KARACHI - The government and private hospitals of the metropolis are facing shortage of Cell Culture Vaccines and Rabies Immune Globulin, which are being used in the treatment of dog or rabid dog bite cases, although thousands of people die of rabies annually in the country. Physicians are facing trouble in providing medical treatment to people affected by the said disease. Talking to TheNation on Sunday, Dr Nasim Salahuddin, a member of World Health Organisation (WHO) Experts Panel and the head of the Department of Infectious Diseases Indus Hospital, said that shortage of the said vaccines had also seen in big government hospitals which include Civil Hospital Karachi (CHK) and Jinnah Postgraduate Medical Centre (JPMC). She said, "The vaccines should be approved from WHO, while the available vaccines are not pre-qualified by the WHO. Such types of vaccines are being used in India. The one dose of the said vaccine costs Rs 600. According to old statistics prepared by National Institute of Health (NIH), nearly 2,000 to 5,000 deaths are reported annually due to rabies in Pakistan, which has already been termed as a 'rabies-endemic' country because of lack of awareness regarding the disease." Dr Salahuddin said that the government must take notice of scarcity of the important medicines and life-saving drugs. According to experts of the international health organisations, "Two types of vaccines which protect against rabies in humans are nerve tissue and cell culture vaccines. The nerve tissue vaccines cause more reactions subsequent to administration and are less potent, but also less expensive than cell culture vaccines. WHO recommends replacement of nerve tissue vaccines with the more efficacious, safer vaccines which are developed through cell culture. It also advises that cell culture vaccines that have been specifically authorised for intradermal immunisation which represent an acceptable alternative to standard administration by the intra-muscular route." Talking about the treatment procedure of the rabies or dog bite cases, Dr Salahuddin said that one patient, affected with such problem required five doses (injections) during 21 days to get protected from the deadliness of rabies. The vaccines should be injected by proper-trained doctors or paramedical staff because improper treatment can caused vaccine failure that is why several cases of vaccine failures are surfaced in the city, she added. As per advises made by the experts of WHO, wound cleansing and immunisations should be done as soon as possible after the patient got contacted with an animal. Following the WHO recommendations we can prevent the onset of rabies in virtually 100 per cent of exposures. Once the signs and symptoms of rabies have started appearing than there is no treatment possible and the disease is almost fatal.