not available in the market, which adds to the problem,” she added.

The abundance of stray dogs in the country has also made matters worse. For instance, last year, the number of dog bites incidents exceeded 8,800 at the JPMC alone.

JPMC Executive Director Seemi Jamali had said in an interview last year that around 40 dog-bite patients are brought to the hospital daily. Similarly, Indus Hospital’s Dr Naseem Salahuddin had said that the hospital received around 50 dog-bite cases every day and 6,500 cases were registered at the healthcare facility last year.

The Sindh Health Department said that till August 2019, 1,22,566 people were bitten by dogs. As per the health department’s statistics, most number of dog-bites cases were reported in Qambar, Dadu and Naushahro Feroze. As many as 11,935 cases were reported in Qambar, 11,330 in Dadu and 10,847 in Naushahro Feroze.

Earlier this year, the case of a 9-year-old boy in Larkana provoked anger and outrage when Hasnain from Larkana passed away after undergoing treatment in Indus Hospital.

“Today, the nine-year old boy from Larkana died at the Indus Hospital Karachi due to full-blown rabies. He was probably mauled on face by a rabid dog in his hometown. His parents took him to a public health facility where they gave him some injections but apparently the anti-rabies vaccine (ARV) was not administered properly and immunoglobulin was not given to the ill-fated boy,” said the hospital.

Aftab Gohar, the in-charge of the Indus Hospital dog bites centre, said: “When a rabid dog bites a person and the wound is very deep, the patient must be given immunoglobulin immediately, which contains antibodies that fight the rabies virus transmitted to the body of the person through the saliva of the rabid dog. In addition to immunoglobulin, the patient should be given four to five doses of an international quality anti-rabies vaccine.”

It is important to note that the presence of ARV is essential to prevent more deaths due to rabies in Pakistan in general and Sindh in particular.