Girl dies of rabies in Kerala despite 3 jabs

Following the increase in stray dog bite cases in Kerala — resulting in deaths in a few incidents — including the 12-year-old girl who died on Monday despite taking rabies vaccine, the issue has now reached the Supreme Court.

The girl who was undergoing treatment for dog bite in Kottayam Medical College Hospital and had even taken the rabies vaccine, passed away on Monday in Pathanamthitta, said people in the know of the development.

The minor was bitten on August 14 when she had gone out to buy milk and had suffered six wounds including one on her face, said persons in the know of development. Her parents said that after being rushed to the hospital, she had taken three out of four doses of vaccine before her condition deteriorated.

The stray dog bite case was not the first one as the number of such cases have been on rise in Kerala, following which, two petitioners, Father Gevarghese Thomas and Sabu Stephen had moved the court.

The plea was earlier posted for September 26, but was pushed forward toSeptember 9after the counsel’s repeated intervention citing mounting dog bite cases.

The top court agreed to take up the petition on September 9 after counsel, for the petitioners, V K Biju insisted that there was a steady hike in cases in Kerala and also cited the case of the 12-year-old girl’s death.

“From god’s own country Kerala has become a dog’s own country. Aged, daily-wagers and children are getting attacked. It is serious issue especially affecting the poor,” the counsel contended.

As per the Kerala health ministry statistics, over 95,000 people were bitten by dogs in eight months this year and 14 deaths were reported compared to 11 last year. Out of 14 deaths, five had taken the rabies vaccine. Worried, the state government last week had announced an experts’ committee to probe these deaths and examine the efficacy of vaccines.

Union minister of fisheries and animal husbandry P Rupala told the Lok Sabha last month while answering a question of Communist Party of India (Marxist) leader A M Ariff that Kerala was among the top six states with maximum number of dog bite cases in the country.

Statistics in last five years also show cases are going up steadily in the state: from 1,48,899 in 2019 to 1,21, 529 cases till August 2022. Rabies deaths are also on the rise: From nine cases in 2018 to 14 deaths till August 2022.

Meanwhile, as per experts, deaths are preventable in almost 99% cases with effective administration of rabies vaccine.

Animal lovers have meanwhile blamed sheer apathy and shoddy animal birth control (ABC) programmes for the sorry state of affairs. They said the situation worsened after the Animal Welfare Board of India stopped Kudumbhasree, a women self-help group, from carrying out the ABC saying it was not maintaining proper standard while carrying out the sterilisation drives.

“For many local bodies, ABC is just a ritual. They open their eyes when the threat reaches its peak. In 2016, the apex court had appointed a committee under former high court judge Siri Jagan to study the stray dog menace and most of his recommendations were not implemented,” said Hari Kumar, an animal rights activist. Responsible ownership of pets, effective ABC and scientific waste management will go a long way in tackling the issue, the activist said further.

Last week, chief minister Pinarayi Vijayan had also admitted in the assembly that “few deaths despite taking vaccines have increased concern of people.” Last month, in Palakkad an 18-year-old girl died a month after taking the full course of rabies vaccine.

“It all depends on the nature of bite. How deep it is and how close to vital organs? If virus reached the brain or spinal cord the antibodies circulating the blood are unable to eliminate it. Large molecules cannot cross the blood brain barrier that protects brain and spinal cord. Earlier the vaccine it is better,” said internal medicine expert Dr N M Arun.

“Published studies find that excessive viral load from multiple and deep bites, wounds on the face or delay in wound washing, delay in seeking medical care, failure to give immunoglobulin into wounds, low potency vaccine and deviation from protocol can be fatal. Usually rabies occurring in spite of vaccine is very rare. We need more studies into it,” said health expert Dr Rajeev Jayadevan.

“It is sad despite our best efforts we could not save the little girl. We have already constituted an expert panel to study such deaths,” said state health minister Veena George.

Congress leader Ramesh Chennithala asked the government to probe the parents’ compliant that the girl was not given proper treatment in a local government hospital initially.

Meanwhile the samples of the deceased sent to NIV Pune confirmed heavy presence of rabies virus. “One of the bites was close to her neck. It turned fatal affecting her brain. She was also administered immunoglobulin,” said medical college superintendent Dr PK Jayaprakash.

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