Following reports of a shortage of anti-rabies vaccine in the state of Karnataka, the state health department has reached out to officials in Kerala and Tamil Nadu to ensure that there is a minimal supply of the vaccine available in hospitals across the state.
While Kerala will be providing 10,000 vials of the vaccine to Karnataka, Tamil Nadu will be providing 5,000 vials of the vaccine.
In addition, the Karnataka State Health and Family Welfare department has also decided that it will be placing orders for the anti-rabies vaccine with manufacturers of the vaccine directly, rather than approach the Karnataka State Drugs Logistics and Warehousing Society. Till date, the Karnataka State Drugs Logistics and Warehousing Society has been the one to provide the vaccine to government hospitals and healthcare centres in the state.
While tenders for the supply of drugs were issued in December 2018 and January 2019, they were not met with a good response. Officials from the state had earlier said that they would be floating another tender, however, they have now decided to approach manufacturers of the vaccine directly instead.
While a nationwide shortage of the vaccine has been reported, some states such as Kerala and Tamil Nadu have a long term contract with companies which supply them with the vaccine. As a result, the two states now have an adequate stock of the vaccine. Dr Sajjan Shetty, Joint Director of the National Vector Borne Disease Control Program told TNM earlier that the hospitals were initially being told to procure the drugs from an open market source using funds which had been allocated to the hospitals.
An anti-rabies vaccine is administered to people who present with dog bites or any other exposure to a rabies-infected animal. It is given over a period of a few weeks in four doses. The immediate steps to be taken when someone is bitten by an infected animal is to wash and cleanse the wound thoroughly with soap and water after which a tetanus toxoid injection is given. The vaccine is given after this.
The rabies virus is a member of the Lyssavirus genus. When an infected animal bites a person, the virus may enter via the wound. Domestic dogs have been noted to be the most common hosts of the disease, with the World Health Organisation (WHO) having estimated that 99 percent of human deaths occur due to dog bites. It further notes that the disease can be prevented entirely utilising the vaccine.
The virus enters the broken skin and makes its way to the brain through the bloodstream. Upon reaching the brain, the symptoms of the disease begin to manifest in the individual. This may be either “furious” or “paralytic” in nature. The furious type of symptoms are what are usually seen and can appear as insomnia, anxiety, confusion, agitation and even hydrophobia (fear of water). In the paralytic type, people may lose control over their sensory functions. Furious rabies is more commonly seen, with up to 80 percent of cases presenting in this manner.