ABSTRACT
In March 2024, the first ever human case of rabies, following a dog bite, was detected in Timor-Leste. This paper briefly discusses the circumstances of transmission, clinical presentation, palliative care of the case and public health measures taken. Timor-Leste was previously considered rabies-free. Any person who is bitten or scratched by an animal that could potentially transmit rabies virus (especially dogs, bats, monkeys or cats) in Timor-Leste should be assessed for consideration of provision of rabies post-exposure prophylaxis.
Subject(s)
Bites and Stings , Post-Exposure Prophylaxis , Rabies virus , Rabies , Animals , Cats , Dogs , Female , Humans , Bites and Stings/virology , Chiroptera/virology , Rabies/diagnosis , Rabies/veterinary , Rabies/transmission , Rabies Vaccines/administration & dosage , Rabies virus/isolation & purification , Timor-Leste/epidemiology , AdolescentABSTRACT
Germany has been considered free of terrestrial rabies since 2008 as a result of intensive vaccination and surveillance efforts but reservoirs of the lyssaviruses EBLV1 and EBLV2 persist in bat colonies and thus pose a potential risk of infection. We report on a patient who suffered a bat bite in an urban setting in which European bat lyssavirus 1 (EBLV-1) was detected in the euthanized bat. We performed active and passive postexposure prophylaxis (PEP). This case study illustrates the ongoing risk of rabies infection due to close bat contacts in Germany and is intended to sensitize primary care physicians to take such exposure events seriously and to perform a regular PEP including administration of rabies immunoglobulin.
Subject(s)
Bites and Stings , Chiroptera , Lyssavirus , Post-Exposure Prophylaxis , Rabies , Chiroptera/virology , Humans , Animals , Lyssavirus/immunology , Bites and Stings/virology , Rabies/prevention & control , Rabies/transmission , Rhabdoviridae Infections/prevention & control , Rhabdoviridae Infections/transmission , Rhabdoviridae Infections/virology , Male , Germany , Rabies Vaccines/administration & dosageABSTRACT
Objetivo: Analisar os atendimentos antirrábicos humanos de profilaxia pós-exposição no Brasil. Métodos: Estudo descritivo utilizando dados do Sistema de Informação de Agravos de Notificação no Brasil, de 2014 a 2019. Resultados: Foram notificados 4.033.098 atendimentos antirrábicos, com média de 672.183 ao ano. Houve maior percentual de atendimentos em pessoas do sexo masculino (n = 2.111.369; 52,4%), menores de 19 anos de idade (n = 1.423.433; 35,3%), residentes em área urbana (n = 3.386.589; 88,1%), agredidas por cães (n = 3.281.190; 81,5%) e com mordeduras (n = 3.575.717; 81,9%), principalmente em mãos e pés (n = 1.541.201; 35,3%). A conduta profilática mais frequente foi observação e vacina (n = 1.736.036; 44,2%). A conduta profilática foi adequada em 57,8% (n = 2.169.689) e inadequada em 42,2% (n = 1.582.411) dos casos. Conclusão: Apesar das condutas profiláticas adequadas, foram observadas indicações inadequadas que, quando insuficientes, podem acarretar casos de raiva humana e, quando desnecessárias, desperdícios, inclusive desabastecimento de imunobiológicos.
Objetivo: Analizar la atención antirrábica humana de profilaxis post exposición en Brasil, de 2014 a 2019. Métodos: Estudio descriptivo utilizando datos del Sistema de Información de Agravamientos de Notificación en Brasil, de 2014 a 2019. Resultados: Se notificaron 4.033.098 atendimientos antirrábicos, con un promedio de 672.183 al año. Hubo mayor porcentual de atención a personas del sexo masculino (n = 2.111.369; 52,4%), menores de 19 años (n = 1.423.433; 35,3%), residentes en área urbana (n = 3.386.589; 88,1%), agredidas por perros (n = 3.281.190; 81,5%) y con mordidas (n = 3.575.717; 81,9%), principalmente en las manos y pies (n = 1.541.201; 35,3%). La conducta profiláctica más frecuente fue la observación y vacuna (n = 1.736.036; 44,2%). La conducta profiláctica fue adecuada en 57,8% (n = 2.169.689) e inadecuada en 42,2% (n = 1.582.411) de los casos. Conclusión: A pesar de las conductas profilácticas adecuadas, se observaron indicaciones inadecuadas que, cuando insuficientes, pueden resultar en casos de rabia humana y, cuando desnecesarias, desperdicios, incluso desabastecimiento de inmunobiológicos.
Objective: To analyze human anti-rabies post-exposure prophylaxis notifications in Brazil. Methods: This was a descriptive study using data from the Notifiable Diseases Information System in Brazil, from 2014 to 2019. Results: A total of 4,033,098 anti-rabies medical consultations were notified, averaging 672,183 a year. Percentage care was higher among males (n = 2,111,369; 52.4%), those under 19 years old (n = 1,423,433; 35.3%), living in urban areas (n = 3,386,589; 88.1%), attacked by dogs (n = 3,281,190; 81.5%) and bitten (n = 3,575,717; 81.9%), mainly on the hands and feet (n = 1,541,201; 35.3%). The most frequent prophylactic procedure was observation plus vaccination (n = 1,736,036; 44.2%). Prophylactic procedure was appropriate in 57.8% (n = 2,169,689) of cases and inappropriate in 42.2% (n = 1,582,411) of cases. Conclusion: Although there were appropriate prophylactic procedures, we also found procedures that were inappropriate and which, when insufficient, can result in cases of human rabies and, when unnecessary, can result in waste, including shortage of immunobiological products.
Subject(s)
Humans , Animals , Rabies/therapy , Rabies/epidemiology , Post-Exposure Prophylaxis/statistics & numerical data , Bites and Stings/virology , Brazil/epidemiology , Rabies Vaccines/therapeutic use , Disease Notification , Neglected Diseases/epidemiologyABSTRACT
Abstract This study evaluated the prophylactic measures adopted after attacks by dogs and cats in the main city of Northwester São Paulo State, based on the technical manual for post-exposure treatment, considering the not controlled (1990-1996) and controlled (1997-2010) rabies status. A retrospective analysis was done using the data from the SINAN records (W64-CID10) between 1990 and 2010. In most cases, the accidents were mild (76.9%), and biting animals were healthy (75.4%); therefore, no treatment was needed in 53.3% of the cases. In 64.6% of cases, the prescribed PEP treatment was inappropriate. The most indicated PEP treatments consisted of vaccine and RIG (43.4%), and either three doses of mouse brain vaccine or two doses of cell culture vaccine (76.5%), during the not controlled and controlled rabies periods, respectively. The treatment was more appropriate and followed the technical recommendations during controlled rabies periods compared to not controlled (p < 0.0001) periods. However, excessive application of RIG and rabies vaccine was observed in both periods.
Resumo O objetivo da presente pesquisa foi avaliar a conduta profilática adotada após agressões por cães e gatos no município de Araçatuba, SP, com base no Manual Técnico de Tratamento Antirrábico Humano e considerando-se as situações de raiva não controlada (1990-1996) e controlada (1997-2010). Foi realizada uma análise retrospectiva dos dados das fichas do SINAN (W64-CID10) preenchidas pelo serviço de atendimento antirrábico no período de 1990 a 2010. Na maioria dos casos os acidentes foram leves (76,9%) e os animais agressores estavam sadios (75,4%), resultando em 53,3% de dispensa do tratamento. Em 64,6% dos casos em que houve indicação de tratamento esta foi considerada inadequada. No período de raiva não controlada houve maior indicação do tratamento com vacina e soro (43,4%) e no de raiva controlada o tratamento com três doses de vacina Fuenzalida e Palácios ou duas doses de vacina de cultivo celular (76,5%). No período de raiva controlada as condutas foram mais adequadas, segundo as recomendações técnicas, do que no período de raiva não controlada (p < 0,0001), embora, em ambos os períodos, tenha se observado uma aplicação excessiva de soro e vacina.
Subject(s)
Humans , Animals , Male , Female , Infant , Child, Preschool , Child , Cats , Dogs , Rabies/epidemiology , Bites and Stings/epidemiology , Rabies Vaccines/administration & dosage , Post-Exposure Prophylaxis/statistics & numerical data , Rabies/prevention & control , Bites and Stings/virology , Brazil/epidemiology , Cats , Retrospective Studies , MiceABSTRACT
The aim of the present study was to evaluate the data on human exposure to potential rabies virus transmitters in Olinda, State of Pernambuco, Brazil. Data from 7,062 patients who underwent antirabies prophylactic treatment in Olinda between 2002 and 2006 were analyzed. As expected, dogs and cats were involved in most of the cases; i.e. 82.3 and 16.3 percent, respectively. Attacks by nonhuman primates, bats and other species (unspecified) were also reported. Among the 7,062 patients who underwent antirabies treatment, 582 patients abandoned the treatment, either by indication from the health unit (195) or by their own decision (387). In conclusion, this study has indicated that prophylaxis for human rabies in this urban area will require a multifaceted approach, including health education, post-exposure prophylaxis, systematic vaccination for dogs and cats, and possibly selective control over wild animals such as hematophagous bats.
O objetivo deste estudo foi avaliar os dados sobre a exposição humana a potenciais transmissores do vírus rábico em Olinda, Pernambuco, Brasil. Foram analisados dados de 7.062 pacientes submetidos ao tratamento anti-rábico em Olinda entre 2002 e 2006. Como esperado, cães e gatos estiveram envolvidos na maioria dos casos; isto é, 82,3 e 16,3 por cento, respectivamente. Ataques por primatas não-humanos, morcegos e outras espécies (não especificadas) também foram relatadas. Dos 7.062 pacientes submetidos ao tratamento anti-rábico, 582 abandonaram o tratamento, seja por indicação da unidade de saúde (195) ou por decisão própria (387). Concluindo, esse estudo indica que a profilaxia da raiva humana nessa área urbana irá requer uma abordagem multifacetada, incluindo educação em saúde, profilaxia pós-exposição, vacinação sistemática de cães e gatos e, eventualmente, o controle seletivo de animais silvestres, tais como morcegos hematófagos.