The cases of human rabies deaths in the State despite the victims taking anti-rabies vaccine have triggered a major debate over the efficacy of the vaccine.
Public health experts, however, point out that while an annual quality check of the biologicals (vaccine and serum) is necessary, there are several weak links in the system, all of which will need to be studied to evaluate why the five cases of human rabies deaths occurred in the State despite vaccination.
Health Minister Veena George said in the Assembly last week that of the 20 human rabies deaths (As on Aug 28) that occurred in the State, 15 persons had not taken the anti-rabies vaccine. Only four persons had been fully vaccinated as per the rabies vaccination regimen and one had only been partially vaccinated.
On the furore over the “poor quality or low potency” of the vaccine, the fact that the majority of human rabies deaths have occurred because of the failure of people to take the vaccine should not be forgotten, it is pointed out.
On efficacy
While debating over the efficacy of the anti-rabies vaccine, it should also be remembered that of the over one lakh vaccinations administered in Kerala annually, only five deaths have been reported.
Going by the available evidence, public health experts are of the opinion that in all five cases of rabies deaths after vaccination, rather than the potency of vaccine, the nature of the wounds (lacerated wounds involving face, head and neck or hand), failure in proper wound management or delays in administering the immunoglobulin serum could have turned critical.
They also fear that stoking public fears that vaccination against rabies is useless to prevent deaths can in fact be counterproductive and make people turn their face against vaccination.
Now that an expert committee has been set up, all aspects of rabies vaccination, including the efficacy of the intra-dermal vaccination (IDRV), possible failure in the IDRV technique, cold-chain storage of vaccines, adequacy and updation of training in IDRV technique amongst the health staff and, above all, the lack of a uniform protocol for animal wound management in the State and the lack of availability of the life-saving immunoglobulin serum in most hospitals in the periphery should be examined.
Rise in animal rabies
Surveillance reports from the five veterinary laboratories in the State indicate that there has been a high incidence of animal rabies in the State in recent years, in proportion to the increase in stray dog population and the fall in animal vaccination.
Vaccination of all pet animals should be taken up in the State in a campaign mode immediately and even vaccinated animals should be given booster shots as required in the current context, said Swapna Susan Abraham, Deputy Director, State Institute for Animal Diseases, Palode.
Campaign
The Health department is launching a campaign to promote public vigil against rabies, Ms. George said. The focus of the campaign will be on creating public awareness of rabies and the precautions that should be taken to prevent the disease. Awareness creation on the first aid to be adopted and the need for immediate medical attention in the event of an animal bite will focus on schoolchildren also.
Any animal bite, however big or small, should be attended to immediately and after washing the wound with soap and water, the victim should be taken to the hospital as soon as possible and given the vaccine and serum, if necessary. The vaccination schedule should be completed.
The campaign will also focus on the importance of vaccinating pet animals and the importance of disposing of food wastes so that stray dogs do not increase in a locality.
