KARACHI, Aug 9: More than 10,000 patients, including 40 per cent children, die of rabies every year in Pakistan, says a recently released WHO report.

The report says that the commonly required three-prong strategy comprising public awareness, timely medical intervention and elimination of stray dogs by the civic authorities is ignored.

Consequently, every year around 5000 people in Karachi are brought, bitten by rabid dogs, to the emergency sections of major hospitals. The National Institute of Child Health (NICH) alone registers 1200 such cases involving childern.

Dr S.M.Afaq, deputy director NICH, said that during the current year five cases had been reported so far in which more than 100 children and adults had fallen victim to stray dogs.

The majority of victims comprises low-income people who usually seek assistance from government facilities where the approved anti-rabies vaccine is often not available.

The World Health Organisation has banned the vaccine ARV because of fatal complications and it cannot be administered anywhere even if available free of charge.

As an alternative, five doses of the human diploid cell vaccine (HDCV) are recommended in suspected cases where the animal is not available for observation. The sixth dose is recommended where the animal is confirmed rabid or has bitten more people.

The HDCV for intradermal use, despite its efficacy, is not available in Pakistan. The cost factor may be cited as a hindrance; each vial costs Rs500, bringing the total cost to Rs2500. So the proper and regular campaigning against stray dogs can be termed as the most practical option.

The FDA-approved purified chick embryo cell vaccine is available in Pakistan. Apart from being administered in five intramuscular doses (five vials in five visits), it can also be used as intradermal regimen, that is five doses - one vial- five visits.

According to doctors the schedule should be given intradermally and not subcutaneously. Very little training is required for dispensing the regimen. The cost of one vial is only Rs600. This is considered a breakthrough in the management of rabies where the cost factor is a serious problem leading to thousands of deaths. —APP/PPI