Risk of rabies vaccine shortage in humans.

(QBĐT) - The number of rabies deaths nationwide in the first three months of 2024 doubled compared to the same period in 2023. Currently, 16 out of 63 provinces and cities have recorded cases of rabies in humans, with a sharp increase in rabies deaths in the Central and Central Highlands regions. In Quang Binh, one death due to rabies has also been recorded, and the number of people bitten by dogs and cats requiring rabies vaccination has surged since the Lunar New Year. Therefore, the risk of a rabies vaccine shortage is imminent, and if not replenished in time, it will be very difficult to treat and prevent rabies in humans.

The mortality rate is 100% once the disease develops.

Rabies is one of the most prevalent infectious diseases with the highest number of fatalities. Since 2022, the incidence of rabies has been on the rise. In particular, since the beginning of 2024, the number of deaths due to rabies has continuously increased. The country has recorded 27 deaths from rabies in humans, more than double the number recorded during the same period in 2023.

In particular, the Central-Central Highlands region recorded a sudden surge in rabies deaths, currently the highest in the country (13 cases). 100% of rabies deaths were due to not getting vaccinated against rabies or getting vaccinated late after being bitten or scratched by dogs or cats.

Healthcare workers advise patients bitten by dogs (or animals suspected of having rabies) to receive post-exposure prophylaxis (PEP) vaccination against rabies.

Rabies is an acute viral infection of the central nervous system, transmitted from animals to humans through bites, scratches, or licks from rabid animals onto damaged skin. In Vietnam, the main sources of rabies transmission are dogs and cats (dogs are the reservoir of the rabies virus, accounting for 96-97%, while cats account for 3-4%).

Typically, the incubation period for rabies in humans ranges from 2 to 8 weeks, or can be longer than a year, depending on the amount of rabies virus that enters the body through a minor or severe wound and the distance from the wound to the brain. If the wound is severe and close to the central nervous system, the incubation period is shorter, and shortest when the bite is on the head, face, or hands, especially in children.

Recently, several cases have been recorded with short incubation periods, ranging from 10-15 days, many of which involve children under 5 years old who were bitten by dogs or cats on the head and face, causing severe injuries near the central nervous system.

Medical experts confirm that once rabies symptoms appear, both animals and humans have a nearly 100% mortality rate.

Risk of rabies vaccine shortage

According to Do Quoc Tiep, Director of the Provincial Center for Disease Control, the peak period for recording rabies cases is usually the summer, concentrated in August and September; however, this year there has been a sudden surge in the early months of the year. In particular, since the Lunar New Year, the number of people in Quang Binh who have been bitten by dogs or cats and required rabies antiserum and rabies vaccine has increased dramatically.

In January and February alone, the entire province saw over 650 patients visit local health facilities for tetanus shots and rabies vaccines (including over 180 children under 15 years old). Bo Trach and Ba Don were the two localities with the highest number of people requiring tetanus shots and rabies vaccines.

The new generation of rabies vaccines is now very safe and can be administered to pregnant women and children of all ages.

At the vaccination service facility of the Provincial Center for Disease Control, nursing graduate Tran Thi Binh said that in the first three months of this year, the number of people coming for rabies vaccinations has increased dramatically, more than double compared to the same period last year. As of March 29th, the vaccination room had administered HTKD and rabies vaccines to over 150 people with nearly 500 injections, including 45 children under 15 years old.

Here, upon receiving patients, doctors examine, advise, and administer rabies vaccine and HTKD (Anti-Rabies Vaccine) depending on the location and severity of the bite and the rabies situation in animals in the area... "According to the regulations of the Ministry of Health, the rabies prophylaxis treatment protocol must include all 5 doses of vaccine administered on 5 specific days (0-3-7-14-28) to be effective in preventing the disease," nurse Binh explained.

However, due to a surge in cases of dog and cat bites requiring rabies vaccination in the first three months of the year, some district-level health centers and the Provincial Center for Disease Control are currently running out of rabies vaccine. Specifically, the Le Thuy District Health Center has had no rabies vaccine available since mid-March to administer to people bitten by dogs or cats (suspected of having rabies).

“At the end of 2023, the unit planned to purchase rabies vaccine for 2024 and won two tenders for 1,000 vials of vaccine, but almost all of it was used up in the first three months of the year; from March 22nd until now, there hasn't been enough to vaccinate new patients, and the remaining vaccine is only used to provide booster shots for elderly patients in remote areas. Due to the increasing pressure to vaccinate patients, the unit proactively purchased an additional 20% of tender package 1 as per regulations (100 vials). However, this amount of vaccine is only enough to prioritize booster shots and vaccination for children and the elderly in the immediate future. Currently, health sector units are awaiting new guiding circulars to proceed with the 2024 vaccine tender. During this period, if the number of people bitten by dogs and cats does not decrease, there will be difficulties in providing preventive treatment for rabies,” said the Director of the Provincial Center for Disease Control.

Families should limit young children's playtime with dogs and cats, and teach them how to avoid being bitten or scratched by dogs and cats, as well as how to immediately inform their parents if they are bitten or scratched by a dog or cat.

Proactive prevention

The health sector acknowledges that the risk of rabies transmission from animals to humans continues. However, public awareness of the dangers and prevention measures of rabies remains limited, leading to complacency and negligence in treatment after being bitten by dogs or cats. Dog and cat population management is also inadequate, with many localities still allowing dogs and cats to roam freely, increasing the risk of attacks on humans.

Most recently, the case of a 5-year-old girl in Le Thuy district who was bitten in the face by a neighbor's dog and required nearly 50 stitches serves as a wake-up call to everyone and the entire community, urging stronger efforts in preventing and controlling rabies to protect the health and lives of many people, especially young children. It is crucial to educate and guide children on how to avoid dog and cat bites and to immediately inform their parents after being scratched or bitten by a dog or cat.

Bo Trach district has recorded one death due to rabies and has the highest number of people vaccinated against rabies in the province since the beginning of the year. According to Do Xuan Tinh, Head of the Department of Disease Control and Substance Addiction Treatment Counseling (Bo Trach District Health Center): Due to the increasing number of people bitten by dogs and cats, especially in Phong Nha town and the communes of Phuc Trach, Lam Trach, and Xuan Trach, the unit has directed commune health stations to strengthen proactive monitoring of people who have come into contact with animals infected with rabies or suspected of having rabies in the area. This is to promptly detect and encourage those at risk of exposure to the rabies virus to go to medical facilities for vaccination and post-exposure prophylaxis.

At the same time, strengthen communication efforts within the community regarding rabies and post-exposure prophylaxis; coordinate with the veterinary sector in managing and vaccinating dogs and cats in the area against rabies.

The Provincial Center for Disease Control advises: Currently, there is no specific treatment for rabies, and the mortality rate is 100% once a patient is diagnosed with rabies. Therefore, to prevent the risk of rabies, people who are scratched or bitten by dogs or cats should immediately wash the wound under running water with soap for 15 minutes; if soap is unavailable, rinse the wound with plain water. Use iodine solution or 70% alcohol to disinfect the wound, avoid bruising the wound, and do not suture or bandage the wound. Afterwards, go to a medical facility for examination, consultation, and rabies vaccination as soon as possible.

Inner City

Source: https://www.baoquangbinh.vn/suc-khoe/202403/nguy-co-thieu-vac-xin-phong-benh-dai-tren-nguoi-2216906/