1
|
Shen T, Welburn SC, Sun L, Yang GJ. Progress towards dog-mediated rabies elimination in PR China: a scoping review. Infect Dis Poverty 2023; 12:30. [PMID: 37024944 PMCID: PMC10077633 DOI: 10.1186/s40249-023-01082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/14/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Rabies continues to be a serious threat to global public health endangering people's health and public health safety. In the People's Republic of China, multi-sectoral and comprehensive prevention and control strategies have aimed to extensively curb human rabies transmission. Here, we examine the current state of rabies infection in China, explore strategic interventions put in place in response to WHO's ambition of "Zero rabies deaths by 2030" and critically assess the constraints and feasibility of dog-mediated rabies elimination in China. METHODS This study analyzed and evaluated the process towards dog-mediated rabies elimination in China from five perspectives: namely, human, dog, policy, challenge, and prospects. Evidence-based data on progress of dog-mediated rabies elimination in China was derived from a number of sources; a literature search was undertaken using PubMed, Web of Science and CNKI databases, distribution data for human rabies cases as derived from the Data-center of the China Public Health Science and policy and document data were obtained from official websites of the relevant China ministries and commissions. RESULTS The incidence of human rabies cases in China have shown a downward trend year-on-year since 2007. Implementation of a government-led, multi-sectoral "One Health" approach to combating rabies has driven down the total number of rabies deaths nationwide to around 200 in 2020. The number of provincial-level administrative divisions (PLADs) reporting human cases of rabies has also decreased to 21 in 2020, 13 of which reported less than 10 cases. Furthermore, the number of outpatient visits seeking rabies post-exposure prophylaxis has risen dramatically over the past two decades, with demand being 15 times higher than it was initially. There remain however, significant gaps in rabies elimination outcomes across the different regions of China. To date the target of achieving a canine rabies vaccination rate of > 75% has not been met. The challenges of rabies immunization of dogs and dog management in underdeveloped cities and rural areas need to be addressed together with more effective animal surveillance and rabies risk from and too wildlife and livestock. CONCLUSIONS The Chinese government-led, multi-sectoral "One Health" approach to combating rabies and has made significant progress over the past decade. Development and adoption of more cost-effective One Health strategies can achieve more nationally beneficial rabies elimination outcomes. The ambitious target of "Zero rabies deaths by 2030" can be met through establishment of long-lasting herd immunity in dogs by means of dog mass vaccination campaigns, dog population management, epidemiological surveillance and the application of large-scale oral rabies vaccine to eliminate rabies in wild animals coupled with deployment of cost-effective human post-exposure prophylaxis, and community education.
Collapse
Affiliation(s)
- Tianren Shen
- Zhejiang University-University of Edinburgh Joint Institute, Zhejiang University, International Campus, 718 East Haizhou Road, Haining, 314400, People's Republic of China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9JZ, Scotland, UK
| | - Susan Christina Welburn
- Zhejiang University-University of Edinburgh Joint Institute, Zhejiang University, International Campus, 718 East Haizhou Road, Haining, 314400, People's Republic of China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9JZ, Scotland, UK
| | - Long Sun
- Department of Infectious Diseases, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, People's Republic of China
| | - Guo-Jing Yang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, The School of Tropical Medicine, The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, Hainan, People's Republic of China.
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9JZ, Scotland, UK.
| |
Collapse
|
2
|
Guzman FD, Iwamoto Y, Saito N, Salva EP, Dimaano EM, Nishizono A, Suzuki M, Oloko O, Ariyoshi K, Smith C, Parry CM, Solante RM. Clinical, epidemiological, and spatial features of human rabies cases in Metro Manila, the Philippines from 2006 to 2015. PLoS Negl Trop Dis 2022; 16:e0010595. [PMID: 35852994 PMCID: PMC9295989 DOI: 10.1371/journal.pntd.0010595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 06/18/2022] [Indexed: 11/18/2022] Open
Abstract
Rabies remains a public health problem in the Philippines despite the widespread provision of rabies vaccines and rabies immunoglobulin (RIG) as post-exposure prophylaxis (PEP). Detailed descriptions of recent human rabies cases in the Philippines are scarce. This study aimed to describe the clinical, epidemiological, and spatial features of human rabies cases between January 1, 2006, and December 31, 2015. We conducted a retrospective hospital-based case record review of all patients admitted to one referral hospital in Manila who received a clinical diagnosis of rabies. During the 10-year study period there were 575 patients (average 57.5 cases per year, range 57 to 119) with a final diagnosis of rabies. Most patients were male (n = 404, 70.3%) and aged ≥ 20 years (n = 433, 75.3%). Patients mostly came from the National Capital Region (n = 160, 28.0%) and the adjacent Regions III (n = 197, 34.4%) and IV-A (n = 168, 29.4%). Case mapping and heatmaps showed that human rabies cases were continuously observed in similar areas throughout the study period. Most patients had hydrophobia (n = 444, 95.5%) and/or aerophobia (n = 432, 93.3%). The leading causative animals were dogs (n = 421, 96.3%) and cats (n = 16, 3.7%). Among 437 patients with animal exposure history, only 42 (9.6%) had been administered at least one rabies vaccine. Two patients (0.5%), young children bitten on their face, had received and a full course of rabies vaccine. Human rabies patients were continuously admitted to the hospital, with no notable decline over the study period. The geographical area in which human rabies cases commonly occurred also did not change. Few patients received PEP and there were two suspected cases of PEP failure. The retrospective design of this study was a limitation; thus, prospective studies are required. Rabies remains a public health problem in the Philippines despite improvements in the availability of rabies vaccines and rabies immunoglobulin (RIG) as post-exposure prophylaxis (PEP). The incidence of rabies is highest in Metro Manila and surrounding areas. We reviewed the records of all human rabies patients admitted to the national infectious disease hospital in Manila between 2006 and 2015. This hospital treats most cases in this area. During the 10-year study period, human rabies cases were continuously admitted to the hospital, with no notable decline in numbers by year. Most patients were adult men bitten by domestic dogs. The geographical areas in which cases commonly occurred during the 10-year period also did not change over time. Only 9.6% of patients had received at least one dose of a rabies vaccine as PEP. Although the risk of PEP failure is reported to be almost zero, we identified two suspected cases of PEP failure. The retrospective design of this study was a limitation, and the exact details of PEP were not reliably available. As human rabies death is a significant public health concern, the circumstances of each case should be prospectively investigated. Further research is required to understand how to reduce the number of rabies cases.
Collapse
Affiliation(s)
| | - Yuta Iwamoto
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Nobuo Saito
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Japan
- * E-mail:
| | | | | | - Akira Nishizono
- Department of Microbiology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Motoi Suzuki
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Oladeji Oloko
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Koya Ariyoshi
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Chris Smith
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Christopher M. Parry
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | |
Collapse
|
3
|
Uzunović S, Skomorac M, Bašić F, Mijač-Musić I. Epidemiological Features of Human Cases After Bites/Scratches From Rabies-suspected Animals in Zenica-Doboj Canton, Bosnia and Herzegovina. J Prev Med Public Health 2019; 52:170-178. [PMID: 31163952 PMCID: PMC6549012 DOI: 10.3961/jpmph.18.252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 04/02/2019] [Indexed: 12/16/2022] Open
Abstract
Objectives: To determine the epidemiological features of patients and animals after bites/scratches from rabies-suspected animals in Zenica-Doboj Canton, Bosnia and Herzegovina. Methods: Data from all patients (and the causative animals) admitted to the Antirabies Service of the Institute for Health and Food Safety Zenica in the 2009-2017 period were analyzed, including age, sex, anatomical site of the bite/scratch, animal type (stray/owned/wildlife), veterinary observations of the animal, and whether antirabies post-exposure prophylaxis (PEP) was indicated and/or administered. Results: In total, 1716 patients were admitted. Bites/scratches were most frequently recorded during April and May (n=181, 10.5% and n=163, 9.5%, respectively). The persons admitted were mostly from the Zenica municipality (n=1278, 74.5%; incidence: 11.55/ 1000), which is 66.6% urbanized. Males were more frequently represented (n=1089, 63.6%). The patients were mostly 50-64 and 25-49 years of age (n=425, 24.7% and n=390, 22.7%, respectively). Dog bites were the most common cause (n=1634, 95.1%, of which n=1258, 77.0% were caused by stray dogs). PEP was indicated for 997 (58.1%) patients. Only 340 (19.9%) animals underwent veterinary observations (3.1% of stray and 76.1% of owned animals). The largest number of injuries were presented at lower extremities, 1044 (60.8%) cases. Conclusions: Zenica-Doboj Canton is a rabies-free region. Due to the high rate of stray animals not undergoing veterinary observations, the non-existence of a unique dog registry, and the consequent lack of information about stray animals in terms of number, vaccination, neutering, and euthanasia, there is an urgent need for improving the prevention and control of rabies within the One Health framework.
Collapse
Affiliation(s)
- Selma Uzunović
- Department for Clinical Microbiology, Institute for Health and Food Safety Zenica, Zenica, Bosnia and Herzegovina
| | - Muhamed Skomorac
- Department for Epidemiology, Institute for Health and Food Safety Zenica, Zenica, Bosnia and Herzegovina
| | - Fatima Bašić
- Department for Epidemiology, Institute for Health and Food Safety Zenica, Zenica, Bosnia and Herzegovina
| | - Ivona Mijač-Musić
- Department for Epidemiology, Institute for Health and Food Safety Zenica, Zenica, Bosnia and Herzegovina
| |
Collapse
|
4
|
Guo C, Li Y, Huai Y, Rao CY, Lai S, Mu D, Yin W, Yu H, Nie S. Exposure history, post-exposure prophylaxis use, and clinical characteristics of human rabies cases in China, 2006-2012. Sci Rep 2018; 8:17188. [PMID: 30464190 PMCID: PMC6249250 DOI: 10.1038/s41598-018-35158-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/31/2018] [Indexed: 11/23/2022] Open
Abstract
Rabies is still a public health threat in China. Evaluating the exposure history, clinical characteristics, and post-exposure prophylaxis (PEP) of the cases could help in identifying approaches to reducing the number of these preventable deaths. We analysed data collected from 10,971 case-investigations conducted in China from 2006 to 2012. Most cases (n = 7,947; 92.0%) were caused by animal bites; 5,800 (55.8%) and 2,974 (28.6%) exposures were from domestic and free-roaming dogs, respectively. Only 278 (4.8%) of these domestic dogs had previously received rabies vaccination. Among all cases, 5,927 (59.7%) cases had category III wounds, 1,187 (11.7%) cases initiated the rabies PEP vaccination and 234 (3.9%) cases with category III wounds received rabies immunoglobulin. In our adjusted logistic regression model, male cases (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI]: 1.09-1.44) and farmers (aOR = 1.39, 95% CI: 1.10-1.77) and person older than 55 years (aOR = 1.48, 95% CI: 1.01-2.17) were less likely than females and persons in other occupations or younger than 15 years to initiate PEP vaccination. The median incubation period was 66 days (interquartile range (IQR): 33-167 days). To reduce the number of human deaths due to rabies, rabies prevention campaigns targeting males and farmers and older people should be conducted. Increasing routine rabies vaccination among domestic dogs will be essential in the long term.
Collapse
Affiliation(s)
- Chun Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Li
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
- WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Yang Huai
- International Emerging Infections Program, Division of Global Health Protection, Centers for Disease Control and Prevention, Beijing, China
| | - Carol Y Rao
- International Emerging Infections Program, Division of Global Health Protection, Centers for Disease Control and Prevention, Beijing, China
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shengjie Lai
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
- WorldPop, Department of Geography and Environment, University of Southampton, Southampton, UK
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
| | - Di Mu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenwu Yin
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hongjie Yu
- Key Laboratory of Surveillance and Early-warning on Infectious Disease, Division of Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China.
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China.
| | - Shaofa Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| |
Collapse
|
5
|
Qi L, Su K, Shen T, Tang W, Xiao B, Long J, Zhao H, Chen X, Xia Y, Xiong Y, Xiao D, Feng L, Li Q. Epidemiological characteristics and post-exposure prophylaxis of human rabies in Chongqing, China, 2007-2016. BMC Infect Dis 2018; 18:6. [PMID: 29295708 PMCID: PMC5751830 DOI: 10.1186/s12879-017-2830-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 11/12/2017] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND According to the global framework of eliminating human rabies, China is responding to achieve the target of zero human death from dog-mediated rabies by 2030. Chongqing is the largest municipality directly under central government in China. We described the epidemiological characteristics and post-exposure prophylaxis (PEP) of human rabies in this area, in order to provide a reliable epidemiology basis for further control and prevention of human rabies. METHODS The most updated epidemiological data for human rabies cases from 2007 to 2016 in Chongqing were collected from the National Disease Reporting Information System. A standardized questionnaire was applied to the human rabies cases or family members of cases as proxy to investigate the PEP situation. RESULTS A total of 809 fatal human rabies cases were reported in Chongqing from 2007 to 2016. There was a trend of gradual annual decline about number of cases from 2007 to 2013, followed by stable levels until 2016. Rabies was mostly reported in summer and autumn; a majority of cases were noted in farmers (71.8%), especially in males (65.3%). The cases aged 35-74 and 5-14 years old accounted for 83.8% of all the cases. We collected information of 548 human rabies cases' rabies exposure and PEP situation. Of those, 95.8% of human rabies cases were victims of dog bites or scratch, and 53.3% of these dogs were identified as stray dogs. Only 4.0% of the domestic dogs were reported to have been vaccinated previously. After exposure, 87.8% of the 548 human rabies cases did not seek any medical services. Further investigation showed that none of the 548 cases received timely and properly standardized PEP. CONCLUSION Human rabies remains a major public health problem in Chongqing, China. Dogs are the main reservoir and source of human rabies infection. Unsuccessful control of canine rabies and inadequate PEP of cases might be the main factors leading to the serious human rabies epidemic in this area. An integrated "One Health" approach should be encouraged and strengthened in this area; with combined effort it would be possible to achieve the elimination of human rabies in the expected date.
Collapse
Affiliation(s)
- Li Qi
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kun Su
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
- Department of Military Epidemiology, College of Military Prevention, Third Military Medical University, Chongqing, China
| | - Tao Shen
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenge Tang
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
| | - Bangzhong Xiao
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
| | - Jiang Long
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
| | - Han Zhao
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
| | - Xi Chen
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
| | - Yu Xia
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
| | - Yu Xiong
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
| | - Dayong Xiao
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
| | - Liangui Feng
- Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Qin Li
- Chongqing Municipal Center for Disease Control and Prevention, No.8, Changjiang 2nd Road, Yuzhong District, Chongqing, China
| |
Collapse
|
6
|
Liu Q, Wang X, Liu B, Gong Y, Mkandawire N, Li W, Fu W, Li L, Gan Y, Shi J, Shi B, Liu J, Cao S, Lu Z. Improper wound treatment and delay of rabies post-exposure prophylaxis of animal bite victims in China: Prevalence and determinants. PLoS Negl Trop Dis 2017; 11:e0005663. [PMID: 28692657 PMCID: PMC5519202 DOI: 10.1371/journal.pntd.0005663] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 07/20/2017] [Accepted: 05/24/2017] [Indexed: 11/18/2022] Open
Abstract
Background Rabies is invariably a fatal disease. Appropriate wound treatment and prompt rabies post-exposure prophylaxis (PEP) are of great importance to rabies prevention. The objective of this study was to investigate the prevalence and influencing factors of improper wound treatment and delay of rabies PEP after an animal bite in Wuhan, China. Methodology This cross-sectional study was conducted among animal bite victims visiting rabies prevention clinics (RPCs). We selected respondents by a multistage sampling technique. A face-to-face interview was conducted to investigate whether the wound was treated properly and the time disparity between injury and attendance to the RPCs. Determinants of improper wound treatment and delay of rabies PEP were identified by a stepwise multivariate logistic regression analysis. Principal findings In total, 1,015 animal bite victims (564 women and 451 men) responded to the questionnaire, and the response rate was 93.98%. Overall, 81.2% of animal bite victims treated their wounds improperly after suspected rabies exposure, and 35.3% of animal bite victims delayed the initiation of PEP. Males (OR = 1.871, 95% CI: 1.318–2.656), residents without college education (OR = 1.698, 95% CI: 1.203–2.396), participants liking to play with animals (OR = 1.554, 95% CI: 1.089–2.216), and people who knew the fatality of rabies (OR = 1.577, 95% CI: 1.096–2.270), were more likely to treat wounds improperly after an animal bite. Patients aged 15–44 years (OR = 2.324, 95% CI: 1.457–3.707), who were bitten or scratched by a domestic animal (OR = 1.696, 95% CI: 1.103–2.608) and people who knew the incubation period of rabies (OR = 1.844, 95% CI: 1.279–2.659) were inclined to delay the initiation of PEP. Conclusions Our investigation shows that improper wound treatment and delayed PEP is common among animal bite victims, although RPCs is in close proximity and PEP is affordable. The lack of knowledge and poor awareness might be the main reason for improper PEP. Educational programs and awareness raising campaigns should be a priority to prevent rabies, especially targeting males, the less educated and those aged 15–44 years. Although the incidence of animal bites is increasing in China, residents’ knowledge about appropriate wound treatment and prompt PEP is insufficient. A face-to-face interview was conducted to investigate whether the wound was treated properly and to determine the time disparity between injury and consultation to the RPCs among animal bite victims. We discovered that a minority of people treated wounds appropriately, and more than one-third of participants delayed the initiation of PEP. A stepwise multivariable logistic regression analysis was used to identify the influencing factors of improper wound treatment and the delay of rabies PEP. Males (OR = 1.871, 95% CI: 1.318–2.656), residents without college education (OR = 1.698, 95% CI: 1.203–2.396), respondents liking to play with animals (OR = 1.554, 95% CI: 1.089–2.216), and people who knew the fatality of rabies (OR = 1.577, 95% CI: 1.096–2.270), were likely to treat wounds improperly after an animal bite. Participants aged 15–44 years (OR = 2.324, 95% CI: 1.457–3.707), residents bitten or scratched by a domestic animal (OR = 1.696, 95% CI: 1.103–2.608), and people who knew the incubation period of rabies (OR = 1.844, 95% CI: 1.279–2.659) tended to delay the initiation of PEP. The results also showed that knowledge of rabies among residents is insufficient. These findings highlight the urgent need for public educational and awareness-raising programs that would improve appropriate wound treatment and prompt PEP to prevent rabies-related deaths.
Collapse
Affiliation(s)
- Qiaoyan Liu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaojun Wang
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bing Liu
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yanhong Gong
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Naomie Mkandawire
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenzhen Li
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenning Fu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Liqing Li
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- School of Economics and Management, Jiangxi Science and Technology Normal University, Nanchang, Jiangxi, China
| | - Yong Gan
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jun Shi
- Department of Orthopedics, Shiyan Traditional Chinese Medicine Hospital, Shiyan, Hubei, China
| | - Bin Shi
- Xinhua Street Community health center of Jianghan District, Wuhan, Hubei, China
| | - Junan Liu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- * E-mail: (ZL); (CS); (JL)
| | - Shiyi Cao
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- * E-mail: (ZL); (CS); (JL)
| | - Zuxun Lu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- * E-mail: (ZL); (CS); (JL)
| |
Collapse
|
7
|
Ma C, Hao X, Deng H, Wu R, Liu J, Yang Y, Li S, Han Y, Wei M, Zhang J, Wang J, Li H, Tian H, Xu B, Yu P, Wu X. Re-emerging of rabies in Shaanxi province, China, from 2009 to 2015. J Med Virol 2017; 89:1511-1519. [PMID: 28112421 DOI: 10.1002/jmv.24769] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 11/16/2016] [Accepted: 12/28/2016] [Indexed: 11/10/2022]
Abstract
To explore the epidemiological, phylogeographic, and migration characteristics of human rabies in Shaanxi province, China from 2009 to 2015. The collected data were described and the sequenced glycoprotein (G) and nucleoprotein (N) genes were implemented to estimate the evolutionary rates and phylogeographic patterns using BEAST v.1.8.2. A total of 269 rabies cases were reported and 70.26% of the cases were male and 61.71% were between the ages of 19-59. The majority of the cases were farmers (83.27%). The estimated evolutionary rate of the N genes was 2.4 × 10-4 substitutions/site/year and the G genes was 3.4 × 10-4 . The time of the most recent common ancestor (TMRCA) was estimated around 1990. We detected viral migration paths from Sichuan, Guizhou, and Hunan to Hanzhong prefecture of Shaanxi and then spreaded to Xi'an and other prefectures. The main population affected by rabies virus was male adult farmers. The evolution rate of rabies viruses in Shaanxi was similar with the prior results reported by others and the ancestor virus should be circulating in neighboring province Sichuan around 1990 and then transmitted to Shaanxi. Promptly standard wound treatment and timely post-exposure prophylaxis should be compulsory for the dog-bitten victims.
Collapse
Affiliation(s)
- Chaofeng Ma
- Xi'an Center for Disease Control and Prevention, Xi'an, China
| | - Xiaoyun Hao
- Xi'an Medical Emergency Center, Xi'an, China
| | | | - Rui Wu
- Xi'an Center for Disease Control and Prevention, Xi'an, China
| | - Jifeng Liu
- Xi'an Center for Disease Control and Prevention, Xi'an, China
| | - Yang Yang
- Xi'an Center for Disease Control and Prevention, Xi'an, China
| | - Shen Li
- Shaanxi Center for Disease Control and Prevention, Xi'an, China
| | - Yifei Han
- Hanzhong Center for Disease Control and Prevention, Xi'an, China
| | - Mingmin Wei
- Weinan Center for Disease Control and Prevention, Xi'an, China
| | - Junjun Zhang
- Xianyang Center for Disease Control and Prevention, Xi'an, China
| | - Jingjun Wang
- Shaanxi Center for Disease Control and Prevention, Xi'an, China
| | - Hengxin Li
- Xi'an Center for Disease Control and Prevention, Xi'an, China
| | - Huaiyu Tian
- College of Global Change and Earth System Science, Beijing Normal University, Beijing, China
| | - Bing Xu
- College of Global Change and Earth System Science, Beijing Normal University, Beijing, China
| | - Pengbo Yu
- Shaanxi Center for Disease Control and Prevention, Xi'an, China
| | - Xiaokang Wu
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| |
Collapse
|
8
|
Rupprecht CE, Nagarajan T, Ertl H. Current Status and Development of Vaccines and Other Biologics for Human Rabies Prevention. Expert Rev Vaccines 2016; 15:731-49. [PMID: 26796599 DOI: 10.1586/14760584.2016.1140040] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Rabies is a neglected viral zoonosis with the highest case fatality of any infectious disease. Pasteur's historical accomplishments during the late 19(th) century began the process of human vaccine development, continuing to evolve into the 21(st) century. Over the past 35 years, great improvements occurred in the production of potent tissue culture vaccines and the gradual removal from the market of unsafe nerve tissue products. Timely and appropriate administration of modern biologics virtually assures survivorship, even after severe exposures. Nevertheless, in the developing world, if not provided for free nationally, the cost of a single course of human prophylaxis exceeds the average monthly wage of the common worker. Beyond traditional approaches, recombinant, sub-unit and other novel methods are underway to improve the availability of safe, effective and more affordable rabies biologics.
Collapse
|