Rabies encephalitis, a lethal viral but vaccine-preventable disease, claimed another life in Karachi when a man from Khairpur district of Sindh died late on Friday night at the Jinnah Postgraduate Medical Centre, officials said.

“A 55-year-old Rajab Ali was bitten by a stray dog 10 years back but he was not immunised. He was bitten again by a stray dog in Khairpur two months ago and he developed rabies and was brought to Karachi. He was provided comfort care but only survived for four days and expired a short while ago at the JPMC. He was a farmer by profession,” Executive Director JPMC Dr Seemin Jamali told the media late on Friday night.

It was the 13th death due to rabies in the city this year. A 50-year-old woman from District Sanghar died last month, who was also provided hospice care at the Dog Bite Centre of the JPMC after developing full-blown rabies in July 2019.

Experts say rabies was a viral disease that was mainly caused by a bite from a rabid dog and it was incurable if the victim was not given anti-rabies vaccine (ARV) and immunoglobulin immediately after dog bite.

The Sindh health officials said Ali was the 13th victim with full-blown rabies but first from Khairpur district, adding that the number of deaths due to rabies could be much higher in the province, where over 95,000 people have so far been bitten by stray dogs till July 2019.

Dr Seemin Jamali said they provided hospice care -- which focuses on the palliation of a chronically or terminally ill patient’s pain and symptoms -- to the victim and counselling to his family members, adding that the patient had developed hydrophobia and was in immense pain and misery.

“Nothing can be done for such patients and we help them to have maximum peace and comfort in the last days of their life. That is why it is immensely important that people are prevented from dog bite and if somebody is bitten by a stray or even a pet dog, he or she must be given ARV and immunoglobulin,” Dr Seemin said.

A 12-year-old boy from Thatta district of Sindh was the 11th victim of Rabies Encephalitis who died at the JPMC in June, officials of the Sindh Health Department said, adding that six nine people have died due to full-blown rabies at the JPMC, while four people who were mostly children succumbed to the lethal viral illness at Indus Hospital this year.

What is Rabies Encephalitis?

Rabies Encephalitis is a dog-borne viral illness caused mostly by the biting of stray dogs, and if ARV is not administered to the affected person along with immunoglobulin, the patient suffers a miserable death due to hydrophobia and other complications of the disease.

Ironically, Pakistan is facing an acute shortage of ARV after Indian companies reduced its supply to Pakistan, citing growing global demand and lesser production, while the number of dog bite cases is on the rise due to some NGOs’ opposition to killing stray dogs.

Dr Seemin Jamali maintained that it was the ninth death due to Rabies Encephalitis at the JPMC in 2019, while so far 7,000 people have been brought to the hospital this year who were bitten by stray dogs and were given ARV and immunoglobulin at the hospital’s dog bite centre.

On the other hand, four persons also died due to Rabies Encephalitis at the Indus Hospital Karachi, while the hospital received over 7,000 people with dog bite cases who were given treatment along with ARV and immunoglobulin shots at the hospital, informed Dr Naseem Salahuddin, Head of Infectious Diseases at the Indus Hospital.

Over 95,000 dog-bite cases in Sindh have been recorded in the first seven months. As many as 85,000 people, most of them children, have been bitten by stray dogs in the first seven months of the current year in the entire Sindh so far, said Director General Health Sindh Dr Masood Solangi while talking to The News.

As many as 70,000 people were bitten by stray dogs in five divisions of Sindh, excluding Karachi, until May 2019. There are reports of 15,000 to 17,000 dog-bite cases reported at three tertiary-care hospitals of Karachi during this period, Dr Solangi said, adding that dog-bite cases were on the rise as compared to last year, due to growing number of stray dogs in the province.

According to the data of the dog-bite cases, the highest number of dog-bite cases was reported from the Larkana division, where 22,822 people were bitten by stray dogs in the first five months of the year, followed by Hyderabad division, where over 21,099 people fell victim to stray dogs.

Over 12,215 people were attacked and injured by stray dogs in Nawabshah division in the same period, while over 6,000 dog-bite incidents were reported from Sukkur and Mirpurkhas divisions.

Sindh Health Department officials say that between 15,000 and 17,000 people became victims of stray dogs in Karachi’s six districts, adding that the number of dog-bite cases could be much higher, as many people go to private hospitals and smaller health facilities that do not report these cases to the authorities.

“The commissioners have repeatedly been urged to start killing stray dogs after growing incidents of dog-bite cases in Sindh, including Karachi,” Dr Solangi said, adding that he has written to the commissioners of the six districts to six divisions to launch strong and efficient campaigns in their areas to get rid of stray dogs so that people could be saved from being bitten by the canines.

“I have written to the commissioners of all six divisions of Sindh to start efficient campaigns against stray dogs and get people rid of them, as we have difficulty in acquiring ARV, which is essential for preventing people from developing Rabies Encephalitis and meeting a miserable death,” said Dr Solangi.