Eradication of Rabies in Pakistan – Still a Handspan Away
Every morning on the way to work through this hustling bustling city of Karachi, I look around and find fresh looking youngsters, others looking worn and wearied; some in full swing of life and others falling prey to sickness and ill health. But the city isn’t quite the open book it seems to be – harboring untold tales in its dark alleys and eroded public health system.
It’s a surprise to no one that Karachi faces an enormous infectious disease burden. Prevention is always the number one priority of a health care system, but in the case of non-treatable infectious diseases, effective prevention is of utmost importance. By their very nature infectious diseases are communicable, and so all counter measures against them must similarly have a population-wide reach. In the absence of concerted efforts at wiping out infectious diseases, we are left with the gravest of plagues still not gone: polio, tuberculosis, rabies; all nearly eliminated from the rest of the planet.
Let’s focus on rabies today. Rabies – a lethal viral disease, one that hands you a heart-wrenchingly painful death. The rabies virus, a negative-stranded RNA virus belongs to the rhabdovirus family of viruses. The vector of this disease is stray animals, particularly dogs, and it is transmitted from animal to human via animal bites.
Rabies is not a reportable disease in Pakistan and hence its incidence is grossly under reported. There is no specific treatment for rabies. Following a dog bite, the immediate emergency measure to take is to wash the area bitten and administer immunoglobulins (Igs). Other vaccines are given over a period of about two weeks.
The classic symptom of rabies is hydrophobia, i.e. fear of water. This refers to panic and intense spasm of pharyngeal muscles upon looking at water, even thinking about drinking water. Victims not uncommonly are left alone in isolation rooms in hospitals to die a horrifying death.
At present the only way to eradicate this disease is vaccination of all animals, or euthanization, which is culling of stray dogs. The latter has justifiably received criticism for being inhumane. The local city councils should set up a system of reporting all incidents of rabies, providing emergency treatment, and organized vaccination of animals.
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