Among the most despicable of the recent consumer frauds in China is the sale of counterfeit rabies vaccine. Eight people in south China’s Guangxi Zhuang Autonomous Region have been arrested for producing fake vaccine that may have resulted in the death of one child, and threatened 1000 other people.

The fake vaccine was identified during the investigation of the death of a four-year-old child in December 2009. The child was bitten by a rabid dog and received a series of vaccines from a local clinic. Despite the treatment, he died a few weeks later.

There are at least a couple of very serious concerns with counterfeit rabies vaccines:

1. The use of fake, ineffective rabies vaccine for post-exposure treatment in place of real vaccine could result in deaths that could have otherwise been prevented. Rabies is basically 100% preventable if proper treatment (with an effective vaccine) is administered in a timely manner.  Without this treatment, exposed individuals are at risk of developing clinical rabies, which is basically 100% fatal.
2. Poorly prepared vaccines could themselves lead to serious adverse reactions, because they may contain any number of contaminants to which the body may react. Contamination of "fake" rabies vaccine with live rabies virus is not out of the question – the use of such a counterfeit contaminated vaccines could actually give a person rabies instead of preventing it.

It’s not clear which of the above scenarios may have resulted in the death of the four-year-old boy last year. The child died about three weeks after being bitten by the dog, and had clinical signs of rabies at the time of death. Three weeks is an extremely short incubation period for natural infection, but it’s not impossible. Short incubation periods can occur, especially with severe bites to the head or neck (the location of the bite in this case was not reported). However, if the "fake" rabies vaccine used to treat the child was contaminated with live rabies virus (which is possible), then it’s not impossible that the boy didn’t get rabies from the dog bite, but rather was infected by the contaminated vaccine.

Either way, it’s not a good situation. Rabies is a major problem in China, with over 2000 deaths last year alone. The last thing people need is confusion about whether they should be vaccinated and fear that the vaccine might be worse than the bite.