synopsis

Kerala has been witnessing a steep rise in stray dog attacks with several being severely injured or dead. 19 people have died of rabies poisoning so far this year. Five deaths occurred in 2020 and 11 deaths in 2021. Last year more than five lakh people were bitten by cats and dogs.

Government figures indicate a sharp rise in the number of dog and cat bites in Kerala. Till the month of June, 1,47,287 people have sought treatment in government hospitals due to dog bites. 19 people have died of rabies poisoning so far this year. Five deaths occurred in 2020 and 11 deaths in 2021. Last year more than five lakh people were bitten by cats and dogs.

Number of dog bites since 2017:

2017 - 1,35,749
2018 - 1,48,899
2019 - 1,61,055
2020 - 1,60,483
2021 - 2,21,379
2022 - 1,47,287 (so far)
The death toll has also skyrocketed

Even though the number of people bitten by stray dogs is more than one lakh in previous years, the death due to rabies is happening since 2020.

So far this year, 19 people have died of rabies. In 2021, 11 deaths occurred due to rabies. There were five deaths in 2020. There are complaints that 3 people who died this year could not survive despite taking the vaccine.

Sreelakshmi (19 years old), a college student who was being treated for rabies in Palakkad Mankara, died in the month of June. The girl had taken all four vaccines as per the instructions of the health department. The first vaccine was taken from Thrissur Medical College. Of the remaining three doses, two were from Palakkad District Hospital and one from Valluvanad Hospital. A woman named Sheela died of rabies in Thrissur in the month of July in the previous year. They had also received the vaccine.

After this, Chandrika, a resident of Perampra Koothali, Kozhikode, was bitten by a stray dog ​​at Puthyedath and died despite taking the rabies vaccine. She died while undergoing treatment at Kozhikode Medical College Hospital. On July 21 last year, seven people, including Chandrika, were bitten by a stray dog ​​in the field in front of the house. They were vaccinated against rabies first at the Perambra Taluk Hospital and then at the Medical College Hospital.

A stray dog ​​that bit four people in Mala, Thrissur has been confirmed to be infected with rabies. In Alappuzha and Kayamkulam also similarly stray dogs attacks took place. 9 people including the home guard were injured that day. A street dog attacked passers-by near the Kayamkulam police station. Stray dog ​​nuisance is also rampant in Vaikom.

Why does death happen?

The virus enters the body through the wound through the dog's saliva. The virus reaches the brain and spinal cord through nerves. It takes days and weeks for this virus to attack humans. The speed of reaching through the nerve is 5-100 mm per day. If it reaches the brain and spinal cord, rabies can be confirmed. Death is certain because a person infected with rabies can never come back to life. Bites on the face and hands can sometimes spread the virus quickly to the brain.

Also, is immunoglobulin given with the vaccine to those who are seriously injured?

RIG (rabies immunoglobulin) are ready-made anti-rabies antibodies. After first aid, the injection is done directly into the open wound. These antibodies instantly destroy any remaining virus in the area.

Another important question is whether to check the depth and intensity of wounds in dog bite victims and give immune globulin along with the vaccine. Health experts say that immune globulin should be given to those bitten on the face and neck. If it is not applied directly to the wound, it will not be effective. There is also a need to check whether it is given accurately. The government should clarify how many hospitals in the government sector are getting enough immunoglobulin. The hospital authorities themselves say that many of the lower-level hospitals do not have a stock of immunoglobulin.

Is there a situation where vaccine injection guidelines are not followed?

The rabies vaccine is injected intradermally (into the skin) or intramuscularly (into the muscle). It helps in creating an immune response in the body. The vaccine becomes active in about 7 days. However, once the virus has already reached the brain or central nervous system, antibodies circulating in the blood cannot eliminate it.

This is because large molecules of antibodies cannot cross the blood-brain barrier that protects the brain and spinal cord. The earlier the vaccine is taken, the more likely it is to prevent the virus from reaching the central nervous system. So don't delay getting the vaccine if bitten. Vaccine injection is done on the basis of National guidelines for rabies prophylaxis of the National Center for Disease Control of the central government. If this is not followed, the effectiveness of the injection is likely to be reduced.

Failure to maintain or store vaccines:

The question arises as to whether cold storage of vaccines is better. Anti-rabies vaccine should be stored at 3 to 8 degrees Celsius, even a small difference in temperature can affect its quality. Even if the power supply goes out, it is a problem. It is also important that such a system is accurate in all areas where the anti-rabies vaccine is administered.

As there are no vaccine testing systems in Kerala, we have to trust the manufacturers.

Quality of the vaccines:

There is no system in Kerala to check the quality of the vaccine. The vaccine should be taken to Central Drug Laboratory (CDL) Kasauli for testing. The vaccine must be transported by plane to the lab at the correct temperature. For that one has to go with the cache of vaccines. It is impractical for the drug controller department to take a plane ticket and send someone to Kasauli with a vaccine at the right temperature.

The serious lapse is that the government did not take any action to ensure that the batch of vaccine given to those who died despite taking the vaccine was of quality. The most serious thing is that despite the controversy, the Drugs Controller Department has not received any complaint from the Medical Services Corporation or any notification to send the vaccine for testing. In other words, even when people and health experts express concern, there is no action on the part of those responsible.

The question of the drugs controller department is how can it be checked without receiving a complaint, and it can proceed according to the norms? 

Even the drug test is only for the sake of the name. By the time the test result of the drug to be tested comes out, the batch of drugs will be completely consumed. In short, we can trust the manufacturers, their tests, and drugs, injections, and vaccines. It should be noted here that fake vaccine use was reported in India in 2002.

Illegal vaccines:

When there was a severe shortage of rabies vaccines, the health minister instructed the corporation to take immediate steps. The 16,000 vials of vaccine that arrived in Kerala not only lacked the final certificate from the Central Drug Testing Lab (CDL) but also did not complete the preliminary tests required by the manufacturers. The rule is that the company should monitor the drug for 14 days, but only 7 days were completed.

Sterilization, vaccination and sheltering of stray dogs are done as per the Animal Birth Control (Dogs) Rules, 2001 made to reduce the number of stray dogs. According to this rule, municipalities should take steps to ensure sheltering of dogs and ensure their care in coordination with animal protection organizations. The Animal Birth Control Program (ABC) is a program developed by the World Health Organization to control stray dog ​​populations and rabies.

Local bodies cannot take their own funds to carry out the neutering of dogs as it is too expensive. Starting from hiring skilled people to catch the dogs, their salary, vehicle rental, veterinarian's salary, and taking care of the captured dogs even after the surgery is a huge expense. There are local bodies that don't even have space to house them.

In the event that the amount could not be diverted from their own funds, the local bodies have stopped dog breeding and neutering altogether. With this, the number of stray dogs increased. The number increased to such an extent that people cannot even walk on the road.

The reason why the street dog nuisance is so severe is because of the increase in garbage. The government is not taking effective measures to solve it.