Supply of anti-rabies vaccines critically low at SMHS

Srinagar, Apr 1: The supply of anti-rabies vaccine in government hospitals across Kashmir is alarmingly low.

An official of anti-rabies section at SMHS hospital claimed that the hospital faces a shortage of the vaccines.

“We are in a supply limitation situation where rabies vaccine supplies are less than ideal. The stocks might run out soon. It’s high time they replenish it,” he said.

The Kashmir’s tertiary care hospital registered more than 14,000 cases of dog bites from across the valley in the last three years.

Official data accessed by The Kashmir Monitor shows that more than 900 cases of dog bites were reported in the first two months of 2019.

Nazir Ahmad, Extension Educator at SMHS hospital, the only anti-rabies clinic in Kashmir, said the hospital currently has only 100 vials of the vaccines stored in ice-lined refrigerator (ILR).
“Our HOD has made these available for emergency cases and we give vaccines to only those who cannot afford to purchase them from the open-market,” said Nazir.

There are three categories of animal bites. Category I involves touching or feeding animal, lick on intact skin, which requires no action.

Category II involves nibbling of uncovered skin, minor scratches or abrasions without bleeding; in that case, the wound needs to be cleaned and the patient administered Anti-Rabies Vaccination (ARV).

The third category involves single or multiple transdermal bites or scratches, licks on broken skin or contamination of mucous membrane with saliva; in that case, the wound needs to be cleaned and the patient given Anti-Rabies Vaccination along with Rabies Immunoglobulin.

Dr Ambreen, Demonstrator Department of Community Medicine and In-charge at Anti Rabies Clinic SMHS, said that at periphery hospitals, category III medicos are given vaccines in accordance to the old guidelines, which wastes more vials of vaccines.

The doctor said that earlier vaccines were given as per the five-dose regimen, where the vaccines were administered on days 0, 3, 7, 14 and 28.
“But now, the guidelines have been updated. It (vaccines) is now given as 0, 3, and 7.”

Moreover, Dr Ambreen said that category III patients necessarily need Rabies Immunoglobulin “but we receive referral category III patients from periphery hospitals who are not given the Rabies Immunoglobulin vaccines which can be fatal for them.”

Dr Mohammad Salim Khan, Head Community Medicine, SMHS said, “It is a major issue that there is an acute shortage of vaccines in the hospitals in the valley and even at the national level.”
He said the basic problem was the production of vaccines, which, he claimed, had drastically decreased over the years.

“We have suffered many difficulties to keep the supply available in the hospital for the major emergency cases,” he said.
Director Health, Dr Kunzes Dolma refused to comment on the issue.