The Hindu : Lack of trained staff hits anti-rabies treatment

Online edition of India's National Newspaper
Tuesday, Jul 16, 2002

Southern States

Southern States - Kerala-Thiruvananthapuram

Lack of trained staff hits anti-rabies treatment

By Our Staff Reporter

THIRUVANANTHAPURAM JULY 15. The anti-rabies treatment unit, which was shifted from the Public Health Laboratory (PHL) to the General Hospital, the only referral centre for rabies cases for the southern districts, is facing dearth of staff trained to treat the potentially fatal zoonotic disease.

Though the unit was shifted from the PHL to the General Hospital a month ago as a measure for streamlining the preventive treatment for dog-bite victims, neither the full complement of staff nor vaccine storage facilities have been relocated on the new premises.

The anti-rabies unit is currently functioning as part of the General Surgery unit at the General Hospital. At present, only two assistant surgeons from the PHL have been deputed on a temporary basis to run the anti rabies unit at the hospital. It is learnt that these staff would be redeployed at the PHL next month. Previously, the patients were examined at the PHL and sent over to the General Hospital for administration of vaccines.

It is pointed out that the general surgery units are already tied up with managing the out-patient units, operation theatres and post-operative wards and would be hard pressed to undertake effective rabies management. The anti-rabies unit would have to be upgraded into a full-fledged centre with adequate trained staff, vaccine storage facility and uninterrupted supply of vaccines, if it was to provide effective anti-rabies treatment.

The anti-rabies unit would require a basic staff of three doctors, two nurses and an assistant to provide effective rabies management. The shortage of rabies vaccines is also a recurrent problem though according to the current stock position, the vaccine vials are sufficient for a month.

Over 50 dog-bite victims are referred to the anti-rabies treatment unit every day. The referrals are from as far off places such as Pathanamthitta and the border districts of Tamil Nadu. Referrals are also made from the anti-rabies unit at the Medical College, which does not have the facility for rabies immune globulin treatment.

It is pointed out that examining the history of the suspected rabies patient is as important a component in rabies management as it is time-consuming. It is essential to distinguish true rabies from rabies hysteria, a psychological condition in persons who think they may have been bitten by a rabid animal.

Often, at the conclusion of a thorough examination, only 50 per cent of the patients would require to be put on anti-rabies prophylaxis, which are administered in the form of human diploid cell rabies vaccine or the rabies immune globulin.

According to doctors, rabies management also has an important counselling component that could be time-consuming as well. Often, the suspected victims and their families would have endless doubts about precautionary measures to be taken or observable behavioural changes that they should be alert about during the treatment.

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