Human exposure to rabies in Yemen: Incidence, trend, and mortality 2011-2017 (Preprint)

BACKGROUND Rabies remains a neglected disease and poorly controlled throughout the developing world, particularly Africa and Asia, where most human rabies deaths occur. OBJECTIVE This study aimed to describe the epidemiology of rabies, its trend, and its geographical distribution in Yemen METHODS Cumulative data from Rabies surveillance system for the period 2011 to 2017 was obtained from the National Rabies Control Program. The data included the number of persons bitten by a suspected animal, their gender and age, and the result of animal’s lab-test. Cases were defined as human victims bitten or injured by animals confirmed to be infected with rabies and received post exposure prophylaxis at any rabies control unit during 2011-2017 RESULTS During the period 2011-2017, a total of 76049 persons were bitten or injured by a suspected rabid animal. Of those, 21,927 (29%) were exposed to positively confirmed rabid animal and had PEP. Of all cases 68% were males and 32% were females. About 15% of cases were under five years, 41% aged 5-14 years, 28% aged 15-40 years, and 16% aged > 40 years. One third (36.8%) of reported cases were from Amanat Al Asimah followed by 32% from Ibb governorates, 12% from Dhamar, 8% from Al Hudaydah, 5% from Taizz, and 4% from Amran. The annual mean number of the cases exposed to positively confirmed rabid animal and had PEP was 3132. The annual incidence rate of exposure to positively confirmed rabid animal was 14 per 100,000 population. The annual mean number of deaths was 42 and the annual mean mortality rate was 2 per 1000,000 populations. CONCLUSIONS Rabies is still a worrying health problem in Yemen with a higher percentage among children and males. The annual incidence of exposure was 14 per 100,000 population. An electronic system should be introduced to improve reporting. It is important to have sufficient supply of vaccines and immunoglobulins in control units especially in the affected governorates. Education, communication and information campaigns about preventive measures targeting school-age populations are strongly recommended. Moreover, vaccination campaigns in the canine population to avoid animal-to-human transmission is necessary.

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Challenges facing human rabies control: the Lebanese experience

Epidemiology and Infection ◽

10.1017/s0950268813002392 ◽

2013 ◽

Vol 142 (7) ◽

pp. 1486-1494 ◽

Cited By ~ 7

Author(s):

A. BIZRI ◽

A. ALAWIEH ◽

N. GHOSN ◽

A. BERRY ◽

U. MUSHARRAFIEH

Keyword(s):

Regional Cooperation ◽

Public Awareness ◽

Passive Immunization ◽

Human Rabies ◽

Post Exposure Prophylaxis ◽

Post Exposure ◽

Zoonotic Infections ◽

Rabies Control ◽

Animal Bites ◽

Exposure Prophylaxis

SUMMARYRabies is one of the most important zoonotic infections worldwide. The burden of the disease continues to be significant in countries in the Middle East where the most important vector is stray dogs. Control efforts are hindered by lack of awareness and incomplete post-exposure prophylaxis. The aim of this article is to re-assess the situation of rabies in Lebanon and compare it to other Middle Eastern countries. Eight cases of rabies and 5280 incidents of animal bites to humans were reported to the Lebanese Ministry of Public Health between 2001 and 2012. Dogs were the only vector of infection and were responsible for most reported animal bites to humans. An average of 3·2 doses of vaccine per bite was administered as post-exposure prophylaxis. The status of human and canine rabies control, the risks associated with children's behaviour and the hazards of secondary wild reservoirs are discussed. Our data illustrates the importance of prevention through vector control, public awareness and education, and timely administration of active and passive immunization, as well as the significance of regional cooperation and monitoring the circulation of viral variants in wild animals.

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History of Rabies Incidence and Rabies Control in Serbia in Support of the Zero by 2030 Campaign to Eliminate Dog-Mediated Human Rabies

Viruses ◽

10.3390/v14010075 ◽

2021 ◽

Vol 14 (1) ◽

pp. 75

Author(s):

Srđan Stankov ◽

Dušan Lalošević ◽

Anthony R. Fooks

Keyword(s):

Health Department ◽

Human Rabies ◽

Surveillance Program ◽

Post Exposure Prophylaxis ◽

Canine Rabies ◽

Rabies Control ◽

Novi Sad ◽

Exposure Prophylaxis ◽

Rabies Prevention ◽

Rabies Vaccination

Urban (principally canine-mediated) rabies has been a public health risk for people living in Serbia for centuries. The first legal act in urban rabies prevention in Serbia was established in 1834 by introducing high taxes for pet dog owners. Five years later in 1839, the first set of literature describing rabies prevention was issued by the health department from The Serbian Ministry of Interior. An overview of cauterization of rabies wounds was presented as the principal method of rabies post exposure prophylaxis. In 1890, a human rabies vaccination was introduced in Serbia with the royal government directive which ordered patients to be treated at the Pasteur Institute in Budapest in receipt of rabies vaccination. Urban (canine) rabies was eliminated during the 1980s, but sylvatic (principally fox-mediated) rabies still prevailed. The last human rabies case was recorded in the Province of Kosovo and Metohija in 1980. Sylvatic rabies in Serbia is in the final stages of elimination by orally vaccinating foxes (Vulpes vulpes). The only published finding of a lyssavirus among Serbian bats was made in 1954 by Dr Milan Nikolić in the vicinity of Novi Sad. In 2006, a comprehensive two-year active surveillance program of lyssaviruses in bats in Serbia was undertaken. In this single study, all of the bats from Serbia tested negative for a lyssavirus.

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IMPACT OF CULLING STRAY DOGS AND VACCINATION ON THE CONTROL OF HUMAN RABIES: A MATHEMATICAL MODELING APPROACH

International Journal of Biomathematics ◽

10.1142/s1793524511001283 ◽

2011 ◽

Vol 04 (04) ◽

pp. 379-397 ◽

Cited By ~ 4

Author(s):

C. P. BHUNU

Keyword(s):

Control Strategies ◽

Developing Nations ◽

Human Rabies ◽

Post Exposure Prophylaxis ◽

Post Exposure ◽

Analytical Results ◽

Rabies Control ◽

Animal Control ◽

To Come ◽

Exposure Prophylaxis

Human rabies cases are not declining in Africa and Asia even though possible interventions are available. A mathematical model for the transmission dynamics of rabies is presented and analyzed in the presence of intervention strategies (culling, dog vaccinations, pre- and post-exposure vaccinations for humans). The reproduction number is computed and rigorously analyzed. Analytical results suggest that the key to rabies control lies in good animal control and seeking medical advice early, once exposed to a dog bite. Numerical simulations support analytical results obtained. We conclude that the post-exposure prophylaxis might be the best possible way to control rabies in developing nations if it can be made easily accessible to those in need. However, due to costs of vaccines which are beyond the reach of many people in developing nations, it may be best to come up with better animal control strategies to control the spread of rabies.

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Qualitative Study of Stakeholder Perceptions Related to Requirements for Elimination of Dog Rabies in Sri Lanka by 2025

Open Science Journal ◽

10.23954/osj.v4i1.1879 ◽

2019 ◽

Vol 4 (1) ◽

Cited By ~ 1

Author(s):

Kamalika Harshini Ubeyratne Janrabelge ◽

Lertrak Srikitjakarn ◽

Dirk Udo Pfeiffer ◽

Sunil-Chandra Narapity Pathirannehalage ◽

Lisa Kohnle ◽

...

Keyword(s):

Sri Lanka ◽

Human Rabies ◽

Post Exposure Prophylaxis ◽

Government Officials ◽

Disease Reporting ◽

Weakest Link ◽

Rabies Control ◽

Disease Risks ◽

Exposure Prophylaxis ◽

Vaccination Campaigns

Rabies has been eliminated in some Asian countries including Japan, Singapore, Maldives, and Hong Kong. Sri Lanka is close to joining that group: human rabies cases declined from 288 in 1975 to 23 in 2017, due largely to intradermal post-exposure prophylaxis. The weakest link in rabies elimination in Sri Lanka is inconsistent prevention at the source due in part to insufficient institutional capacity to achieve the goal of 70% dog vaccination coverage.Obstacles to rabies control identified through focus groups and in-depth interviews with stakeholders, government officials, non-government agents, and community residents include insufficient motivation for disease reporting and development of a clear protocol for disease reporting by the public, lack of awareness in some areas of the importance of disease reporting exacerbated by logistical issues, uneven vaccination coverage due to insufficient communication regarding government vaccination campaigns, and incomplete implementation of government policies. Other issues included a need for more responsible dog ownership and better understanding of rabies disease risks amongst dog owners. Dog-associated factors included the need for improved understanding of drivers of variation in dog population size, for lower sterilization cost to owners, and for monitoring of post-surgical complications.An integrated national dog rabies monitoring and reporting system based on effective partnerships among relevant institutions plus additional decentralized dog rabies diagnosis laboratories plus additional local veterinary and medical government staff are needed.

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Avaliação dos profissionais de saúde no atendimento antirrábico humano

Revista de Enfermagem UFPE on line ◽

10.5205/1981-8963-v12i5a230541p1233-1240-2018 ◽

2018 ◽

Vol 12 (5) ◽

pp. 1233

Author(s):

Maria Elda Alves de Lacerda Campos ◽

Bruna Coelho De Macedo ◽

Glenda Katherine Silvetre da Silva ◽

Flávia Emília Cavalcante Valença Fernandes

Keyword(s):

Regression Analysis ◽

Health Professionals ◽

Control Method ◽

Epidemiological Surveillance ◽

Human Rabies ◽

Post Exposure Prophylaxis ◽

Post Exposure ◽

Rabies Control ◽

Vaccine Type ◽

Exposure Prophylaxis

RESUMOObjetivo: avaliar a conduta dos profissionais de saúde no atendimento antirrábico humano. Método: estudo quantitativo, descritivo, com 2.789 casos que sofreram agressão por cão ou gato para a profilaxia antirrábica humana pós-exposição, no período de 2013 a 2015, notificados no Sinan. Os dados foram analisados pelo programa Stata 12.0 e realizou-se análise de regressão logística para a avaliação da adequação da conduta. Resultados: a mordedura representou maior proporção dos casos (85,6%). Os cães e gatos representaram 98,4% das espécies agressoras. Desses, 81,8% foram referidos como sadios. Dos tratamentos indicados, 68% foram do tipo observação e vacina. Constatou-se que, das condutas indicadas, 70,1% foram adequadas. Conclusão: a partir da avaliação das condutas dos profissionais de saúde no atendimento antirrábico humano, pôde-se verificar que a maioria delas foi realizada da forma correta e de acordo com as normas ministeriais. No entanto, constatou-se um número considerável de condutas inadequadas refletindo a necessidade constante de qualificação dos profissionais para a instituição da profilaxia antirrábica. Descritores: Raiva; Profilaxia Pós-Exposição; Vigilância Epidemiológica; Educação em Saúde; Políticas Públicas; Pessoal de Saúde.ABSTRACTObjective: to evaluate the behavior of health professionals in human rabies control. Method: a descriptive, quantitative study with 2,789 cases of dog or cat aggression for post-exposure human rabies prophylaxis in the period from 2013 to 2015, reported in Sinan. The data was analyzed by the Stata 12.0 program and a logistic regression analysis was performed to assess the suitability of the conduct. Results: the bite represented a higher proportion of cases (85.6%). Dogs and cats accounted for 98.4% of the aggressor species. Of these, 81.8% were referred to as healthy. Of the treatments indicated, 68% were of the observation and vaccine type. It was found that 70.1% of the behaviors indicated were adequate. Conclusion: based on the evaluation of the health professionals' conduct in the human rabies control, it was verified that most of them were performed correctly and in accordance with ministerial norms. However, a considerable number of inadequate behaviors were observed reflecting the constant need to qualify professionals for the institution of anti-rabies prophylaxis. Descriptors: Rabies; Post-Exposure Prophylaxis; Epidemiological Surveillance; Health Education; Public Policies; Health Personnel.RESUMENObjetivo: evaluar la conducta de los profesionales de salud en la atención antirrábica humana. Método: estudio cuantitativo, descriptivo, con 2.789 casos que sufrieron agresión por perro o gato para la profilaxis antirrábica humana post-exposición, en el período de 2013 a 2015, notificados en el Sinan. Los datos fueron analizados por el programa Stata 12.0 y se realizó un análisis de regresión logística para evaluar la adecuación de la conducta. Resultados: la mordedura representó mayor proporción de los casos (85.6%). Los perros y gatos representaron el 98.4% de las especies agresoras. De los 81.8% fueron referidos como sanos. De los tratamientos indicados, el 68% fueron del tipo observación y vacuna. Se constató que, de las conductas indicadas, el 70.1% fueron adecuadas. Conclusión: a partir de la evaluación de la conducta de los profesionales de salud en la atención antirrábica humana se puede verificar que la mayoría de ellas fueron realizadas de la forma correcta y de acuerdo con las normas ministeriales. Sin embargo, se constató un número considerable de conductas inadecuadas, reflejando la necesidad constante de calificación de los profesionales para la institución de la profilaxis antirrábica. Descriptores: Rabia; Profilaxis Post-Exposición; Vigilancia Epidemiológica; Educación en Salud; Políticas Públicas; Personal de Salud.

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Benefit–Risk Assessment of the French Surveillance Protocol of Apparently Healthy Biting Dogs and Cats for Human Rabies Prevention

Veterinary Sciences ◽

10.3390/vetsci8070132 ◽

2021 ◽

Vol 8 (7) ◽

pp. 132

Author(s):

Guillaume Crozet ◽

Tiffany Charmet ◽

Florence Cliquet ◽

Emmanuelle Robardet ◽

Barbara Dufour ◽

...

Keyword(s):

Risk Assessment ◽

Traffic Accidents ◽

Scenario Tree ◽

Human Rabies ◽

Post Exposure Prophylaxis ◽

Policy Makers ◽

Benefit Risk Assessment ◽

Surveillance Protocol ◽

Exposure Prophylaxis ◽

Apparently Healthy

In France, apparently healthy dogs and cats that bite humans must undergo an observation period of 15 days with three veterinary visits to ascertain that they remain healthy, indicating that no zoonotic transmission of rabies virus occurred via salivary presymptomatic excretion. This surveillance protocol is mandatory for all pets that have bitten humans, despite France’s rabies-free status in non-flying mammals (i.e., a very low rabies risk). In this context, we aimed to perform a benefit–risk assessment of the existing regulatory surveillance protocol of apparently healthy biting animals, as well as alternative surveillance protocols. A scenario-tree modelling approach was used to consider the possible successions of events between a dog or cat bite and a human death attributed to either rabies or to lethal harm associated with the surveillance protocol (e.g., lethal traffic accidents when traveling to veterinary clinics or anti-rabies centers). The results demonstrated that the current French surveillance protocol was not beneficial, as more deaths were generated (traffic accidents) than avoided (by prompt post-exposure prophylaxis administration). We showed here that less stringent risk-based surveillance could prove more appropriate in a French context. The results in this study could allow policy-makers to update and optimize rabies management legislation.

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Post-exposure prophylaxis vaccination rate and risk factors of human rabies in mainland China: a meta-analysis

Epidemiology and Infection ◽

10.1017/s0950268818003175 ◽

2018 ◽

Vol 147 ◽

Author(s):

D. L. Wang ◽

X. F. Zhang ◽

H. Jin ◽

X. Q. Cheng ◽

C. X. Duan ◽

...

Keyword(s):

Risk Factors ◽

Rural Areas ◽

Meta Analysis ◽

Mainland China ◽

Vaccination Rate ◽

Human Rabies ◽

Post Exposure Prophylaxis ◽

Eastern Region ◽

Post Exposure ◽

Exposure Prophylaxis

AbstractRabies is one of the major public health problems in China, and the mortality rate of rabies remains the highest among all notifiable infectious diseases. A meta-analysis was conducted to investigate the post-exposure prophylaxis (PEP) vaccination rate and risk factors for human rabies in mainland China. The PubMed, Web of Science, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical and Wanfang databases were searched for articles on rabies vaccination status (published between 2007 and 2017). In total, 10 174 human rabies cases from 136 studies were included in this meta-analysis. Approximately 97.2% (95% confidence interval (CI) 95.1–98.7%) of rabies cases occurred in rural areas and 72.6% (95% CI 70.0–75.1%) occurred in farmers. Overall, the vaccination rate in the reported human rabies cases was 15.4% (95% CI 13.7–17.4%). However, among vaccinated individuals, 85.5% (95% CI 79.8%–83.4%) did not complete the vaccination regimen. In a subgroup analysis, the PEP vaccination rate in the eastern region (18.8%, 95% CI 15.9–22.1%) was higher than that in the western region (13.3%, 95% CI 11.1–15.8%) and this rate decreased after 2007. Approximately 68.9% (95% CI 63.6–73.8%) of rabies cases experienced category-III exposures, but their PEP vaccination rate was 27.0% (95% CI 14.4–44.9%) and only 6.1% (95% CI 4.4–8.4%) received rabies immunoglobulin. Together, these results suggested that the PEP vaccination rate among human rabies cases was low in mainland China. Therefore, standardised treatment and vaccination programs of dog bites need to be further strengthened, particularly in rural areas.

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CROSS- SECTIONAL STUDY OF ANIMAL BITE VICTIMS AND RABIES POST EXPOSURE PROPHYLAXIS UNDER NRCP (NATIONAL RABIES CONTROL PROGRAMME) AT A RURAL HOSPITAL OF NORTH 24 PARGANAS OF WEST BENGAL, INDIA.

10.36106/ijsr/5631768 ◽

2021 ◽

pp. 4-6

Author(s):

Chinmay Nandi ◽

Saikat Bhattacharya ◽

Soumitra Mondal ◽

Shibasish Banerjee

Keyword(s):

Cross Sectional Study ◽

Control Programme ◽

Post Exposure Prophylaxis ◽

Sectional Study ◽

Cross Sectional ◽

Case Record ◽

Post Exposure ◽

Rabies Control ◽

Animal Bites ◽

Exposure Prophylaxis

Objectives -Rabies, an Endemic disease, is responsible for extensive morbidity and mortality in India. About 96% of the mortality and morbidity is associated with dog bites. The aim of the study was to estimate the prevalence and pattern of animal bites and rabies post exposure prophylaxis under National Rabies Control Programme Methodology – It was a Record cross sectional study where complete enumeration of all animal bite victims were done. Total 2940 such cases were found in that year. Data of 42 cases was excluded due to incomplete records. Data was analysed using MS Excel. Animal Bite Exposure register under National Rabies Control Programme, Patient Treatment cards, Consolidated reports were evaluated as study tools. Results - Majority of the wounds were found in limbs in 2695 (93%) cases. It is followed by wound in other areas like face 104(3.6%) and back 95 (3.3%). In a few cases site of wound was not mentioned in the case record. Children were most commonly affected (28.2%).Cat -bite is most common (49.3%). Around 84.9% were Category II bite and rest are category III. Conclusion - Dogs and cats are mostly responsible of animal bites in this part of the country. There is need to control stray dogs .Children are found to be most vulnerable for animal bites. There is gap between eligible candidates for vaccine and those who actually received it both in Category II and III animal bite victims.

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Human rabies post-exposure prophylaxis relative to the disease epidemiological status

Ciência & Saúde Coletiva ◽

10.1590/1413-81232018241.32832016 ◽

2019 ◽

Vol 24 (1) ◽

pp. 315-322 ◽

Cited By ~ 1

Author(s):

Bruno Fonseca Martins da Costa Andrade ◽

Taísa Santos de Melo Andrade ◽

Luzia Helena Queiroz

Keyword(s):

Rabies Vaccine ◽

Human Rabies ◽

Post Exposure Prophylaxis ◽

Post Exposure ◽

Paulo State ◽

Technical Manual ◽

Prophylactic Measures ◽

Exposure Prophylaxis ◽

Main City ◽

Technical Recommendations

Abstract This study evaluated the prophylactic measures adopted after attacks by dogs and cats in the main city of Northwester São Paulo State, based on the technical manual for post-exposure treatment, considering the not controlled (1990-1996) and controlled (1997-2010) rabies status. A retrospective analysis was done using the data from the SINAN records (W64-CID10) between 1990 and 2010. In most cases, the accidents were mild (76.9%), and biting animals were healthy (75.4%); therefore, no treatment was needed in 53.3% of the cases. In 64.6% of cases, the prescribed PEP treatment was inappropriate. The most indicated PEP treatments consisted of vaccine and RIG (43.4%), and either three doses of mouse brain vaccine or two doses of cell culture vaccine (76.5%), during the not controlled and controlled rabies periods, respectively. The treatment was more appropriate and followed the technical recommendations during controlled rabies periods compared to not controlled (p < 0.0001) periods. However, excessive application of RIG and rabies vaccine was observed in both periods.

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