KARACHI, Jan 7: The National Institute of Child Health (NICH) has expressed serious concern over the alarming rise of dogbite cases in the city, as according to a report, the hospital has registered 83 cases from various localities of the city in the 1st week of this month.

Whereas on average, this largest children’s hospital of the province has been receiving one hundred to two hundred dogbite patients every month.

“Year 2002 has started with an alarming rise in the incidence of dogbites. As much as eighteen children have been reported from Shah Faisal Colony alone, between January 4 and 6.

“This week, most of the incidents have been reported from Shah Faisal Colony, Landhi, and Orangi Town, while sporadic cases are being reported from all over the city,” the report said.

The youngest reported patient, baby Fatima, daughter of Abdul Ghani, from Shah Faisal Colony, was ten months old, while Raza, son of Sajjad, was 11 years of age.

The NICH provides treatment to children up to the age of 14 years, while children above that age go to other hospitals, including the JPMC and the Civil Hospital. Collection of data from these hospitals may give rise to a more horrifying picture.

“No action has been taken by the concerned authorities despite several complaints by the NICH in the second week of December,” the report added.

The NICH’s report, in order to aware the masses about the first aid measures to be taken after the incident, has advised the people to flush the wounds thoroughly with plenty of soap water to remove as much saliva as possible, and thereby removing the virus from the wound.

“The mechanical removal of virus should be followed by application of virucidal solution, such as 70 per cent alcohol. Application of anti-rabies serum should be infiltrated, it provides immediate blockage of attachment of the virus,” it suggested.

The wound should not be sutured, at least within 24 to 48 hours of the injury, because it will cause additional trauma and will help virus gain access to the deeper tissues. Measures should be taken against tetanus.

About post-exposure treatment, the report suggested active immunization vaccine, including Nerve Tissue Vaccine (NTV-ARV) and Human Diploeic Cell Vaccine (HDCV), which are now available in Pakistan.

It suggested to use booster doses after 10, 20 and 90 days after completion of 14 injections. A booster dose on D90 is optional.

Immunity usually lasts for six months to a year. So exposure after six moths of the completion of immunization should be considered as a fresh case.

The treatment consists of 5XIml injections on days D1, D3, D7, D14 and D30 after contact with an animal, who is rabid or suspected of being so.

“Homologous serotherapy must be employed immediately in case of any serious bite, when the animal is unknown or suspected of being so. Passive antibody is available in the form of equine antiserum (ARS) or human immunoglobulin (Imogam rabies, 300 IU/2ml),” the report said.

No man could surely say when the deadly symptoms will appears. For this, a post-exposure vaccination should be stared at the earliest to ensure that the individual will be immunized before the rabies virus reaches the CNS.

Pakistan is a rabies endemic area, so every animal bite should be considered with suspicion. Immediate institution combined vaccine and serum therapy in all severe bites are strongly recommended. Simultaneously observe the animal up to five days. If the animal remains healthy up to this period, discontinue the treatment and further observe the animal up to ten days.

The report said that the HDCV, though costly, has been recommended all over the world. It is more safe and effective but is costly. The NICH and other hospitals do not bear the cost of the vaccine.—PPI