KARACHI, Dec 15: Incidence of stray dogbite have assumed alarming proportions in Karachi as in the first half of December 30-40 such cases have been reported in the city. Most of the victims were children.
According to a press release issued on Saturday by the National Institute of Child Health (NICH), Karachi, unfortunately few people know what has to be done if someone is bitten by dog and where to seek remedy for dogbite, which may become pernicious if left untreated or treated carelessly.
Unfortunately, statistics are not available as to how many case of dogbite occur in Karachi, other parts of the country and in the country as a whole in a year. Pakistan is a rabies endemic country but only few hospitals provide treatment for dogbite.
In Karachi only, four government hospitals, Abbasi Shahid Hospital, Civil Hospital, the JPMC and the NICH, have the required facility for the treatment of dogbite cases.
All these hospitals receive vaccines (ARV) from the NIH Islamabad in a limited quantity due to which they are usually short of supply.
It has been witnessed that relatives of the victims run from one hospital to another to get victims vaccinated.
About 1,200 victims of dogbite come annually to the NICH and another 1,200 may be going to other city hospitals as at least 5,000 cases of dogbite occur every year in Karachi. This put the civic agencies responsible for eliminating stray dogs in a poor light.
There is no laboratory which can confirm the status of the dog, as rabid or otherwise. ARV carries fatal risk of developing neuroparalytic reaction in up to 1/120 vaccines and in view of it, it is not recommended in the developed countries.
HGCV costs about Rs3,000-Rs5,000 a patient, and it is a risk-free and effective vaccine. But government hospitals do not have this expensive vaccine.
Once a patient develops symptoms of rabies, there is very little chance of recovery as fatality is virtually 100 per cent once the symptoms develop.
For prevention of rabies among men following steps are necessary to follow which include cleaning and flushing the wound thoroughly with plenty of soap and water to remove as much saliva as possible so as to remove the virus from the wound.
The removal of virus should be followed by the application of virucidal solution such as 1 per cent providone-iodine or 70 per cent alcohol. Local application of antirabies serum should be infiltered as it provides immediate blockage of attachment of virus to the nerve-endings.
The wound should not be sutured at least within 24-48 hours of the bite as it may cause additional trauma and will help virus to gain access into deeper tissues. Besides, measures should also be taken against tetanus.
Pakistan is a rabies endemic area so every animal-bite should be considered with suspicion. Immediate institution of combined vaccine and serum therapy in all severe bites are strongly recommended. Simultaneously the animal should also be observed for at least 10 days. If the victim remains healthy for five days, treatment should be discontinued in consultation with physician.—PPI
