The experts’ committee that conducted a detailed investigation into the 21 cases of human rabies deaths in the State, especially the six deaths wherein the victims died despite having been administered the anti rabies vaccine and immunoglobulin serum, has pointed to the category 3 bites (deep lacerated wounds on face, neck, palms) sustained by these individuals as the possible factor that could have made a difference between life and death.
The committee has also pointed to the delays/failures that occurred when it came to the washing of bite wounds, which could have proved to be a life-saver because immediate washing of the wounds with soap and water can bring down the virus load in the wound by 70%.
The category 3 wounds and the failure to deliver immediate first aid might have led to the direct entry of the virus into the nerve fibres, resulting in human rabies and inevitable death.
Rabies virus has a long incubation period but the fact that many of those who developed human rabies had begun showing symptoms even before the vaccination cycle was over, also pointed to the nature of the wounds aiding faster entry of the virus into the nerve fibres
The committee, which conducted detailed field investigations and verbal autopsies regarding all 21 deaths has also brought focus to the fact that out of the 21 cases of human rabies, the majority—15 persons—had ignored the animal bite and did not take the anti-rabies vaccine or serum.
Given the claims of high health-seeking behaviour in the State, whether these persons remained unvaccinated because of lack of awareness about the perils of animal bites or mere carelessness is something that needs to be probed.
The human rabies deaths that occurred in the State despite the victims being administered the vaccine and serum had led to wild speculations about the efficacy of the biologicals. However, since then, the government had received reports from the Central Drug Laboratories after repeat testing that the biologicals met all quality standards.
Also, blood tests done at NIMHANS of people who had received the same vaccines had reported good antibody response, indicating the potency of the vaccine.
The report was handed over to Health Minister Veena George by the experts’ committee on Wednesday. Ms. George said that the government would take suitable action after studying the report.
The committee, chaired by the Director of Medical Education Thomas Mathew, had as members, Reeta S. Mani, Additional Professor, Department of Neurovirology, NIMHANS; R. Aravind, Head of Infectious Diseases, Thiruvananthapuram Govt Medical College; Swapna Susan Abraham, Deputy Director, State Institute for Animal Diseases, Palode; Director of Institute of Advanced Virology E. Sreekumar, Assistant Director (Public Health) S. Harikumar; and P.M. Jayan, State Drugs Controller as members.