Rabies is primarily a disease of animals, and is transmitted to man by the bite of an infected animal, usually a dog. It is almost always fatal and one of the most torturous forms of death from any infectious disease. Children under 15 years age are most affected as they play in the streets and are unable to run away or defend themselves against an attacking animal. Many families have been devastated by the loss of a child or a working family member. However, if the victim is given proper wound care and post exposure prevention soon after the bite, rabies is 100% preventable.
Nearly 15-20,000 cases of dog bites are recorded annually among the three major hospital of Karachi, while many more remain undocumented. Some of the bites are severe, disfiguring, as well as dangerous, especially when bitten on the head, face or neck in children. If untreated, the victim may develop the fatal brain infection –rabies, which is irreversible. Occasionally, several rogue dogs maul small, defenseless children. The Indus Hospital (TIH) alone treats 30-40 such dog bites daily.
In response to such tragic injuries, we have formed the ‘Rabies-free Karachi Team’ under the aegis of Indus Hospital Research Center (IHRC). We have identified a fishing village, Ibrahim Hyderi, with a human population of 1.5 million, from where TIH receives at least several bite victimsin a day. Through the Union Council members we have contacted the local population to secure their supportfor elimination of rabies.
WHO/OIE strictly discourages killing of dogs, as not only is this inhumane, but also, ineffective in reducing dog population. WHO/OIE recommends mass dog vaccination (MDV) of at least 70% of dogs in an area, which will produce herd immunity against rabies. In order to reduce dog population, the recommended strategy is to perform Animal Birth Control (ABC).
‘Rabies-free Karachi Team’ proposes to run a pilot project in Ibrahim Hyderi, by means of MDV and ABC. The project for MDV will prevent rabies among dogs, thus interrupting transmission to humans. ABC will yield long term benefit by reducing dog population. The local community will be safe from attacks of feral dogs, which not only create nuisance, but also can be dangerous to adults and children. We have complete support of the Karachi Metropolitan Corporation (KMC) under administration of the Mayor of Karachi, Mr. Waseem Akhtar.
As this will be our first experience in performing MDV and ABC, we have invited experts from Sri Lanka and South Africa to train local personnel and veterinarians who will perform the procedures. Arrangements for their travel and accommodation will be made through official channels.
WHO/OIE is prepared to provide dog anti-rabies vaccine, which will be utilized for vaccination of feral, as well as, owned dogs in Ibrahim Hyderi. We will use the services of locally trained personnel to catch dogs, and vets to perform MDV and ABC procedures. All personnel will be given Pre exposure prophylaxis (PreP) injections against rabies prior to their training.
The success of MDV and ABC will be extrapolated to other areas of Karachi where similar problems abound.