What's behind rising dog bite deaths in Kerala? Expert Committee report soon

Of the 22 people who had died of rabies this year alone, five had taken vaccination. The alarming increase in post-vaccination rabies deaths in Kerala had prompted Chief Minister Pinaryi Vijayan to assure the Assembly On August 30 that an expert team would be constituted to study the efficacy of the rabies vaccine.

A seven-member Expert Committee has now been formed with Dr Thomas Mathew, the Director of Medical Education, as chairman. The other members are: Dr E Sreekumar, Director, Institute of Virology; Dr Reeta S Mani, additional professor, Department of Neurology, World Health Organisation, Collaborative Centre for Reference and Research for Rabies, NIMHANS, Bangalore; P M Jayan, Drugs Controller; Dr Aravind R, head of the department, Infectious Diseases Department, Thiruvananthapuram Medical College; Dr Swapna Susan Abraham, deputy director, State Institute for Animal Diseases, Palode, Thiruvananthapuram; and Dr Harikumar S, assistant director, Public Health, Directorate of Health Services, Thiruvananthapuram.

The team has also been given a 'Terms of Reference' broader than what was promised in the Assembly by the Chief Minister. On August 30, the Chief Minister had said that the expert committee would be formed to assess the efficacy of the rabies vaccines in the backdrop of the widespread belief that quality norms were set aside while procuring the latest set of vaccines. The Chief Minister made this assurance right after health minister Veena George made a passionate defence of the procurement process in the Assembly.

Though the health minister claimed that the vaccines were subject to three levels of quality checks, the Kerala State Medical Services Corporation, which does the procurement, later contradicted the minister and confirmed the Opposition charge that quality control norms were eased to expedite quicker purchase.

The newly-constituted expert team will analyse the potency of the rabies vaccine but it has also been asked to provide a more exhaustive picture of the rabies management mechanism in Kerala.

There will be nine Terms of Reference for the team. One, the possible reasons for rabies death in a few vaccinated individuals to whom the serum was also administered.

Two, missed opportunities to prevent rabies death and strategies to intervene. Three, knowledge, attitude, and skill of people involved in vaccination programs including training needs.

Four, adequacy of existing vaccination policy and modifications if any. Five, efficacy of vaccine by analyzing antibody response to the vaccine. Six, material management issues including the maintenance of cold chains.

Seven, instances of omission or commission, if any, from the medical point of view or otherwise, on the part of any person/persons/ institutions/ establishments for which they are to be made accountable.

Eight, necessary proposals/suggestions/ recommendations for future course of action and also suggestions to achieve zero rabies death by 2025. Nine, any other relevant matter in this connection, the committee deems fit for consideration.

The Committee will have to submit its report in a month.