ISLAMABAD, Nov 16: The National Institute of Health (NIH) has initiated a process of acquiring cell culture rabies vaccine- manufacture technology from China.

Clinical trial of the rabies vaccine is in progress at the NIH and the cost of the vaccine has been estimated at almost half of that imported by multinational companies, a spokesman for the NIH said.

The NIH through its Rabies Prevention and Control Programme, started in the year 2000 with the support of WHO and the ministry of health, has trained more than 200 doctors and paramedics through refresher courses, workshops and seminars to treat the animal-bite cases, he added.

The spokesman said mere vaccination of dog-bite cases was not the answer to control rabies. Instead, he said, elimination of stray dogs has to be given equal importance for which the cooperation of local bodies, district governments and municipal administration is imperative. Besides, pet dogs and cats should be vaccinated.

He said rabies infection was almost 100 per cent fatal if proper post-exposure treatment was not given immediately after the bite. "No vaccine in the world gives 100 per cent protection against infection or disease."

According to a WHO report, human rabies deaths have been reported despite post-exposure treatment with tissue culture vaccine.

The spokesman said rabies vaccine (sheep brain type) was a very delicate biological product and highly temperature- sensitive. Utmost care is required for the maintenance of cold chain during transportation and storage in hospitals and dispensaries.

However, he said, every batch of rabies vaccine was issued by the NIH after test and release from the quality control laboratory. Therefore, quality is not questionable, but efficacy depends on a number of factors such as proper maintenance of cold chain, time interval between bite and the start of treatment, use of rabies immunoglobulin, booster doses and individual's own response.

Several thousand doses of this vaccine are used all over the country and the NIH, on average, treats 30 to 35 cases of animal bites in a month with the same sheep brain vaccine following the recommended treatment protocol with good results, he said.

Proper management of the case at the health facility level is vital and several factors like site of bite, status of the biting animal, proper first-aid treatment, interval between bite and start of treatment, immunogenic response of the patient to the vaccine have to be considered, he said.