129 died of rabies at Indus Hospital, JPMC in 10 years: study.

KARACHI -- As many as 129 patients have lost their lives to rabies in over a decade at two major tertiary care hospitals of the city. Most of the victims travelled by road to Karachi after failing to receive treatment at health facilities in the interior parts of Sindh, says a research study.

Recently published in the journal Transactions of the Royal Society of Public Health and Hygiene, the research is authored by Dr Naseem Salahuddin and co-workers at the Indus Hospital and Health Network (IHNN).

The study analysed 129 cases of the fatal disease reported at the emergency departments of the IHNN, Karachi, and the Jinnah Postgraduate Medical Centre (JPMC) between January 2009 and December 2019.

There was a complete lack of information on the number of rabies deaths in Pakistan as it was not a 'notifiable ailment', she added.

It revealed that there is very poor awareness of rabies prevention among laypersons, and home remedies such as application of salt, chillies, etc., are often employed, which preclude correct post-exposure prophylaxis (PEP) and may actually be harmful.

'Most people do not wash the wound immediately with soap and water, as recommended, as this simple process would remove saliva and dirt, and reduce chances of rabies by 30 per cent. The challenge is that most deaths occur in rural areas where the victim is taken to a shrine for dum-dua,' Dr Salahuddin shared.

Neglected disease

According to the study, rabies is a grossly neglected disease in Pakistan. The 129 cases of the fatal disease were either the result of a lack of awareness or the non-availability of anti-rabies vaccine and rabies immunoglobulin (RIG) at the healthcare facilities where the victim initially reported after the bite.

'The disease is 100 per cent fatal if not treated effectively soon after a bite from a rabid animal, whose saliva contains the rabies virus. Once inoculated into the skin or mucous membranes, the virus travels gradually toward the central nervous system and results in acute, progressive encephalitis (inflammation of brain tissues),' it says.

Rabies can be completely prevented if the wound is immediately and thoroughly flushed and washed with soap and flowing water, followed by an effective anti-rabies vaccine series and rabies RIG injection into each bite wound.

Failure to get complete vaccination

Under the study, one rabies case was attributed to a cat while another to a jackal, while all other attacks were reported from stray dogs and...