Karachi: A 12 year old boy from Jacobabad has been brought in critical condition to Indus Hospital Korangi after developing full blown rabies encephalitis, once again exposing dangerous gaps in Pakistan’s rabies prevention system as experts warn that the country is falling far short of the vaccine doses actually needed to save lives.
Indus hospital officials said the child was shifted to Karachi from Jacobabad district of Sindh and is currently receiving palliative care after the disease progressed to an advanced stage. According to the available history, the boy had sustained multiple dog bites on both hands and one leg around two months ago after being attacked by an unknown stray dog that reportedly also bit several other people in the area.
Family members told doctors that the child was taken to a nearby healthcare facility soon after the incident, where rabies vaccination was reportedly administered. However, there is no documentation to confirm that complete and appropriate post exposure prophylaxis was given, including timely doses and rabies immunoglobulin, which is critical in severe bite cases.
Doctors said the child began showing classical symptoms of rabies on Tuesday, including hydrophobia, aerophobia and severe agitation. By the time he reached Karachi, the disease had already entered its encephalitic stage, which is almost invariably fatal.
Public health experts say the case is a tragic but familiar story in Sindh, where stray dog populations are high, bite incidents are frequent and access to complete rabies treatment remains patchy, especially in smaller towns and rural districts such as Jacobabad.
Rabies is a viral disease that attacks the central nervous system and is transmitted to humans through bites or scratches from infected animals, most commonly dogs. While the disease is completely preventable through timely and complete post exposure prophylaxis, it is almost always fatal once clinical symptoms appear.
According to National Institute of Health Islamabad, Pakistan officially estimates that it needs around five hundred thousand doses of anti rabies vaccine annually. However, infectious disease experts and clinicians working in high burden areas say this figure grossly underestimates the true need.
“Based on dog bite incidence and population exposure, Pakistan realistically needs at least two million doses of rabies vaccine every year, along with adequate supplies of rabies immunoglobulin,” said a Karachi based infectious disease specialist, adding that Sindh alone accounts for a significant share of dog bite cases reported nationally.
Health data from Sindh shows that thousands of dog bite cases are reported annually from Karachi, Hyderabad, Larkana and interior districts, yet many victims either receive incomplete vaccination or none at all due to stock shortages, lack of awareness or poor referral systems.
Doctors warn that many patients, particularly children, are given only one or two vaccine doses or are treated at facilities that do not follow standard rabies protocols. In severe bites involving hands, face or multiple wounds, failure to administer rabies immunoglobulin can prove fatal even if vaccines are later given.
The situation is further complicated by weak municipal control of stray dog populations, limited coordination between local governments and health departments, and the absence of a sustained dog vaccination program, experts say.
“In urban centers like Karachi, we keep seeing rabies deaths because prevention is fragmented. In rural Sindh, the situation is even worse. By the time patients reach tertiary hospitals, it is often too late,” a senior public health official said.
Pakistan is among the countries with the highest rabies burden globally, with unofficial estimates suggesting hundreds to over a thousand human deaths every year, many of them children. Most deaths occur in Sindh and Punjab, where human dog interaction is high and preventive services are uneven.
Health experts are urging federal and provincial authorities to urgently revise vaccine forecasting, ensure uninterrupted supply of anti rabies vaccine and immunoglobulin, standardize treatment protocols across all health facilities, and invest in mass dog vaccination and population control.
They stress that the death of the 12 year old boy from Jacobabad was entirely preventable. “Rabies does not kill because we lack science. It kills because we fail to deliver basic public health,” a clinician said.
As the child lies in palliative care in Karachi, his case stands as a stark reminder that without urgent corrective action, rabies will continue to silently claim young lives across Sindh and the rest of the country.
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