KARACHI: A study published in an international journal reported the first case of cow-transmitted rabies, which affected a young farmer whose life was saved through timely medical intervention at Karachi`s Indus Hospital in 2024.

The study A rabid cow bites the hand that feeds it is published in International Journal of Infectious Diseases (IJID).

According to the study, an 18-year-old farmer was bitten on the hand and thumb by his cow while attempting to feed it. Fortunately, being aware of the risk of cow-transmitted rabies, he reported on the same day to the hospital`s Rabies Prevention and Training Center (RPTC).

The victims` wounds were serious, requiring administration of rabies immunoglobulin (RIG) a medication used to prevent rabies following exposure, in combination with a rabies vaccine. However, the medication, the study says, was `deemed unnecessary` because the farmer had been `reliably` immunised four years back when he was bitten by a dog. Hence, he received only the vaccine doses that helped him develop antibodies against the virus.

At discharge, he was instructed to keep the cow under observation and report any changes in its behaviour. Three weeks after the bite, the farmer reported to the clinic thatthe cow was behaving `strangely` and died a few days later.

`The Dow University of Health Sciences received a report of a possible rabid cow and sent out a team of workers to decapitate the cow`s head for rabies studies, whereas the rest of the body was buried deeply. Reverse transcriptionpolymerase chain reaction from brain tissue was positive.

`Villagers further verified that the cow had been bitten by a stray dog some days previously but were unable to verify if the same dog had wounded other animals or persons, the study says.

Rabies is an ancient viral zoonotic disease caused by the Lyssavirus, transmitted to humans through the bite of an infected animal, typically a dog, and 100 per cent fatal without timely and appropriate post-exposure treatment.

An estimated 60,000 people die from rabies worldwide each year but data collection in low-and-middle-income countries is lacking. Most rabies deaths occur in rural areas where victims often succumb to fatalism, resorting to alternative medicine as a final attempt at a cure, yet ultimately passing away.

Unusual case According to experts, Pakistan is among the countries in Asia that are endemic to rabies; unfortunately, very few centers are equipped to provide proper postexposure prophylaxis (PEP) for animal bites.

The rabies virus potentially infects all warm-blooded mammals, with varying susceptibility among species. Livestock are affected by rabies worldwide in unknown numbers, mainly through bites from rabid dogs or carnivorous wildlife.

`Bovine rabies is not uncommon. Previous reports from villagers have indicated cases of rabies in livestock, with documented deaths among cows, buffaloes and donkeys. But, this is the first as far as I know of a person being bitten by a rabid cow,` shared Dr Naseem Salahuddin, leadresearcher and author of the study, also heading the infectious diseases department at the hospital.

Rabies in cattle, she pointed out, was a serious concern in Pakistan due to its impact on livestock health and potential zoonotic transmission to humans.

`This case should serve as a wake-up call for the authorities to control rabies in rural areas where livestock is a crucial agricultural sub-sector for generating income.

Cattle dying of rabies deprive farmers of theirlivelihood,` she said, adding that the cow with proven rabies, in this particular case, could have been deadly for the victim had he neglected to seek treatment or received substandard treatment.

In Pakistan, the study says, livestock contributes 37.5 per cent of farm value and about 9.4pc of the country`s gross domestic product. For many rural households, agricultural and livestock commerce serves as their lifeline, providing security against drought.

Approximately 35 millionpeople are engaged in livestock-related activities, earning around 40 per cent of their income from this sector `This case report exemplifies the presence of bovine rabies in Pakistan affecting humans, which has not been reported earlier. Many cases of animal rabies may have gone undetected and warrant vigilant surveillance.

Moreover, the loss of livestock to rabies must be addressed, and human and animal anti-rabies vaccines must be instituted through govern-ment support,` the study says.

In 2013, 13,330 animal bite cases were reported at the Indus Hospital. Of these, 12,524 (94pc) cases involved dog bites whereas the remaining 806 cases (6pc) were attributed to bites from other domestic animals, including cats, donkeys, horses, and cows.

Symptoms of bovine rabies include excessive salivation, altered behavior, excitability and mania, which can progress to motor paralysis and death.