3 Human Rabies in Canada

Background: Vaccinating dogs against rabies is an effective means of reducing human rabies. Methods: We analyzed 1,327 clinically diagnosed human rabies deaths and mass dog vaccination (MDV) data during 2006–2018 to quantify the impacts of MDV on human rabies incidence in Bangladesh and a subset of rabies death data (n = 422) for clinico-epidemiological analysis. Results: We found a positive and increasing trend of dog population vaccination (P = .01 and τ = 0.71) and a negative and declining trend (P < .001 and τ = −0.88) of human rabies cases (correlation coefficient, −0.82). Among 422 human rabies death cases, most victims (78%) sought treatment from traditional healers, and 12% received postexposure prophylaxis (PEP). The mean incubation period of rabies cases with exposure sites on the head and neck (35 days) was shorter than the upper limb (mean, 64 days; P = .02) and lower limb (mean, 89 days; P < .01). MDV is effective for reducing human rabies cases in Bangladesh. Conclusions: Creating awareness among the animal bite victims to stop relying on traditional healers rather seeking PEP, addressing the role of traditional healers through an awareness education program in respect to the treatment of dog bites, ensuring availability of PEP, and continuing to scale up MDV can help prevent human rabies deaths.Funding: NoneDisclosures: None

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Temporal and spatial distributions of animal and human rabies cases during 2012 and 2018, in Tunisia

Veterinary Medicine and Science ◽

10.1002/vms3.438 ◽

2021 ◽

Author(s):

Sana Kalthoum ◽

Kaouther Guesmi ◽

Raja Gharbi ◽

Mohamed Naceur Baccar ◽

Chedia Seghaier ◽

...

Keyword(s):

Human Rabies ◽

Spatial Distributions ◽

Temporal And Spatial

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Human rabies control in Lebanon: a call for action – CORRIGENDUM

Epidemiology and Infection ◽

10.1017/s0950268821000352 ◽

2021 ◽

Vol 149 ◽

Author(s):

M. F. Kassir ◽

T. El Zarif ◽

G. Kassir ◽

A. Berry ◽

U. Musharrafieh ◽

...

Keyword(s):

Human Rabies ◽

Rabies Control

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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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Rabies in the Critical Care Unit: Diagnostic and Therapeutic Approaches

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100054056 ◽

2011 ◽

Vol 38 (5) ◽

pp. 689-695 ◽

Cited By ~ 10

Author(s):

Alan C. Jackson

Keyword(s):

Critical Care ◽

Critical Care Unit ◽

Virus Antigen ◽

Rabies Vaccine ◽

Human Rabies ◽

Therapeutic Approaches ◽

Rna Detection ◽

Critical Care Units ◽

Antiviral Therapies ◽

History Of

ABSTRACT:Worldwide, human rabies is prevalent where there is endemic dog rabies, but the disease may present unexpectedly in critical care units when suggestive clinical features have passed. In North America transmission from bats is most common and there is often no history of a bat bite or even contact with bats. Laboratory diagnostic evaluation for rabies includes serology plus skin biopsy, cerebrospinal fluid, and saliva specimens for rabies virus antigen and/or RNA detection. Rare patients have survived rabies, and most received rabies vaccine prior to the onset of illness. Therapeutic coma (midazolam and phenobarbital), ketamine, and antiviral therapies (dubbed the "Milwaukee Protocol") were given to a rabies survivor, but this therapy was likely not directly responsible for the favorable outcome. There have been many subsequent failures of similar therapeutic approaches. There is no scientific rationale for the use of therapeutic coma in human rabies. New approaches to treating human rabies need to be developed.

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