Naseem Salahuddin, Muniba Jawad.
Human Rabies: Experience of Eight Cases at Liaquat National Hospital, Karachi.
Infect Dis J Jan ;9(2):23-4.

Rabies is almost exclusively an infectious disease problem in the developing countries. A World Health Organization (WHO) Rabies Survey in 1992 estimated that 90% of human rabies occurred in the developing world. Although it is an uncommon infection, the disease is uniformly fatal and ends in an extremely painful and torturous death.

We describe the clinical presentations of eight cases of rabies seen at LNPMC between 1996 and 1999. All were due to bite from rabid dogs. The age range of the patients was six years to fifty-five years. Seven were male and one was female. The interval between the dog bite and on-set of rabies was three days to six months. Five cases were from small towns or rural areas and three from within Karachi. In one instance the patient developed rabies while the dog remained alive and healthy, raising the possibility of a carrier state of the virus in dogs. Seven cases were given Nerve Tissue Vaccine and one was given Human Diploid Cell Vaccine. However, none of the cases was given Rabies Immune Globulin. All the rabies victims died within days of onset of symptoms.

It is concluded that rabies is a uniformly fatal disease that is preventable if appropriately managed at the time of the dogbite. Appropriate management includes passive immunization (rabies immune globulin) plus active immunization with a cell line vaccine. In our experience nerve tissue vaccines are ineffective in the prevention of rabies.

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