KARACHI, July 25: A 10-year-old boy from a village in Mirpurkhas district died of rabies at the Civil Hospital Karachi on Friday night, indicating that the healthcare system needed to be geared up to handle dog-bite cases in an efficient manner.
Dr Tariq Kamal Ayubi of the Civil Hospital told Dawn that Bharo, a resident of Somaar Goth in Mirpurkhas, was bitten by a rabid dog on July 1. But, he was administered the proper kind of anti-rabies vaccines on Friday, that is 23 days after he was bitten by the dog.
Describing the details of the case, Dr Ayubi said: "The boy was taken to a nearby health centre immediately after the incident, where he was administered 14 shots of the sheep brain vaccine, which incidentally has been discarded world wide," he remarked.
The World Health Organization (WHO) has also advised against the use of this vaccine. "When the family members, two of whom were also bitten, realized that despite vaccination his condition was deteriorating fast, Bharo was taken to the Liaquat Medical University Hospital, Jamshoro. There, the family was advised that the boy should be taken to the Civil Hospital immediately," he said.
Dr Ayubi said that when Bharo was brought to the Civil Hospital Karachi on Friday he was given three vials of immunoglobulins. "This is a passive immunization which should be given in every dog-bite case. But because very few doctors know of this, the health centres in the interior administer the sheep brain vaccine which is produced in Islamabad."
He said that Bharo's brothers were also administered immunoglobulins. Elaborating why shots of immunoglobulins were necessary in dog-bite cases, the doctor said that the sheep brain vaccines took from seven to 10 days to act against rabies.
"So, if the dog bite wound is near the head, the sheep brain vaccines prove useless. The immunoglobulins, on the other hand, start the action right away," he added. Dr Seemin Jamali of the Jinnah Postgraduate Medical Centre told this reporter that her hospital had stopped using the sheep brain vaccine several years ago. She said: "We always insist on administering immunoglobulins."
Meanwhile, Dr Naseem Salahuddin of the Infectious Diseases Society of Pakistan (IDSP) appealed on Saturday to immediately launch a campaign against stray dogs. "We have met City Nazim Naimatullah Khan several times and apprised him of the menace of dog bites.
The Nazim had promised us about a year ago that a campaign would be launched as soon as money was available. But no action has been taken so far in this connection," she said. Dr Naseem said that she would meet Naimatullah Khan again and urge him to launch a drive.
In the meantime, she said the IDSP would start a campaign at its own. "Under the very initiative, we will make efforts to educate public that dog bite cases can kill. We will also tell the masses that rabies was not treatable," she added.
