Tharparkar man's death takes Sindh's rabies toll to 38

Two more rabies cases were recorded at Karachi hospitals on Monday, a death and a child fighting the infection, taking the number of rabies cases reported in Sindh this year to 38, as doctors warned that the stray dog population and dog-bite cases were both rising.

Died despite four doses

A 38-year-old man from Tharparkar, identified by Indus Hospital as Naimatullah from Nohriyo village in Diplo tehsil, died of rabies at Indus Hospital Karachi, Dawn and The Express Tribune reported.

He had been bitten by a dog about two and a half months earlier and received four doses of the rabies vaccine at the tehsil headquarters hospital in Diplo between late July and early August. He was admitted to Indus Hospital on October 7 after developing symptoms.

Doctors believe his wound had not been properly washed when he was given first aid. “While the most important factor in preventing rabies is receiving post-exposure prophylaxis, the rabies vaccine and rabies immunoglobulin if needed, on time, a dog bite victim can still develop the infection if the wound is not properly washed,” a doctor told Dawn.

A child in intensive care

The second case is a 12-year-old boy from Hyderabad who was brought to the emergency department of the Jinnah Postgraduate Medical Centre (JPMC) with hydrophobia, irritability and fits.

He had suffered severe dog bites to his hand and chest about two months earlier, but his family had not sought any treatment, a senior doctor said. A neuromedicine team was called in after doctors suspected rabies encephalitis. The boy was given his first vaccine dose in the emergency department and was being moved to the intensive care unit, The Express Tribune reported.

The numbers this year

• Indus Hospital Karachi: 29 rabies cases and more than 15,000 dog-bite cases
• JPMC: eight rabies fatalities, according to The Express Tribune, and around 11,000 dog-bite cases
• Indus Hospital Badin: one rabies death
• Who is affected: patients from across Sindh, including Karachi, with a significant number of children, Dawn reported

Experts say many rabies cases go unreported because patients use home remedies or turn to faith healers for “treatment”.

What doctors advise

JPMC chief medical officer Dr Ammar Danish said the government had launched awareness campaigns, but public awareness remained inadequate. He said the stray dog population was growing and dog-bite incidents were rising rapidly.

His advice:

• Wash at once: clean dog bites or scratches thoroughly with soap and running water for at least 15 minutes
• Get help fast: go to the nearest hospital without delay, without waiting for symptoms to appear
• Complete the treatment: rabies vaccination and, where needed, rabies immunoglobulin are essential
• No home remedies: do not apply chilli, oil or other substances to wounds

Rabies is almost always fatal once symptoms appear, but it can be prevented with early wound cleaning, timely vaccination and immunoglobulin.

Why it matters

Every one of these deaths could have been prevented. Experts are calling for public awareness, humane control of the dog population and proper treatment in hospitals. Until that happens, families in Sindh will keep losing loved ones, many of them children, to a disease the world knows how to stop. Read our report on cancer patients abandoning treatment at JPMC over costs.

This article draws on reporting by Dawn and The Express Tribune.