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Lu R, Lin J, Zhou Y, Chen Q, Fan Z, Wu S, Qin P, Li L. Rabies vaccination adherence and associated factors among rabies-exposed patients in Shenzhen, China: a hospital-based cross-sectional study. Epidemiol Infect 2024; 152:e15. [PMID: 38195536 PMCID: PMC10894897 DOI: 10.1017/s0950268824000049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/17/2023] [Accepted: 01/03/2024] [Indexed: 01/11/2024] Open
Abstract
Adherence to post-exposure prophylaxis and post-exposure vaccination (PEV) is an important measure to prevent rabies. The purpose of this study was to explore the adherence to the vaccination protocol and its influencing factors among rabies-exposed patients in Shenzhen, China. A cross-sectional survey was conducted in a tertiary hospital in Shenzhen, China, to obtain epidemiological characteristics of patients; knowledge, attitude, and practice scores of rabies prevention; and medical records. A total of 326 patients requiring full rabies PEV were included in this study, and only 62% (202) completed the full course of vaccination according to the norms of the vaccination guidelines. After multifactor logistic regression, the factors influencing adherence to vaccination were as follows: age 31 to 40 years, time spent to reach the nearest rabies prevention clinic was >60 min, the time of injury was at night to early morning, the place of injury was a school/laboratory, the animal causing injury was a cat, the health status of the animal causing injury could not be determined, and patients with higher practice scores (all p<0.05). Understanding the factors influencing rabies vaccination adherence among rabies-exposed patients in urban areas of China and promote changes in patients' practice toward rabies prevention is essential for rabies elimination by 2030.
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Affiliation(s)
- Ruiqi Lu
- School of Public Health, Shantou University, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Jinsheng Lin
- Emergency Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Yang Zhou
- Emergency Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Qian Chen
- Emergency Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Zaiying Fan
- Emergency Department, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Shuning Wu
- Department of Thyroid and Breast Surgery, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Pei Qin
- Clinical Center for Public Health, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Liping Li
- School of Public Health, Shantou University, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
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Chen R, Zeng Y, Deng Z, Liu H, Chen M, Liang Y. Optimizing Dog Rabies Vaccination Services to the Public: A Discrete Choice Experiment in Guangdong, China. Animals (Basel) 2023; 13:1767. [PMID: 37889650 PMCID: PMC10251847 DOI: 10.3390/ani13111767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/22/2023] [Accepted: 05/23/2023] [Indexed: 10/29/2023] Open
Abstract
Vaccination for dogs is essential for controlling rabies and achieving the goal of eliminating dog-mediated rabies globally by 2030. This paper aims to investigate the preferences for public services regarding rabies vaccination, in an effort to optimize the existing rabies vaccination and prevention programs in China. The households investigated had significant preferences for dog rabies vaccination service attributes. The households can be classified into three types: resolute executors (52.13%), mischievous rebels (5.85%), and incentivized compliers (42.02%). The residence, the presence of children in the household, perception of the safety risks, and knowledge of rabies may be sources of heterogeneity. Supportive services on dog rabies vaccination should be made available, such as arranging weekend vaccination services, building mobile vaccination stations, providing home vaccination services, and increasing vaccine supply through multiple channels. Furthermore, multiple measures can be taken to increase rabies vaccination awareness among family members and facilitate dog management innovation to further increase the level of rabies prevention and control.
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Affiliation(s)
- Ruiqi Chen
- College of Economics & Management, South China Agricultural University, No. 483 Wushan Road, Tianhe District, Guangzhou 510642, China; (R.C.); (Y.Z.); (H.L.)
| | - Yingxin Zeng
- College of Economics & Management, South China Agricultural University, No. 483 Wushan Road, Tianhe District, Guangzhou 510642, China; (R.C.); (Y.Z.); (H.L.)
| | - Zhile Deng
- College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China;
| | - Hongfu Liu
- College of Economics & Management, South China Agricultural University, No. 483 Wushan Road, Tianhe District, Guangzhou 510642, China; (R.C.); (Y.Z.); (H.L.)
| | - Manyi Chen
- Nanling Corridor Country Revitalization Institute, Xiangnan University, Chenzhou 423000, China
| | - Yaoming Liang
- College of Economics & Management, South China Agricultural University, No. 483 Wushan Road, Tianhe District, Guangzhou 510642, China; (R.C.); (Y.Z.); (H.L.)
- College of Veterinary Medicine, South China Agricultural University, Guangzhou 510642, China;
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Rupprecht CE, Mshelbwala PP, Reeves RG, Kuzmin IV. Rabies in a postpandemic world: resilient reservoirs, redoubtable riposte, recurrent roadblocks, and resolute recidivism. ANIMAL DISEASES 2023; 3:15. [PMID: 37252063 PMCID: PMC10195671 DOI: 10.1186/s44149-023-00078-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/02/2023] [Indexed: 05/31/2023] Open
Abstract
Rabies is an ancient disease. Two centuries since Pasteur, fundamental progress occurred in virology, vaccinology, and diagnostics-and an understanding of pathobiology and epizootiology of rabies in testament to One Health-before common terminological coinage. Prevention, control, selective elimination, and even the unthinkable-occasional treatment-of this zoonosis dawned by the twenty-first century. However, in contrast to smallpox and rinderpest, eradication is a wishful misnomer applied to rabies, particularly post-COVID-19 pandemic. Reasons are minion. Polyhostality encompasses bats and mesocarnivores, but other mammals represent a diverse spectrum of potential hosts. While rabies virus is the classical member of the genus, other species of lyssaviruses also cause the disease. Some reservoirs remain cryptic. Although global, this viral encephalitis is untreatable and often ignored. As with other neglected diseases, laboratory-based surveillance falls short of the notifiable ideal, especially in lower- and middle-income countries. Calculation of actual burden defaults to a flux within broad health economic models. Competing priorities, lack of defined, long-term international donors, and shrinking local champions challenge human prophylaxis and mass dog vaccination toward targets of 2030 for even canine rabies impacts. For prevention, all licensed vaccines are delivered to the individual, whether parenteral or oral-essentially 'one and done'. Exploiting mammalian social behaviors, future 'spreadable vaccines' might increase the proportion of immunized hosts per unit effort. However, the release of replication-competent, genetically modified organisms selectively engineered to spread intentionally throughout a population raises significant biological, ethical, and regulatory issues in need of broader, transdisciplinary discourse. How this rather curious idea will evolve toward actual unconventional prevention, control, or elimination in the near term remains debatable. In the interim, more precise terminology and realistic expectations serve as the norm for diverse, collective constituents to maintain progress in the field.
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Affiliation(s)
- Charles E. Rupprecht
- College of Forestry, Wildlife & Environment, College of Veterinary Medicine, Auburn University, Auburn, AL 36849 USA
| | - Philip P. Mshelbwala
- School of Veterinary Science, University of Queensland, Gatton, Australia
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - R. Guy Reeves
- Max Planck Institut Für Evolutionsbiologie, 24306 Plön, Germany
| | - Ivan V. Kuzmin
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555 USA
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Jane Ling MY, Halim AFNA, Ahmad D, Ramly N, Hassan MR, Syed Abdul Rahim SS, Saffree Jeffree M, Omar A, Hidrus A. Rabies in Southeast Asia: a systematic review of its incidence, risk factors and mortality. BMJ Open 2023; 13:e066587. [PMID: 37164462 PMCID: PMC10173986 DOI: 10.1136/bmjopen-2022-066587] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
OBJECTIVE Rabies is a neglected zoonotic disease that can infect all mammals, including humans. We aimed to summarise the current knowledge of the incidence, risk factors and mortality of rabies in Southeast Asia. DESIGN Systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. DATA SOURCES Scopus, Web of Science and PubMed were searched from 1 January 2012 to 21 February 2023. ELIGIBILITY CRITERIA Original English language articles published between 2012 and 2023 were included. DATA EXTRACTION AND SYNTHESIS Nine independent reviewers extracted data and assessed the risk of bias. The quality appraisal of included articles was carried out using the Mixed Methods Appraisal Tool. RESULTS A total of eight articles were included in this analysis. In Vietnam, the incidence of rabies ranged from 1.7 to 117.2 per 100 000 population. The cumulative incidence in Sarawak was estimated at 1.7 per 100 000 population. In Indonesia, 104 human rabies cases were reported from 2008 to 2010, while in Thailand, a total of 46 rabies cases were reported in Thailand from 2010 to 2015. In the Philippines, the incidence of rabies ranged from 0.1 to 0.3 per 100 000 population. An increased risk of rabies virus infection was associated with a high population density, illiteracy, seasonal patterns and dog butchers. The case fatality rate was 100%. CONCLUSION This study included research from Southeast Asia, which may not represent rabies infection in other regions or continents. In addition, the role of publication bias should be acknowledged as grey literature was not included. The occurrence of rabies in Southeast Asia is due to the high number of unvaccinated stray and pet dogs, working hazards (dog butchers in Vietnam), the unavailability of the rabies vaccine in rural regions and misinformation about the significance of seeking treatment after dog bites. PROSPERO REGISTRATION NUMBER CRD42022311654.
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Affiliation(s)
- Miaw Yn Jane Ling
- Department of Public Health Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | | | - Dzulfitree Ahmad
- Department of Public Health Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Nurfatehar Ramly
- Department of Public Health Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | | | | | - Azizan Omar
- Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Aizuddin Hidrus
- Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
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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.
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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.
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Shi-Gang W, He-Lei L, Hong X, Jing W. Epidemiological and clinical features of human rabies in Dazu District, Chongqing, China from 2014 to 2021. Future Virol 2023. [DOI: 10.2217/fvl-2022-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
The epidemiological and clinical data of human rabies cases in the Dazu District of Chongqing from 2014 to 2021 were analyzed retrospectively to determine the epidemiological and clinical features of human rabies cases in Chonqing, China. Nine cases were reported. All cases occurred in farmers from rural areas associated with lower rabies awareness, and eight cases had a definitive history of animal exposure, most commonly in the form of domestic dog bites. All nine patients presented as manic and died within 1–8 days from disease onset (mortality rate of 100%). Increased public awareness of rabies prevention and control is needed, especially among middle-aged and elderly populations in rural areas.
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Affiliation(s)
- Wang Shi-Gang
- Department of Infectious Disease, The People's Hospital of Dazu, Chongqing, 402360, China
| | - Liu He-Lei
- Department of Infectious Disease, The People's Hospital of Dazu, Chongqing, 402360, China
| | - Xia Hong
- Department of Infectious Disease, The People's Hospital of Dazu, Chongqing, 402360, China
| | - Wu Jing
- Department of Infectious Disease, The People's Hospital of Dazu, Chongqing, 402360, China
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Wei Y, Li D, Yang Z, Chen K, Pan X, Xu J, Chen S. One Health responses to prevent the occurrence of rabies due to attacks by a rabid stray dog. Vet Med Sci 2023; 9:618-624. [PMID: 36315409 PMCID: PMC10029876 DOI: 10.1002/vms3.986] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Abstract
BACKGROUND The number of human rabies cases caused by pet dogs in Guangzhou has been decreasing after years of comprehensive interventions. Consequently, attacks by stray dogs become a major issue in rabies control. OBJECTIVES To share our experience of successfully dealing with rabies to provide some inspiration for prevention and control in countries and regions affected by it. METHODS A multidisciplinary One Health response was initiated to control this outbreak. Rabies virus was detected by PCR in the brain tissue of the associated stray dog. The sequences were aligned with reference sequences downloaded from GenBank using ClustalX. The maximum likelihood method implemented in MEGA 5.0 software package was used in a phylogenetic analysis of the aligned sequences. RESULTS Twelve patients with exposure to the stray dog were identified in the field investigation. Rabies vaccines and immunoglobulin were administered to all patients within 48 h. After 1 year of follow-up, no exposed patients showed symptoms. Maximum likelihood analysis of the nucleotide sequences obtained from the PCR products indicated that the rabies virus in the dog was closely related to isolates from neighbouring provinces of Guangdong as well as those from surrounding countries of China. CONCLUSIONS Multidisciplinary One Health intervention is effective not only in the control of rabies but also in rapid emergency responses to attacks by rabid stray dogs.
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Affiliation(s)
- Yuehong Wei
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong province, China
| | - Dapeng Li
- Huadu District Center for Disease Control and Prevention, Guangzhou, Guangdong province, China
| | - Zhicong Yang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong province, China
| | - Kuncai Chen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong province, China
| | - Xinhong Pan
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong province, China
| | - Jianmin Xu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong province, China
| | - Shouyi Chen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong province, China
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Chen X, Duan X, Cao S, Wen D, Zhang Y, Wang B, Jia C. Source apportionment based on lead isotope ratios: Could domestic dog's blood lead be used to identify the level and sources of lead pollution in children? CHEMOSPHERE 2022; 308:136197. [PMID: 36064012 DOI: 10.1016/j.chemosphere.2022.136197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 07/24/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
Domestic dogs have been proved to be used as "sentinel organisms" to monitor human lead exposure. However, whether dogs' blood can be used to identify the levels and pollution source of children's lead exposure still needs evidence. To evaluate the potential use of domestic dogs' blood lead as an indicator of lead exposure levels and pollution source of children, accompanying with potential environmental media samples, lead concentrations and isotope ratios (expressed as 207Pb/206Pb, 208Pb/206Pb) in blood were investigated and compared between children and dogs, who came from a Pb-Zn smelter area, a coal fired area and a control area without industrial activity. The results showed that there were significant correlations in blood lead levels (BLLs) between children and dogs in the study areas (p < 0.01). The lead isotope ratios (LIRs) in blood of children and dogs were disparate among the three areas, however, the LIRs of dogs were quite correlated with those of children in each area (p < 0.01). With the comparison of LIRs between potential pollution sources (slag, ore, coal, paint) and blood samples, the identified lead sources based on dogs' blood were found to be coincident with those based on children's blood. Ore smelting and coal combustion were the main sources of lead exposure for the dogs and children in the smelting area, and coal combustion was the predominant source for the children and dogs living in the coal burning area and control area. The results showed that dogs' BLLs might be used to estimate children's BLLs, and blood LIRs measurements of dogs' could be used as an alternative for identifying the sources of children's lead exposure. This study further provided relevant evidence for dogs to be sentinels exposed to human lead exposure and an alternative method for source apportionment of children's lead exposure.
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Affiliation(s)
- Xing Chen
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
| | - SuZhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Dongsen Wen
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Yaqun Zhang
- Gansu Academy of Eco-environmental Science, Lanzhou, 730000, China
| | - Beibei Wang
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Chunrong Jia
- School of Public Health, University of Memphis, Memphis, TN, 38152, USA
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Zhang X, Tian X, Pang B, Wang Z, Zhai W, Jiang X, Kou Z, Ding S, Wang X. Epidemiological Characteristics of Human Rabies - Shandong Province, China, 2010-2020. China CDC Wkly 2022; 4:793-797. [PMID: 36284606 PMCID: PMC9547725 DOI: 10.46234/ccdcw2022.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 02/18/2022] [Indexed: 11/08/2022] Open
Abstract
Introduction Rabies is a viral zoonotic disease that causes progressive and fatal inflammation in the brain. Rabies has caused more than 5,000 human deaths in Shandong Province since 1955. This study aimed to analyze the epidemiological characteristics of human rabies in Shandong Province from 2010 to 2020 and to provide a scientific basis for policy changes. Methods The data of reported human rabies cases from 2010 to 2020 were obtained from China's National Notifiable Disease Reporting System, and data related to exposure and post-exposure prophylaxis (PEP) of the cases were acquired through case investigation. Results A total of 414 human rabies cases were reported in Shandong Province from 2010 to 2020. Out of the 414 total cases, 87.20% were primarily farmers; 83.10% were over 40 years old. 70.29% (265/377) belonged to category Ⅲ exposure; and 96.67% (377/390) were exposed to the virus through infected dogs. The vaccine inoculation rate of these cases after exposure was only 8.85%; 1.03% (4/390) had been vaccinated with rabies immunoglobulin, developing the disease 11 to 13 days after category Ⅲ exposure. Conclusions Dogs were still the primary animal hosts. Most rabies patients died due to no or inadequate post-exposure prophylaxis. Vaccine inoculation rates for dogs should reach the target of 70% as soon as possible. Health departments should improve the accessibility and quality of PEP; and improve the health literacy of the elderly in rural areas.
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Affiliation(s)
- Xiaomei Zhang
- Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Department of Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Xueying Tian
- Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Department of Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Bo Pang
- Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Department of Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Zhiqiang Wang
- Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Department of Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Wenji Zhai
- Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Department of Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Xiaolin Jiang
- Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Department of Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
| | - Zengqiang Kou
- Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Department of Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China,Zengqiang Kou,
| | - Shujun Ding
- Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Department of Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China,Shujun Ding,
| | - Xianjun Wang
- Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Department of Communicable Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong, China
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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.
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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
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Rana MS, Jahan AA, Kaisar SG, Siddiqi UR, Sarker S, Begum MIA, Ghosh S, Sarker S, Ahmed BN, Shamsuzzaman AKM. Knowledge, attitudes and perceptions about rabies among the people in the community, healthcare professionals and veterinary practitioners in Bangladesh. One Health 2021; 13:100308. [PMID: 34458544 PMCID: PMC8379336 DOI: 10.1016/j.onehlt.2021.100308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 08/09/2021] [Accepted: 08/11/2021] [Indexed: 11/26/2022] Open
Abstract
It is crucial to explore knowledge, attitudes and perceptions (KAP) about rabies among the people in the community, the personnel dealing with animal bite management and suspected rabies patients, including humans and animals, to facilitate intervention in improving rabies elimination strategies. In 2016, we conducted an interactive face-to-face survey in three different districts of Bangladesh to understand the extent of KAP towards rabies in the community peoples (CPs), human healthcare professionals (HCPs) and veterinary practitioners (VPs). A set of prescribed questions was employed to measure what proportion of each group possessed sufficient knowledge, positive attitudes and adequate perceptions about rabies. A total of 1133 CPs, 211 HCPs and 168 VPs were interviewed by using a standard questionnaire comprising both closed and open-ended questions. Of the CPs, 49% identified the disease correctly (i.e. rabies is caused by an animal bite or a scratch). Only 29% of the CPs were aware that a wound should be washed immediately with soap and water after an animal bite or a scratch. However, only 49% of the CPs, 65% of the HCPs and 60% of the VPs felt that it is important to consult a physician and receive post-exposure vaccine as the first line of treatment following an animal exposure. Among the HCPs, 23% of the respondents did not possess sufficient knowledge about animal bites as categorised by the World Health Organization (WHO), and 12% of the respondents did not possess the knowledge on how to manage an animal bite properly. Out of 52% of the VPs who previously treated suspected rabid animals, only 29% had a history of taking rabies pre-exposure prophylaxis (PEP). Lack of formal education and rural subsistence were found to largely contribute to poor rabies KAP level among the CPs (P ≤ 0.01). There has been a high demand for proper training to be provided to HCPs and VPs for the effective management of an animal bite incidence in human and animals, respectively. Multi-sectoral collaboration through integrated One Health initiatives including community education, awareness programmes, facilitation of rabies PEP, and dog vaccination as well as its population control are critical in the way forward to control rabies in Bangladesh.
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Affiliation(s)
- Md Sohel Rana
- Communicable Disease Control (CDC), Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka 1212, Bangladesh
- Department of Livestock Services, Ministry of Fisheries and Livestock, Dhaka 1215, Bangladesh
- School of Environmental and Rural Science, University of New England, Armidale, NSW 2351, Australia
| | - Afsana Akter Jahan
- Communicable Disease Control (CDC), Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka 1212, Bangladesh
- Department of Veterinary and Animal Sciences, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - S.M. Golam Kaisar
- Communicable Disease Control (CDC), Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka 1212, Bangladesh
| | - Umme Ruman Siddiqi
- Communicable Disease Control (CDC), Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka 1212, Bangladesh
| | - Subir Sarker
- Department of Veterinary and Animal Sciences, University of Rajshahi, Rajshahi 6205, Bangladesh
- Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Melbourne, VIC 3086, Australia
| | - Mst Ismat Ara Begum
- Department of Veterinary and Animal Sciences, University of Rajshahi, Rajshahi 6205, Bangladesh
| | - Sumon Ghosh
- International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), Dhaka 1212, Bangladesh
| | - Sudeb Sarker
- Communicable Disease Control (CDC), Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka 1212, Bangladesh
- Department of Livestock Services, Ministry of Fisheries and Livestock, Dhaka 1215, Bangladesh
| | - Be-Nazir Ahmed
- Communicable Disease Control (CDC), Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka 1212, Bangladesh
| | - Abul Khair Mohammad Shamsuzzaman
- Communicable Disease Control (CDC), Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka 1212, Bangladesh
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12
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Wang Z, Yuan Y, Chen C, Zhang C, Huang F, Zhou M, Chen H, Fu ZF, Zhao L. Colloidal Manganese Salt Improves the Efficacy of Rabies Vaccines in Mice, Cats, and Dogs. J Virol 2021; 95:e0141421. [PMID: 34495701 PMCID: PMC8577392 DOI: 10.1128/jvi.01414-21] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 08/30/2021] [Indexed: 12/14/2022] Open
Abstract
Rabies, caused by rabies virus (RABV), remains a serious threat to public health in most countries worldwide. At present, the administration of rabies vaccines has been the most effective strategy to control rabies. Herein, we evaluate the effect of colloidal manganese salt (Mn jelly [MnJ]) as an adjuvant of rabies vaccine in mice, cats, and dogs. The results showed that MnJ promoted type I interferon (IFN-I) and cytokine production in vitro and the maturation of dendritic cells (DCs) in vitro and in vivo. Besides, MnJ serving as an adjuvant for rabies vaccines could significantly facilitate the generation of T follicular helper (Tfh) cells, germinal center (GC) B cells, plasma cells (PCs), and RABV-specific antibody-secreting cells (ASCs), consequently improve the immunogenicity of rabies vaccines, and provide better protection against virulent RABV challenge. Similarly, MnJ enhanced the humoral immune response in cats and dogs as well. Collectively, our results suggest that MnJ can facilitate the maturation of DCs during rabies vaccination, which can be a promising adjuvant candidate for rabies vaccines. IMPORTANCE Extending the humoral immune response by using adjuvants is an important strategy for vaccine development. In this study, a novel adjuvant, MnJ, supplemented in rabies vaccines was evaluated in mice, cats, and dogs. Our results in the mouse model revealed that MnJ increased the numbers of mature DCs, Tfh cells, GC B cells, PCs, and RABV-specific ASCs, resulting in enhanced immunogenicity and protection rate of rabies vaccines. We further found that MnJ had the same stimulative effect in cats and dogs. Our study provides the first evidence that MnJ serving as a novel adjuvant of rabies vaccines can boost the immune response in both a mouse and pet model.
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Affiliation(s)
- Zongmei Wang
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Yueming Yuan
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Chen Chen
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Chengguang Zhang
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Fei Huang
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Ming Zhou
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Huanchun Chen
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Zhen F. Fu
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Ling Zhao
- State Key Laboratory of Agricultural Microbiology, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, Huazhong Agricultural University, Wuhan, China
- Key Laboratory of Preventive Veterinary Medicine of Hubei Province, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
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Bennasrallah C, Ben Fredj M, Mhamdi M, Kacem M, Dhouib W, Zemni I, Abroug H, Belguith Sriha A. Animal bites and post-exposure prophylaxis in Central-West Tunisia: a 15-year surveillance data. BMC Infect Dis 2021; 21:1013. [PMID: 34579662 PMCID: PMC8477457 DOI: 10.1186/s12879-021-06700-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/15/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Rabies is a disease that still exists in developing countries and leads to more fatalities than other zoonotic diseases. Our study aimed to describe the profile of human exposures to animals over fifteen years and to assess the post-exposure prophylaxis (PEP) practices in the governorate of Kasserine (Tunisia) on pre- and post-revolution (2011). METHODS We carried out a descriptive study using surveillance data from a region in Central-West Tunisia. All humans exposed to animals, residents in Kasserine Governorate and declared to the regional directorate of primary health care (RDPH) from January 1st, 2004 to December 31st, 2018 were included. RESULTS A total of 45,564 cases of human exposures to animals were reported over the fifteen-year period of the study with an annual average of 3089.2 ± 403.1. The standardized incidence rate (SIR) of human exposures to animals was 694 per year per 100,000 inhabitants (inh). The most listed offending animal was the dog (91.3%) and the most reported type of exposure was bites (63.7%). The trend in human exposures to animals increased significantly over time. The number of exposures by vaccinated dogs decreased significantly and by unvaccinated and stray dogs increased steeply. When comparing pre-and post-revolution periods, the yearly average of animal exposures post-2011 was significantly greater than the average prior to 2011 (3200 ± 278.5 vs 2952.8 ± 483) (p < 0.001). The yearly average of animal bites post-2011 was significantly greater than the average prior to 2011 (2260.5 ± 372.1 vs 1609.8 ± 217.9) (p < 0.001). The average number of vaccine doses per animal exposure was 2.4. Concerning PEP protocols, protocol A (2 and 3 doses) was indicated in 79% of animal exposures cases. From 2004 to 2018, a downward trend was noted for protocol A (r = - 0.29, p < 0.001) and an upward trend for protocol B (3 and 5 doses) (r = 0.687, p < 0.001). During our study period, 5 fatal cases of human rabies were declared. CONCLUSION Rabies remains a major public health problem in Tunisia. The political dynamics had an impact on the health care system and rabies control. Preventive measures should be applied adequately to decrease the burden of this disease.
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Affiliation(s)
- Cyrine Bennasrallah
- Department of Epidemiology and Preventive Medicine, University Hospital Fattouma Bourguiba, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, Monastir, Tunisia
| | - Manel Ben Fredj
- Department of Epidemiology and Preventive Medicine, University Hospital Fattouma Bourguiba, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, Monastir, Tunisia
| | - Moncef Mhamdi
- Regional Directorate of Primary Health Care of Kasserine, Kasserine, Tunisia
| | - Meriem Kacem
- Department of Epidemiology and Preventive Medicine, University Hospital Fattouma Bourguiba, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, Monastir, Tunisia
| | - Wafa Dhouib
- Department of Epidemiology and Preventive Medicine, University Hospital Fattouma Bourguiba, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, Monastir, Tunisia
| | - Imen Zemni
- Department of Epidemiology and Preventive Medicine, University Hospital Fattouma Bourguiba, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, Monastir, Tunisia
| | - Hela Abroug
- Department of Epidemiology and Preventive Medicine, University Hospital Fattouma Bourguiba, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, Monastir, Tunisia
| | - Asma Belguith Sriha
- Department of Epidemiology and Preventive Medicine, University Hospital Fattouma Bourguiba, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, Monastir, Tunisia
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14
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Savu AN, Schoenbrunner AR, Politi R, Janis JE. Practical Review of the Management of Animal Bites. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3778. [PMID: 34522565 PMCID: PMC8432645 DOI: 10.1097/gox.0000000000003778] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/01/2021] [Indexed: 11/26/2022]
Abstract
Animal bites are common worldwide. Due to the plethora of animals, there are diverse pathogens with specific associated risks and treatment algorithms. It is crucial to understand these to develop and execute appropriate management plans. This practical review was designed to amalgamate the most common bites worldwide and synthesize data to help guide treatment plans. METHODS A PubMed literature search was performed focusing on the major animal bites. High-level studies were preferred and analyzed but lower-level studies were also used if high-level studies did not exist. RESULTS The tables presented in this article cover the pertinent information regarding the incidence, common presentation, initial treatment, and potential complications associated with bites from dogs, cats, horses, rodents, snakes, marine life, and spiders. Many of the pathogens associated with the bites are treatable with various and somewhat common antimicrobials, though some are less easy to access. Basic irrigation, debridement, and wound culture are common to almost every animal and should be the first step in treatment. CONCLUSIONS Based on the current studies, the most important factor in treating animal bites is timely presentation to a medical facility and/or physician. It is critical that the offending animal be accurately identified to help guide medical and surgical algorithms, including specific antimicrobial treatment guided by the most commonly presenting pathogens specific to certain animals.
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Affiliation(s)
- Andrei N. Savu
- From the Ohio State College of Medicine, The Ohio State University, Columbus, Ohio
| | - Anna R. Schoenbrunner
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
- The University of Virginia School of Medicine, The University of Virginia, Charlottesville, Va
| | - Rachel Politi
- Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
- The University of Virginia School of Medicine, The University of Virginia, Charlottesville, Va
| | - Jeffrey E. Janis
- The University of Virginia School of Medicine, The University of Virginia, Charlottesville, Va
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15
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Wang X, Yang F, Huang L, Chen R, Shan Y, Jia Y, Li F. Evaluation of rabies immunoglobulin administration status in China: a retrospective, cross-sectional study at a tertiary hospital in Beijing. Jpn J Infect Dis 2021; 75:76-82. [PMID: 34193661 DOI: 10.7883/yoken.jjid.2021.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This retrospective cross-sectional study included patients with category Ⅲ exposure to the rabies virus at a single center between January and December 2019. Exposure characteristics and clinical data were compared and statistically analyzed among groups willing and unwilling to receive RIG injection, and determinants of its administration were identified by stepwise multivariate logistic regression analyses. In total, 1,757 patients with category Ⅲ exposure were enrolled: 845 males (48.1%) and 912 females (51.9%; median age: 28 [9-50] years). Among them, 1,297 (73.8%) received RIG injection (median age: 28 [8-50] years) and 460 (26.2%) refused to receive the injection (median age: 25 [15-48] years). Patients aged 16-25 years (odds ratio [OR]=3.006, 95% confidence interval [CI]=1.957-4.619), 26-45years (OR=2.940, 95% CI=2.011-4.298), 46-55 years (OR=3.647, 95% CI=2.233-5.959) and over 56 years (OR=6.660, 95% CI=4.009-11.062); those with injuries caused by cats (OR=1.937, 95% CI=1.476- 2.542); and people with scratch (OR=3.319, 95% CI= 2.510-4.390), minor (OR=35.281, 95% CI=18.524-64.198), and moderate (OR=12.711, 95% CI=7.221-22.375) injuries were more likely to refuse injection. The RIG administration level in the settings studied herein is insufficient. Educational and awareness programs should be considered for rabies prevention, especially those targeted at people not injured by dogs, people with minor injuries, and the elderly.
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Affiliation(s)
- Xuefei Wang
- Emergency Department, The Sixth Medical Center of the People's Liberation Army (PLA) General Hospital, China
| | - Fen Yang
- Department of Neurology, Air Force Medicine Center, China
| | - Lisong Huang
- Emergency Department, The Sixth Medical Center of the People's Liberation Army (PLA) General Hospital, China
| | - Ruifeng Chen
- Emergency Department, The Sixth Medical Center of the People's Liberation Army (PLA) General Hospital, China
| | - Yi Shan
- Emergency Department, The Sixth Medical Center of the People's Liberation Army (PLA) General Hospital, China
| | - Yiqing Jia
- Emergency Department, The Sixth Medical Center of the People's Liberation Army (PLA) General Hospital, China
| | - Fei Li
- Emergency Department, The Sixth Medical Center of the People's Liberation Army (PLA) General Hospital, China
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16
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Kalthoum S, Guesmi K, Gharbi R, Baccar MN, Seghaier C, Zrelli M, Bahloul C. Temporal and spatial distributions of animal and human rabies cases during 2012 and 2018, in Tunisia. Vet Med Sci 2021; 7:686-696. [PMID: 33570258 PMCID: PMC8136934 DOI: 10.1002/vms3.438] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 12/28/2020] [Accepted: 01/16/2021] [Indexed: 01/18/2023] Open
Abstract
Rabies is one of the most important zoonosis in Tunisia. In the last 6 years, a dramatic increase in the number of cases in animals had raised concern about the transmission dynamics of rabies and the effectiveness of established control measures. For a better understanding of the epidemiological features of rabies in Tunisia, data on animal and human rabies cases and post-exposure prophylaxis (PEP) protocol, for the period from 2012 to 2018, were analysed to describe the spatial and the temporal distributions of the disease and to guide targeted rabies control measures. Thus, the analysed data have shown that 2,642 animal and 25 human rabies cases were recorded between 2012 and 2018; only few case numbers were reported in wildlife. Time-related distribution showed that the incidence of dog rabies increases over the period of study, from 24,8/100,000 dog population in 2012 to 35,2/100,000 dog population in 2018. Dog seems to be the main reservoir of rabies as it accounted for more than 59% of the animal confirmed cases and the source for more than 80% of the human confirmed cases. Geographical distribution of animal rabies cases revealed the presence of clusters in the North and the Center of Tunisia; only a little number of animal cases were reported in the South. In contrast, the overall human rabies incidence was 0.03 per 100,000 population, during the period of the study. We have found that the incidence of human rabies increases by 13.6% from 2012 to 2015 and drops steadily by 23.41% over the second period (2015 to 2018). A high number of PEP was recorded during the 7-year period, with an average of 360 PEP per 100,000 inhabitants per year. Spatial analysis revealed the presence of clusters of PEP in the Northern and Central governorates. The present study pointed out the need to review the control strategy of rabies in Tunisia and conduct further studies on dog population to provide the basis for a new and efficacious policy of interventions and control program for rabies.
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Affiliation(s)
- Sana Kalthoum
- National Center of Zoosanitary VigilanceTunisTunisia
| | | | - Raja Gharbi
- National Center of Zoosanitary VigilanceTunisTunisia
| | | | | | - Malek Zrelli
- National Veterinary Services of TunisiaTunisTunisia
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Pham QD, Phan LT, Nguyen TPT, Doan QMN, Nguyen HD, Luong QC, Nguyen TV. An Evaluation of the Rabies Surveillance in Southern Vietnam. Front Public Health 2021; 9:610905. [PMID: 33996708 PMCID: PMC8116623 DOI: 10.3389/fpubh.2021.610905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 03/08/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction: Rabies is endemic in Vietnam and has been a statutory notifiable infectious disease since 1998. We, herein, assessed the performance of rabies surveillance in Southern Vietnam and identified areas for improvement. Materials and Methods: We analyzed data on human rabies cases reported during 1991–2018. We adapted guidelines from the U.S. Centers for Disease Control and Prevention to evaluate attributes of surveillance. Between June and November 2018, we interviewed a total of 145 staff from hospitals, preventive medicine centers, and animal health offices at provincial and district levels in five southern provinces. Results: Between 2009 and 2018, an average of nine cases of human rabies (range: 4–20 cases) was reported annually in Southern Vietnam, representing an incidence of 2.7 cases per 10 million population. The highest incidence was observed in 2018 (5.5 cases per 10 million population). Survey data suggested that only 24% (13/53) of participants agreed that the monthly report template was easy to complete and that 42% (23/55) indicated that the change from the paper-based to the electronic case notification systems was easy. Only 7% (2/29) of human rabies cases were reported timely, and 65% (13/20) successfully collected specimens. Approximately 39% (56/144) of staff were aware of turning surveillance data into prevention activities, and 21% (31/145) witnessed data used for strategic program decision making. Conclusions: Although rabies surveillance was quite simple, flexible, and accepted in southern Vietnam, simplifying the report forms, training staff, and improving the timeliness of reporting and data usage are highly recommended for a better implementation of rabies surveillance.
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Affiliation(s)
- Quang Duy Pham
- Planning Division, Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam.,Training Center, Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam.,Vietnam Field Epidemiology Training Program, General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Lan Trong Phan
- Directorial Board, Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thuy Phuong Thi Nguyen
- Department for Disease Control and Prevention, Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Quan Minh Ngoc Doan
- Department for Disease Control and Prevention, Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hai Duc Nguyen
- Planning Division, Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Quang Chan Luong
- Department for Disease Control and Prevention, Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Thuong Vu Nguyen
- Directorial Board, Pasteur Institute in Ho Chi Minh City, Ho Chi Minh City, Vietnam
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18
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Saleem SM, Quansar R, Haq I, Salim Khan SM. Imposing COVID-19 lockdown and reported dog bite cases: An experience from a tertiary antirabies center of North India. J Vet Behav 2021; 42:48-52. [PMID: 36042750 PMCID: PMC9412179 DOI: 10.1016/j.jveb.2021.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/29/2022]
Abstract
The world was taken aback after the corona pandemic started from China and soon engulfed the whole of the world. Strict restrictions were in place since the beginning, and people were confined to their homes; only emergency services were allowed to work. The study's objectives were to see the effect of lockdown on the number of dog bite cases being reported to our antirabies clinic. The study was conducted in the antirabies clinic of the Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir. This study involved a dog bite victim who approached the said clinic during the lockdown, which was implemented in the wake of COVID-19 from March 21, 2020 to June 03, 2020. We included all the dog bite victims living in the Srinagar city and from the adjoining districts who had been bitten by the street dog during the lockdown phase. Over 5 years, 4,670 (73.6%) dog bites among males were reported. The proportion of dog bites among males varies from 72% to 81% in the 5 years. It can be observed that a maximum of 783 (81.1%) dog bites were reported from males during the lockdown period in 2020. Moreover, 2,847 (44.9%) bites were category II dog bites, while 3,392 (55.1%) were category III dog bites. There were fewer dog bites reported at the first, fourth, seventh, eighth, and ninth weeks while there was a little surge in cases on the 2nd, 3rd, 5th, 6th, and 10th week. Lockdown had indirectly reduced the number of dog bite cases reported to the clinic during different lockdown phases than the previous year's data.
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Rana MS, Siddiqi UR, Ghosh S, Jahan AA, Islam MK, Ali Shah MR, Ullah SM, Ali SE, Ahmed BN, Shamsuzzaman AKM. Epidemiological study of human rabies cases in Bangladesh through verbal autopsy. Heliyon 2020; 6:e05521. [PMID: 33251369 PMCID: PMC7679256 DOI: 10.1016/j.heliyon.2020.e05521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/28/2020] [Accepted: 11/11/2020] [Indexed: 11/22/2022] Open
Abstract
Identification of risk factors is crucial to find ways to reduce rabies deaths. We investigated the hospital records of rabies deceased through contact tracing of the relatives of the victims using enhanced verbal autopsies (VA) to identify why the people had to die from rabies in recent years in Bangladesh. Patients whose deaths were confirmed by physicians based on the history of animal exposure and clinical signs were taken into account for VA. Socio-demographic profile of the deceased, animal exposure, nature of the wound, and history of post-exposure prophylaxis (PEP) data were obtained and analysed. The study found 256 cases in which the cause of death was attributed to rabies, most of the victims were male (71.88%), resided in the rural community (80.47%), dependent (49.22%), and children below the age of 15 years (47.27%). Dogs were the single most responsible (81.64%); however, cats (12.11%), jackals (3.91%) and mongoose (2.34%) were also found accountable for rabies incidence (P < 0.05). Significantly, limbs were the most common (67.97%) site of exposure, and the shortest incubation period was identified in the case of bites to head and face (P < 0.05). The majority (86.72%) of the deceased did not receive any PEP; whereas, 66.80% sought treatment from traditional healers. Among the deceased (13.28%, n = 34) who had received PEP, only 8.82% of them completed the full course of the vaccination regimen (P < 0.01); however, none of them had history of taking rabies immunoglobulin (RIG). The study recommends extensive public health awareness programs in the rural community and establishing methods to improve healthcare-seeking behaviours, including receiving PEP instead of visiting traditional healers. Moreover, the availability and accessibility of PEP in the government hospital facilities are desirable, and laboratory-based surveillance with compatible rapid data reporting may be incorporated in the existing policy.
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Affiliation(s)
- Md Sohel Rana
- Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh
- Department of Livestock Services, Ministry of Fisheries and Livestock, Bangladesh
| | - Umme Ruman Siddiqi
- Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh
| | - Sumon Ghosh
- Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh
- International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka 1212, Bangladesh
| | - Afsana Akter Jahan
- Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh
| | - Md Kamrul Islam
- Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh
| | - Md Rashed Ali Shah
- Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh
| | - Sayed Mohammed Ullah
- Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh
| | - S.M. Emran Ali
- Infectious Disease Hospital, Mohakhali, Dhaka 1212, Bangladesh
| | - Be-Nazir Ahmed
- Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Bangladesh
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Qiao YC, Wang F, He YL, Yang Q, Yang J, Wei YS. Regional and age difference of human rabies prevalence of the past fourteen years in China. Prev Vet Med 2020; 187:105161. [PMID: 33418517 DOI: 10.1016/j.prevetmed.2020.105161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 07/27/2020] [Accepted: 09/22/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this study is to describe the epidemiological characteristics about regional and age difference of human rabies in the past fourteen years in China, and provide a reliable epidemiology basis for further control and prevention of human rabies. METHODS The database of "China Public Health Science Data Center" affiliated Chinese CDC was searched with the key words of "rabies" or "epidemiology" or "morbidity" or "mortality" from 2004 to 2018 and the corresponding data about human rabies cases was collected referred to regional and age difference for describing the epidemiological characteristics of human rabies. RESULTS In this study, a total of nearly 26,315 rabies cases (1754 ± 253) and 25,691 rabies-related deaths (1712 ± 255) (Mean ± SE) were reported, and a decreasing trend about the morbidity and mortality of human rabies existed from 0.2039 and 0.2039 (1/100,000) in 2004 to 0.0304 and 0.0295 in 2018. Otherwise, regional difference of human rabies prevalence significantly existed, and juvenile and middle-aged population especially in 50-60 years old were more easily attacked and infected with rabies (all p < 0.05). CONCLUSION This study proved that human rabies still is a major public health problem in China though a decreasing trend about the morbidity and mortality of human rabies existed in the past fourteen years.
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Affiliation(s)
- Yong-Chao Qiao
- Department of Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi, China
| | - Feng Wang
- Department of Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi, China
| | - Yong-Ling He
- Department of Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi, China
| | - Qiu Yang
- Department of Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi, China
| | - Jun Yang
- Department of Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi, China.
| | - Ye-Sheng Wei
- Department of Clinical Laboratory, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi, China.
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Ghosh S, Rana MS, Islam MK, Chowdhury S, Haider N, Kafi MAH, Ullah SM, Shah MRA, Jahan AA, Mursalin HS, Marma ASP, Ali SME, Hossain S, Bhowmik R, Debnath NC, Shamsuzzaman AKM, Ahmed BN, Siddiqi UR, Jhora ST. Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006-2018. Sci Rep 2020; 10:2410. [PMID: 32051481 PMCID: PMC7016137 DOI: 10.1038/s41598-020-59109-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 01/24/2020] [Indexed: 11/23/2022] Open
Abstract
Vaccinating dogs against rabies is an effective means of reducing human rabies. We subjected 1327 clinically diagnosed human rabies death 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 (422) for clinico-epidemiological analysis. A positive and increasing trend of MDV (p = 0.01 and tau = 0.71) and a negative and declining trend (p < 0.001 and tau = -0.88) of human rabies cases (Correlation coefficient: -0.82) have been observed. Among 422 deaths, the majority (78%) of the victims sought treatment from traditional healers, and 12% received post-exposure prophylaxis (PEP). The mean incubation period of rabies in cases with exposure sites on the head & neck (35 days) was shorter than the upper limb (mean = 64 days, p = 0.02) and lower limb (mean = 89 days, p < 0.01). MDV has been found to be effective for reducing human rabies cases in Bangladesh. Creating awareness among the animal bite victims to stop reliance on traditional healers rather seeking PEP, addressing the role of traditional healers through awareness education programme with respect to the treatment of dog bites, ensuring availability of PEP, and continuing to scale up MDV may help to prevent human rabies deaths.
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Affiliation(s)
- Sumon Ghosh
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh.
| | - Md Sohel Rana
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
- Department of Livestock Services, Ministry of Fisheries and Livestock, Dhaka, Bangladesh
| | - Md Kamrul Islam
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Sukanta Chowdhury
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Najmul Haider
- Technical University of Denmark, Section for Epidemiology, National Veterinary Institutes, Copenhagen, Denmark
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, London, UK
| | | | - Sayed Mohammed Ullah
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Md Rashed Ali Shah
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Afsana Akter Jahan
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
- Faculty of Veterinary and Animal Sciences, Gono University, Savar, Dhaka, Bangladesh
| | - Hasan Sayedul Mursalin
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Aung Swi Prue Marma
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - S M Emran Ali
- Infectious Disease Hospital, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | - Rajub Bhowmik
- John Jay College of the City University of New York, 445 W 59th St-10019, New York, USA
| | - Nitish C Debnath
- Food and Agriculture Organization of the United Nation, Dhaka, Bangladesh
| | - Abul Khair Mohammad Shamsuzzaman
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Be-Nazir Ahmed
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Umme Ruman Siddiqi
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Sanya Tahmina Jhora
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
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Du Z, Chen Q, Lyu X, Wang T, Wang C. Analyzing the distribution of rabies clinics and achievements of standardized rabies clinics implementation in mainland China. BMC Health Serv Res 2019; 19:955. [PMID: 31829178 PMCID: PMC6907271 DOI: 10.1186/s12913-019-4730-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 11/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For rabies prevention and treatment, the Chinese government has been establishing standardized rabies clinics since 2016. This study aimed to investigate the distribution of rabies clinics and the achievements of newly-implemented standardized rabies clinics in mainland China, for the purpose of providing further rabies control strategies. METHODS The number of rabies clinics, including per million inhabitants in each region, was determined. We sampled 1200 clinics from 8 provinces by multi-stage stratified sampling, and a questionnaire survey was carried out to record each clinic's achievements. Data collected from 1185 questionnaires were analyzed. RESULTS We found that rabies clinics were mostly located in the southwest, central, and eastern regions of China; these accounted for 67.1% of all clinics. The eastern and south regions showed the lowest number of rabies clinics per million inhabitants (0.15 and 0.12, respectively). The total standard-reaching rate of rabies clinics in mainland China was only 11.0%, with significant differences in the rate among regions (X2 = 33.004, p < 0.001). Specifically, the qualified rates of supporting facilities and functional areas were 13.9% (X2 = 34.003, p < 0.001) and 56.1% (X2 = 9.943, p = 0.019), respectively. Vaccines with 2 different substrates and professional flushing equipment were provided by 40.5% (X2 = 27.935, p = 0.001) and 37.7% (X2 = 54.922, p = 0.001) of clinics, respectively. CONCLUSION Regional differences do exist in the distribution of rabies clinics in mainland China, with relative low number per million population in south and eastern China. There are few standardized rabies clinics in mainland China. Efforts are needed to establish supporting facilities, especially for wound treatment and vaccination. Future research should focus on the improvement of rabies clinics standardization.
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Affiliation(s)
- Zhe Du
- Trauma Center, Peking University People's Hospital, No.11 South Xizhimen Street, Beijing, 100044, China
| | - Qingjun Chen
- Department of Emergency, Beijing Hepingli Hospital, Beijing, China
| | - Xinjun Lyu
- China Center for Disease Control and Prevention, Institute for Viral Disease Prevention and Control, Beijing, China
| | - Tianbing Wang
- Trauma Center, Peking University People's Hospital, No.11 South Xizhimen Street, Beijing, 100044, China.
| | - Chuanlin Wang
- Trauma Center, Peking University People's Hospital, No.11 South Xizhimen Street, Beijing, 100044, China. .,Department of Emergency, Peking University People's Hospital, Beijing, China.
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Epidemiological characterization of bites: A retrospective study of dog bites to humans in Chile during 2009. J Vet Behav 2019. [DOI: 10.1016/j.jveb.2019.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Epidemiological and phylogenetic analysis of rabies virus isolated from humans in Henan province, China. Arch Virol 2019; 164:2811-2817. [DOI: 10.1007/s00705-019-04388-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 08/01/2019] [Indexed: 12/14/2022]
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Feline herpesvirus vectored-rabies vaccine in cats: A dual protection. Vaccine 2019; 37:2224-2231. [PMID: 30878247 DOI: 10.1016/j.vaccine.2019.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/02/2019] [Accepted: 03/05/2019] [Indexed: 01/01/2023]
Abstract
In China, cats cause about 5% of human rabies cases. Rabies control in cats plays a role in achieving the ultimate goal of elimination of dog rabies-mediated human deaths. However, there is no cat-specific rabies vaccine in China yet. In this study, we constructed a recombinant rabies vaccine by using a felid herpesvirus 1 (FHV-1) isolate, and deleted the gI/E in the FHV-1 and replaced the region with a glycoprotein (G) of rabies virus (RABV) strain BD06 through homologous recombination. The recombinant virus FHV-RVG was recovered and purified, and the expression of RABV glycoprotein was verified by indirect immunofluorescent assay. For potency in cats, each animal was inoculated intranasally with 1 ml FHV-RVG at 106.5 TCID50. Blood samples were collected at defined intervals for antibody titration. The animals were challenged by herpes and rabies after completion of vaccination on day 180 and day 194, respectively. Our results demonstrated all vaccinated cats generated antibodies against both FHV-1 and RABV, and reached an arbitrary protective titer > 0.5 IU/ml for rabies viral neutralizing antibody (VNA) by day 14 post inoculation (dpi) and titer peaked on 30 dpi with VNA at 24.5 ± 10.23 IU/ml. All vaccinated cats presented no clinical signs of FHV-1 infection and survived rabies challenge, while the control cats had severe rhinotracheitis and died from rabies after challenge. All this demonstrated that the FHV-based recombinant vaccine is effective in protection against both FHV-1 and RABV infections.
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Wei Y, Liu X, Li D, Chen S, Xu J, Chen K, Yang Z. Canine rabies control and human exposure 1951-2015, Guangzhou, China. Bull World Health Organ 2018; 97:51-58. [PMID: 30618465 PMCID: PMC6307510 DOI: 10.2471/blt.18.217372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/08/2018] [Accepted: 10/26/2018] [Indexed: 12/25/2022] Open
Abstract
Objective To describe changes in rabies surveillance and management in Guangzhou, China between 1951 and 2015, and to analyse human rabies cases over that period. Methods Rabies control policies and strategies implemented by the Guangzhou government were reviewed for three periods: 1951 to 1978, 1979 to 2000 and 2001 to 2015. Data on human rabies deaths and exposure were obtained from Guangzhou and national health and disease records. The demographic characteristics of human cases are reported using descriptive statistics. Findings Between 1951 and 2015, the number of organizations cooperating on rabies control increased: there were two between 1951 and 1978, six between 1979 and 2000, and nine between 2001 and 2015. The number of human rabies cases reported in these periods was 331, 422 and 60, respectively. Organizations involved included city and district centres for disease control and prevention, rabies outpatient clinics, medical institutions and police. Overall, 88% (713/813) of cases occurred in rural districts, though, between 1951 and 2015, the distribution shifted from being predominantly rural to being both urban and rural. The number of people exposed to rabies increased annually. The biggest increases were among those injured by a pet dog or other animal: 3.26 and 4.75 times, respectively, between 2005 and 2015. Conclusion Increased cooperation on rabies control between civil organizations in Guangzhou over decades was associated with a marked decrease in the number of human rabies cases. The Guangzhou experience could thereby provide guidance for other cities experiencing similar rabies epidemics.
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Affiliation(s)
- Yuehong Wei
- Guangzhou Center for Disease Control and Prevention, No. 1 Qi De road, Baiyun District, Guangzhou, China
| | - Xiaoning Liu
- Guangzhou Center for Disease Control and Prevention, No. 1 Qi De road, Baiyun District, Guangzhou, China
| | - Dapeng Li
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Shouyi Chen
- Guangzhou Center for Disease Control and Prevention, No. 1 Qi De road, Baiyun District, Guangzhou, China
| | - Jianmin Xu
- Guangzhou Center for Disease Control and Prevention, No. 1 Qi De road, Baiyun District, Guangzhou, China
| | - Kuncai Chen
- Guangzhou Center for Disease Control and Prevention, No. 1 Qi De road, Baiyun District, Guangzhou, China
| | - Zhicong Yang
- Guangzhou Center for Disease Control and Prevention, No. 1 Qi De road, Baiyun District, Guangzhou, China
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