Various government hospitals throughout Karnataka have been reporting a shortage of anti-rabies vaccine (ARV), compelling the state government to directed hospitals to turn to private sources or the ‘open market’ to procure ARV for time being. A circular regarding the matter has been sent to government healthcare centres and health officials throughout the state.
“For the time being, we have received a stock of the vaccines from Kerala which is being distributed to the hospitals which require it,” Dr Sajjan Shetty, Joint Director of the National Vector Borne Disease Control Program, told TNM. “We have also issued a circular which has directed all government healthcare centers (hospitals and PHCs) to procure the drugs from an open market source using funds from the Arogya Raksha Samiti (ARS) and National Free Drug Supply (NFDS) as needed.”
All hospitals and healthcare centres which fall under the government sector are entitled to use these funds to ensure that there is a stock of necessary drugs. The NFDS was instituted to provide high quality drugs and other pharmaceutical products and equipment to health institutions which fall under the Directorate of Health and Family Welfare Services.
Government hospitals and healthcare centres obtain the drugs they need to maintain a stock from the Karnataka State Drugs Logistics and Warehousing Society. Tenders for the supply of drugs were issued in December 2018 and January 2019, but did not receive a good response. Officials looking into the situation have stated that another tender has been drawn up and that the problem will be sorted out soon.
In Bengaluru, while government hospitals do not have enough stock of the vaccine, hospitals run by the BBMP have an adequate stock of both - the ARV as well as the Human Rabies immunoglobulin which is also administered to those who require it, a BBMP source told TNM.
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. If a person has been bitten by an infected animal, the wound must be thoroughly cleaned with soap and water. Following this a tetanus toxoid injection must be given, after which the anti-rabies vaccine must be given over a period of weeks.
The rabies virus is spread to humans via a bite or scratch from an infected animal. The virus belongs to the Lyssavirus genus. Domestic dogs are the most common hosts, though other animals can be carriers. The World Health Organisation (WHO) estimates that more than 99 percent of human deaths as a result of rabies are the result of dog bites. When an infected animal bites a person, the virus can enter the body of the person via the saliva of the animal through the wound. The WHO has stated that the disease can be prevented entirely through the use of the anti-rabies vaccine. Furthermore it states that ‘mass dog vaccination campaigns’ have been able to curb the spread of rabies in several countries.