KARACHI, Sept 17: Senior doctors at a workshop stressed promotion of the WHO-recommended post-exposure prophylaxis vaccine in treating patients of rabies, a fatal disease yet preventable if a victim is administered this vaccine immediately after his is bitten by dog. They observed that the use of sheep brain vaccine, Semple, had now become obsolete and most of the countries in Asia were no longer using the same. In response to protests by various groups, the NIH Islamabad has also reduced its production.

The workshop, on Rabies Prevention and Surveillance of Dog Bites, was organized jointly by the Infectious Disease Society of Pakistan and JPMC at the latter’s College of Nursing here on Saturday.

JPMC Director Prof Mashhoor Alam said rabies was not a problem being faced only by Pakistan, but also by other countries of the region, including India and Iran. “It is necessary for doctor to properly assess the rabies patient, analyze the case and determine the required dose accordingly, keeping in mind that a smaller than required dose will be ineffective,” he added.

He emphasized on creating awareness regarding urgency of treatment, saying that rabies patients must rush for appropriate treatment. He also called for elimination of stray dogs by municipal administrations.

Prof Alam announced that an ‘infection control committee’ would be set up at the JPMC to check and control all types of infections, including rabies, within the hospital.

Earlier, in his welcome address, JPMC Deputy Director Dr Seemin Jamali said that rabies virus was not carried in blood and only intermittently in saliva, CNS, fluid, urine and some tissues. The patients should be handled in a private and quiet area where all staff should enter with gowns, goggles, masks and gloves. “This is particularly important when intubations and suctioning are performed,” she added.

Dr Jamali said tissues and fluids should be disposed of in the same manner as was in practice in the cases of other infectious diseases, like tuberculosis, hepatitis, etc.

President of the Infectious Disease Society of Pakistan and a Member of the WHO Rabies Expert Panel Dr Naseem Salahuddin pointed out that in the application of Semple vaccine, a patient had to be administered a doze for 14 consecutive days but in many cases patients would default because of various reasons. But with the introduction of Tissue Culture Vaccine (TCV), she added, this cumbersome procedure had almost been eliminated.—PPI