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5 year old Nakul is bitten by a dog but can not get rabies vaccination

Price control chokes anti-rabies vaccines supply, India stares at epidemic

 Rohit Shishodia
The danger of a potential epidemic of rabies looms large in Delhi, India's national capital, and in other parts of the country, due to the vanishing from the market of anti-rabies vaccines. These vaccines are not available in state-run health care facilities and private chemist shops too.

Fear and desperation are clearly visible on the faces of tens of thousands of patients who have suffered dog and other animal bites and are returning disappointed from government hospitals. The situation is such that thousands of animal bite patients are going around without treatment, many carrying the rabies virus that can easily be transmitted to other humans around them.

Governments seem to be ignoring the shortage and not taking any action to redress the non-availability of the vaccines as they have not been available for months even in Delhi. Doctors say it is highly risky if people are left without vaccination. This uncertainty will only lead to death as rabies has no cure and results in 100% mortality, if left untreated.

On June 6, 2019, Seema, a resident of Gokul Puri, came to GTB hospital for vaccination of her 5-year-old son, Nakul. But she could not get her son vaccinated due to non-availability of vaccines in anti-rabies clinic for months. She told DTMT, “My son was bitten by a dog on June 1, 2019, but he is yet to be vaccinated.”

“I also went to private chemist shops but they also don’t have these vaccines. I am not much educated. Where should I go and whom should I approach?” asked a desperate Seema.

Like Seema’s son Nakul, there are thousands of other patients who are not being vaccinated in a number of government and municipal corporation hospitals in Delhi. Government hospitals do not have anti-rabies vaccine.

But how has this situation come to pass in Delhi where a large number of desperate patients are not getting treated for rabies? Government officials blame the poor supply. Retailers and distributors blame the government move to bring the anti-rabies vaccine under price control, which has rendered it loss-making to manufacture these vaccines. The stoppage of production has led to this dire situation of a potential rabies epidemic in Delhi and other areas. The government simply does not have the wherewithal to meet the demand for the vaccines and has taken the foolhardy step of bringing it under drastic price control.

Some who not wish be named said that the central government has reduced the maximum retail price of anti-rabies vaccine at Rs 95/- which used to be Rs 350/-. The result is the health emergency faced by the patients.

Prof Jugal Kishore, Director and HOD, Department of Community Medicine, Safdarjung Hospital, Delhi, told DTMT that rabies is a dead end disease and it has 100% mortality. Once a person is affected with rabies, his death is sure. Vaccination has to be administered at the earliest after the animal bite. 90% of rabies cases take place due to dog bites. Non administering of anti-rabies vaccines has increased the risks manifold to non-infected people.  

Prof Kishore added that symptoms of rabies can manifest after ten days or up three years. There are reports that the symptoms of the virus can manifest even twenty years after the animal bite.

The symptoms of rabies are like those of mad dogs who feel tired, nervous and have short breath. Persons affected with rabies choke while breathing and fear that they will die any time. They can bark like dogs and froth and saliva emanate from their mouth.

"This infection is nervous system related and affects the negri bodies of brain. All animal bites do not convert into rabies,” explained Prof Kishore.

“Fluids, saliva and blood transmission from infected person or animal can lead to rabies to other person or animal. In medical literature, only three men could survive after dog bites,” said Dr Amit Gupta from Department of Medicine, LNJPH, Delhi.


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