Kerala rabies deaths not due to ineffective vaccines: Central team to Union health ministry
ACKNOWLEDGING AN increase in deaths due to rabies in Kerala, a three-member central panel, which visited the state to investigate the cases, has told the Union Health Ministry the deaths were not due to ineffective vaccine or virus variants escaping immunity.
“Supportive evidence on… issues in anti-rabies vaccine efficacy/ potency and circulation of rabies virus variants escaping protection provided by vaccine could not be found,” it has concluded.
The committee flagged issues with availability of anti-rabies vaccine and serum, knowledge gaps in essential wound washing after animal bite, and health workers not knowing when to administer rabies immunoglobulin. The report said that the “target audience” and staff of anti-rabies clinics must be made aware about wound washing and all clinics must have washing areas with soap and water available.
The report also said there was knowledge gap when it came to the decision to choose the anti-rabies serum for people who have suffered category 3 animal bites that is critical for preventing mortality. A bite is considered to be category 3 when there are multiple bites or scratches that break the skin, broken skin has been licked by the animal, or there is contact with bats. The rabies serum is to be administered in cases. The committee included Dr Simmi Tiwari, joint director at Division of Zoonotic Disease Programme Dr Monil Singhai, joint director, Centre for Arboviral and Zoonotic diseases of National Centre for Disease Control.
As for the availability of the anti-rabies vaccines and serums, the committee said that the vaccines were available only in 30% of the primary or urban health centres while serums were available in 3.5% of all facilities. “Uninterrupted supply… at all levels… must be ensured,” the report said. The committee said that in cases examined there were delays in seeking and receiving appropriate bite management. It also suggested reporting failure of newly introduced rabies monoclonal antibodies, antibodies artificially developed in labs to counter rabies that are likely reduce cost and allergic reactions to the serums.
