Though we celebrate 28th September ‘’The World Rabies Day’’ for awareness of general public in Pakistan in order to save ourselves from ‘’DOG BITING’’ a source of ‘’RABIES’’ generates & impacts the human body – a horrifying disease that is lethargic and fatal at the end.
The World Rabies Day reminds us that how to handle such disease efficaciously & effectively that’s found in human and animal, the preventive measure i.e. human vaccine the only tool to eliminate human deaths from rabies & Dogs too instead culling [killing]it also needs anti rabies vaccination.
Pakistan has been shooting and poisoning its stray dogs for decades. Not only this is cruel and ineffective rather madness given there are humane alternatives to stray dog population management and rabies control. “Killing’’ dogs is not the solution as it does not stop the disease; mass dog vaccination is the only proven.
In response to growing concerns of dog-bite incidents in Karachi, a pilot project was formed under the aegis of Indus Hospital Research Centre from January to December 2018. The project was implemented in Ibrahim Hyderi Karachi selected because of its proximity to the hospital, and recorded outbreaks of rabies from within.
Rabies is a viral disease that causes inflammation of the brain in humans and other mammals. Early symptoms can include fever and tingling at the site of exposure. These symptoms are followed by one or more of the following symptoms,
Violent movements – uncontrolled excitement – fear of water
an inability to move parts of the body – confusion – and loss of consciousness.
Rabies is caused by lyssaviruses, including the rabies virus and Australian bat lyssavirus.
Its proven that when an infected animal scratches or bites another animal or human – Saliva from an infected animal can also transmit rabies if the Saliva comes into contact with the eyes, mouth, or nose.
Globally, dogs are the most common animal involved in Rabies spreads. In countries where dogs commonly have the disease, more than 99% of rabies cases are the direct result of dog bites.
In Austria 5,900 Austrians are treated annually after being bitten by dogs – One fifth of those injured are children
United States approximately 4.5 million people are bitten by dogs each year – approximately twenty percent of dog bites become infected.
So the disaster of ‘’Rabies’’ not limited to Pakistan only but across the globe where dog biting is common and of course relevant vaccination they apply – not only to human who infected by dog biting but dog too is vaccinated instead culling that is termed as cruelling & barbaric.
Animal control and vaccination programs have decreased the risk of rabies from dogs in a number of regions of the world. Immunizing people before they are exposed is recommended for those at high risk,
In people who have been exposed to rabies, the rabies vaccine and sometimes rabies immunoglobulin are effective in preventing the disease if the person receives the treatment before the start of rabies symptoms.
Arrange to wash bites and scratches for 15 minutes with soap and water, povidone-iodine, or detergent may reduce the number of viral particles and may be somewhat effective at preventing transmission.
Once symptoms appear, the result is nearly always death. The time period between contracting the disease and the start of symptoms is usually one to three months but can vary from less than one week to more than one year, depends on the distance the virus must travel along peripheral nerves to reach the central nervous system.[
In Karachi while conducting World Rabies Day, emphasized the need for eliminating the fatal disease through mass vaccination and management of dog population – a humane methodology being successfully implemented in parts of Karachi
The objective of World Rabies Day — a global campaign aimed at preventing the spread of the world’s most fatal disease — this year is ‘Rabies: Vaccinate to Eliminate’.
Around 150 cases of dog bite occur daily in Karachi alone
Around 59,000 people die of rabies annually as a result of being bitten by infected dogs — the main source of human rabies deaths.
Most of these deaths, they pointed out, occurred in Africa and Asia while up to 60 per cent of all dog bites and rabies deaths occurred in children under 15 years of age.
According to the experts, Pakistan is also among the countries seriously affected by rabies – It is estimated that 2,000 to 5,000 people die of the disease every year as healthcare facilities frequently run short of anti-rabies vaccines.
Generally it is perceived that humans alone are the victims of these deadly diseases – No dogs too suffer from the disease as a result of mass culling to curb the disease.
Presenting an overview of the Rabies-Free Karachi (RFK) project initially launched in Ibrahim Hyderi last year aimed at vaccinating stray dogs on a large scale, controlling their population and creating public awareness of dog behavior and rabies.
We can control the street dog population through surgical sterilization and mass dog vaccination. Its scale-up work has begun covering regions in Ibrahim Hyderi, Korangi, Lyari and Landhi and it is hoped that the project can be expanded throughout Pakistan.
During the event, the project team spread awareness of rabies, its prevention, and treatment. It was followed by an address of the core and field team members who spoke about their experiences; a dog-catching simulation was administered and the surgical container was opened for inspection, where dogs are surgically sterilized.
The RFK’s aim is to highlight the essential role of mass canine vaccination in rabies elimination. It also indicates the need for human vaccination to save lives in case of potential exposure to rabies,” said Mohammad Aftab Gohar, representing the RFK project.
The unchecked increase in the number of stray dogs on the streets coupled with the shortage of anti-rabies vaccine (ARV) and rabies immunoglobulin injections, used to cure the disease, has led to a rise in the number of deaths caused by the virus. Sindh government and the Karachi Metropolitan Corporation (KMC) seem unable to resolve the issue.
A report issued by the Sindh health department about DOG BITING RABIES states that in the first five months of 2019 alone, a total of 69,453 cases of rabies have been reported in the province.
A total of 22,822 people were bitten by dogs most of the cases have emerged in Larkana division between January and May
Of these, 7,678 incidents occurred in Qambar Shahdadkot
4,381 in Kashmore
4,364 in Shikarpur
3,752 in Larkana city and
2,647 in Jacobabad,
21,099 cases have been reported in Hyderabad division
6,989 most of the cases recorded in Dadu
A total of 3,383 dog bite incidents occurred in Badin,
2,811 in Jamshoro
1,984 in Tando Allahyar
1,590 in Matiiari,
1,490 in Thatta
1,188 in Sujawal and
802 in Tando Muhammad Khan.
There is a shortage of anti-rabies vaccine (ARV) and rabies immunoglobulin (RIG) injections in Sindh. Just this year, four deaths were reported in Karachi due to the absence of the vaccine in hospitals.
Since there is a severe shortage of the vaccine in interior Sindh, rabies patients from across the province are coming to Karachi for treatment. However, where the number of patients visiting the city hospital has risen, the supply of the vaccine and injections has not, as a result government and private hospitals alike are facing a shortage of ARV and RIG.
Jinnah Postgraduate Medical Centre (JPMC), Dr Ruth Pfau Civil Hospital and Indus Hospital have clinics specifically to treat dog bites and they have been providing free of cost treatment to patients. Even private hospitals are not faring well. They are facing a shortage of the vaccine and the treatment they offer is very expensive. The ARVs cost around Rs750 to Rs800 while RIG cost more than Rs800 which is too high for the poor to afford.
The deaths from rabies that are being reported now, however, are being reported not at private hospitals but at government ones.
The three other deaths from rabies were reported at Indus Hospital. These patients were from Karachi, Sindh, and Balochistan. A total of 6,000 patients were treated at Indus Hospital last year but now the number of patients is increasing.
The administration of JPMC, Dr Ruth Pfau Civil Hospital, and Indus Hospital said that they were facing extreme difficulty in access to ARV and RIG. Dr Jamali said that she believes the whole country was facing a shortage.
She said that government institutions need to reduce the number of street dogs. Rabies can be prevented if the vaccine is administered to the affected person immediately and the medication course is completed properly. She added that the patients brought to JPMC, who are bitten by the dogs, mostly include children.
Dr Rubina Bashir of Dr Ruth Pfau Civil Hospital said that the RIG and ARV were short in the hospital. Four vaccines are administered to the patients bitten by dogs. The vaccine has been unavailable in the hospital for last four days and at least 50 vaccines are required on daily basis, she said adding that more than a hundred patients visit the hospital daily from Karachi and interior Sindh.
Dr. Bashir said that the population of street dogs should be controlled and the Karachi Metropolitan Corporation (KMC) should play its role the vaccine would not be needed anymore if dogs are eliminated from the streets, she said.
RIG injections are administered to patients bitten by dogs. This injection is administered inside the wound and it has to become unavailable.
While talking about the precautionary measures that if a dog or any animal bites a person, they should wash the wound properly with soap first to kill the germs and then apply an antiseptic ointment. The affected person should then visit the hospital immediately where proper medical treatment can be given.
According to medical experts, a victim of a dog bite can get affected by rabies if immediate treatment is not provided to them. The life of the person who was bitten by a dog can be saved if the ARV is immediately administered to them and medication course is completed.
She said that around 6,000 cases of dog bites have been reported till now in JPMC in 2019 while the number of deaths from the rabies is 6. She said that there were 7,800 cases of dog bites recorded in 2018 and the number of deaths from the disease was 9.
Following care can be followed to avoid of dog biting- the CDC and the American Veterinary Medical Association have published recommendations which encourage those that are around dogs to:
- not approach an unfamiliar dog
- not run from a dog
- remain motionless when approached by an unfamiliar dog
- curl into a ball, while protecting your head and ears if knocked over
- not panic or make loud noises
- report dogs that are behaving strangely
- do not disturb a dog that is caring for puppies
- not pet a strange dog
- not encourage your dog to play aggressively
- not allow small children to play with a dog unsupervised
- avoid the dog if it is ill
- avoid waking the dog – call the dog by name to retrieve objects from the dog’s mouth
- avoid face-to-face interaction with the dog
- not disturb the dog while it is eating
- reduce the dog’s interaction with children not attempt to break up a dog fight
Part of the effort to reduce the prevalence of dog bite injuries has involved the passage of breed-specific laws, intended to reduce the ownership of dog breeds that are considered more likely to bite or to cause serious injury in the event of a bite.