Rabies due to deadly bites from dogs

India's fight against rabies

09/26/2014

Rabies requires around 55,000 lives every year worldwide. According to estimates by the World Health Organization (WHO), between 18,000 and 20,000 people die each year in India alone. Rabies is transmitted through bites from diseased dogs, monkeys, jackals or cats - and there are countless of them in India. The fight against the virus is correspondingly heavy, especially as the vaccine is scarce and expensive.

Rabies is transmitted by snappy dogs, cats, monkeys and jackals
Time and again, doctors, nurses and caregivers at the Maharishi Valmiki Hospital in the Indian capital New Delhi have to watch people die of rabies. As a particularly bad nurse Sunil Yadav experienced the despair of parents who bring their children too late in the clinic after they were bitten by dogs or monkeys. Because most people in India do not know that rabies always ends fatally when the pathogen reaches the brain and causes meningitis. But the education about the deadly disease is difficult. On Sunday, the World Rabies Day will inform about the virus.

Quick help after animal bites saves lives
After being bitten by an infected animal, the pathogen stays near the portal of entry for about three days, where it multiplies and then travels through the nerve fibers of the peripheral nerves into the spinal cord and finally into the brain. Once it reaches the central nervous system, it also reaches the salivary and lacrimal glands, where it is secreted with its secretions. However, the virus reaches the central nervous system much faster if the pathogen enters the bloodstream through the animal bite. Vaccination is effective only during the early phase in the first few hours after the bite. Once the virus reaches the brain, any help comes too late.

Not every person affected can receive treatment for rabies in India
„We bring everyone who comes to us first to the washroom, "explains Yadav to the news agency, where the wound is meticulously rinsed, cleaned and treated with iodine for several minutes, allowing the number of viruses in the blood to be reduced by up to 80 The patient then receives the rabies immunoglobulin in the form of injections around the wound and into the arm in the opposite room, preventing the pathogen from entering the central nervous system from the wound.

However, such treatment is rare in India. „Anyone who gets bitten should receive serum, "says medical doctor Mukesh Naran, who runs the rabies project in the hospital, to the news agency, but this wish seems to be hopeless: according to UN estimates, around Greater Delhi alone is living 25 million people, the required vaccine but holds only the Maharishi Valmiki Hospital as the only state clinic in stock. „That's the price: A bottle of serum costs 5000 rupees, "said Naran, which is about 64. In private hospitals, most of the clinics, the patients have to bear the costs themselves, but only a few can afford that.

Way to the only state hospital with treatment options of rabies is often too cumbersome
Frequently a rabies treatment already fails during the transport of the patient. Ambulances or shuttle from other clinics to the Maharishi-Valmiki-Hospital are not available. „People come by bus, car rickshaws, cars, bicycles or walk to us, "says the doctor.This is often difficult because the clinic is 35 kilometers from the city center, so traveling is very difficult for many people last due to a bad infrastructure.

Annually, up to 20,000 people in India succumb to rabies. That is more than a third of the world's deaths. What is particularly tragic about this is that there is a preventive vaccine that could significantly reduce the number of people affected in countries like India. Since the vaccine but requires multiple injections on different days and also every two to five years must be refreshed, this possibility is often not used, the doctors report. The procedure was too complicated and expensive.

Vaccination of biting dogs against rabies is just a drop in the bucket
Another way to fight rabies is to catch and vaccinate the transmitter, especially stray dogs. In India, however, there are at least 25 million wild dogs. A law from 2001 prohibits the killing of animals. Nevertheless, an attempt is made, „to reduce the danger of the animals ", explains Ashwath Narayana, Managing Director of the Rabies Foundation in Asia, to the news agency. „That's why the dogs are captured, vaccinated, sterilized, and released, especially in the urban centers. "But that's not much more than a drop in the ocean, because you would have to vaccinate 80 percent of the dogs in order to reach them Gadey Sampath, a doctor at Hyderabad's Institute for Preventive Medicine, told the agency that the vaccine coverage only lasted a year, so the procedure would have to be repeated on a regular basis, but this would require nationwide, coordinated action. „But rabies is not considered an epidemic, "says Sampath.

11-year-old Mudasir Ahmad from Srinagar in the Kashmir valley was the victim of a biting attack on stray dogs. Almost 125 times, the child was bitten and seriously injured. „When we saw him, he was lying in a pool of blood, and more than 20 dogs barked around him, "his uncle Riyaz Ahmad told the news agency, saying the child had to undergo multiple surgeries, including severe head injuries Mudasir the rabies serum. „We have money and could afford the treatment, "states his uncle. „But what about the poor, who helps them??“ (Ag)