Rabies risk soars as over 304,000 stray dog attacks reported in Sindh last year

KARACHI: A staggering 304,069 dog bite cases were reported to the public sector healthcare facilities in Sindh in 2024, with a yearly average increase of 25,800 cases since 2021, exposing the province's struggles to contain the stray dog menace and prevent the spread of rabies.

Experts and literary searches reveal that rabies poses a significant public health threat due to the presence of a large stray dog population. These animals frequently attack people without provocation, necessitating treatment and protection from rabies in both urban and rural areas. However, decision-makers and authorities are struggling to find effective solutions to manage the stray dog population.

A senior KMC health officer emphasised that town, union council, or district municipalities are responsible for managing stray dogs, as well as other wildlife. “Despite the high incidence of dog bite cases, authorities have yet to find a meaningful solution, with debates surrounding culling or spaying/neutering remaining unresolved.”

He, however, estimated that around 6,000 dog bite cases are attended annually at three rabies focal hospitals of KMC, with a maximum of cases registered at Abbasi Shaheed Hospital.

Observers note that children under 15 are disproportionately vulnerable to rabies, as they often play in streets and are unable to defend themselves against attacking animals. Although government quarters have pledged to implement the capture, neuter, release (CNR) method in partnership with animal welfare organisations, progress remains elusive.

A recent study found that Sindh lacks specific legislation explicitly prohibiting the culling of dogs or other animals. Furthermore, efforts to isolate rabies-affected dogs have been limited, and culling has not been effectively implemented.

According to data acquired from the Sindh Health Department, various public sector primary, secondary and tertiary healthcare establishments, including the government teaching hospitals, across the province had recorded 289,417 dog bite cases in 2023, against 243,151 cases in 2022 and 226,767 cases in 2021.

In 2024, the government teaching hospitals in Sindh recorded 59,691 dog victims, while another 244,378 cases were attended at government primary and secondary hospitals and health facilities. In all, 16 confirmed cases, including 15 deaths, were registered at Karachi and Hyderabad.  

Any reliable consolidated data on rabies or dog bite cases reported to both the private and public health facilities is not available in Sindh, but one thing is clear that a good portion of the population here, particularly those living in the suburbs and rural areas, have to suffer the severity of dog bites, including the fatal rabies, with little information about the post-exposure prophylaxis (PEP) for dog bites -- a series of steps to prevent rabies after being bitten by an animal, said a public health expert summing up the situation.

Dog bite victims may have to undergo reconstruction surgery, hospitalisation, treatment for skin and underlying tissues infection, wounds of the leg or arm, wounds of head, neck and torso, bone fracture and blood poisonings, according to medical concerns.

Civil Hospital Karachi’s (CHK’s) Medical Superintendent Dr S M Khalid Bukhari says the Rabies Management Clinic (RMC) at his hospital is a major facility for dog bitten population coming not only from the hospital’s adjacent residential and commercial areas and other city areas but also from Hub, Balochistan. In the recent years there has been no dearth of human rabies immune globulin and anti-rabies vaccines, which are given to dog bite cases as part of PEP, at CHK, he maintained following a question.

When contacted, CHK’s Chief Medical Officer Dr Rumana Farhat, also the incharge of RMC, estimated that an average 50 new dog bite cases, mostly children, are brought to her centre every day from different areas, including Baldia Town, New Karachi and Lyari, for due vaccinations. Victims after proper vaccinations, with no casual approaches, come out of danger --they are safe for life free of any confused state, she remarked.

At the same time, she called for increased awareness about dog bite prevention measures among the masses, including the school-going population, with training of paramedical staffs and doctors on handling of dog bite cases on a priority basis.

An extensive wound washing with cloth and washing soap at home or any local treatment unit as soon as possible after the dog bite is important, she emphasised, adding any vaccination within 24 hours after dog’s assault is ideal.

Data provided by CHK revealed that the RMC registered 17,973 new dog bite cases in 2024, against 12,644 new cases of 2023 – a crucial increase of 45%. A relative study of two-year data gives to understand that RMC witnessed a continued surge in the presentation of new dog bite cases for ARV in the months from November to March.

In addition, there were 217 cases which were brought at CHK for vaccination in 2024 as they were bitten by cats (196), donkeys (14) and monkeys (7).

Taking note of the animal caused injuries, the Pakistan Medical Association (PMA) noted that it is high time for the provincial government to take immediate and decisive action to mitigate the public health crisis.

Dr Abdul Ghafoor Shoro, Secretary General of PMA Central, says the escalating dog bite issue is a significant threat to citizens, but the government sadly failed to effectively address this critical concern.

“The lack of comprehensive measures to control the stray dog population, coupled with the inadequate provision of timely and accessible post-exposure prophylaxis, including rabies vaccinations, leave our community vulnerable to the severe consequences of dog bites.”

The PMA leader further stated that the government should implement effective and humane stray dog population control programmes; ensure the availability of affordable and easily accessible anti-rabies vaccinations at all government hospitals and clinics; and raise public awareness about dog bite prevention and the importance of seeking medical attention promptly.           –M A

Courtesy: Social Track, Karachi.

Photos courtesy: CHK

Case graph: Sindh Health Department