KARACHI, June 12: Whenever a dog or cat bites a person, immediate steps should be taken to prevent the onset of rabies, two doctors in the know told Dawn on Tuesday.
First of all the wounds should be washed, said Dr Naseem Salahuddin of the Infectious Diseases Society of Pakistan. “This will result in the virus becoming non-virulent. That is, the virus will become weak,” she said.
Next, the person bitten by an animal, that may or may not be suffering from rabies, should be taken immediately to a hospital where the verocell, PCEC or PDEC vaccine could be administered. Dr Seemin Jamali of the Jinnah Postgraduate Medical Centre said six shots of such a vaccine were needed. Dr Salahuddin, on the other hand, said only five shots were sufficient.
Both doctors said the first shot should be administered soon after the accident, if possible within a few hours of the accident. The vaccine can be administered easily in the arm. The cost of one shot was about Rs600, said Dr Jamali.
According to Dr Salahuddin, human immuneglobulins should also be administered to the patient. “But this depends on the category of the bite. If the case is of category one, in which only a few minor scratches have appeared on the skin, immuneglobulins may not be required.”
But if the bites are of categories II or III, immuneglobulins should be administered quickly, she said. Dr Jamali said if the bite wounds were on the face, neck or head, immuneglobulins were required.
In case the dog which had bitten the person was decidedly rabid, immuneglobulins were needed, agreed the two professionals.
Dr Jamali said the cost of one vial of immuneglobulins, containing 300 international units, was between Rs5,500 and Rs6,000. The total number of vials to be administered depended on the patient’s weight.
The recommended dosage was 20 international units per kilogramme body weight. Therefore, if the weight of the bitten person was 70kg, then the person would need 1,400 international units of the medication. This translated into 4.6 vials.
Since this is the minimum requirement, five vials should be administered, said Dr Jamali. The cost of the immuneglobulins alone, in this case would be more than Rs20,000.
Dr Salahuddin said sheep brain vaccines, which entailed 14 shots to the abdomen area, were no longer recommended by the WHO.
However, said Dr Jamali, some hospitals still used these outdated vaccines.
Dr Salahuddin said the efficacy of the vaccine was not established. That’s why it should not be used.