Clinical aspects of human rabies in the state of Ceará, Brazil: an overview of 63 cases.

INTRODUCTION: Rabies is considered one of the most relevant public health problems owing to its high fatality rate and the high number of deaths worldwide. METHODS: We included patients with human rabies who attended a reference hospital in the state of Ceará during 1976-2019. RESULTS: Data were available for 63 out of 171 (36.8%) patients. Of these patients, 48 (76.2%) were attacked by dogs. In recent years, wild animals have been the most common aggressor species (marmosets and bats). Only 39 (70%) patients were initially correctly suspected with rabies. Bites were the most frequent exposure (56; 96%), most commonly on the hands (21; 42%) and the head (9; 18.4%). Only 14 (22%) patients had sought medical assistance before the onset of symptoms, and only one completed post-exposure prophylaxis. The most prevalent signs and symptoms included aggressiveness/irritability (50; 79.4%), fever (42; 66.7%), sore throat/dysphagia (40; 63.5%), and myalgia (28; 44.4%). Hydrophobia was present in 17 patients (22.0%). CONCLUSIONS: Most cases of human rabies in Ceará occurred due to the failure to seek medical assistance and/or the failure of the health system in initiating early post-exposure prophylaxis. There is a need for specific information and education campaigns focusing on the cycle of sylvatic rabies as well as prevention measures. Health professionals should undergo refresher training courses on the signs and symptoms of rabies and on the specific epidemiological features of the disease in Brazil.

Epidemiology of human rabies in the state of Ceará, Brazil, 1970 to 2019. / Epidemiologia da raiva humana no estado do Ceará, 1970 a 2019.

OBJECTIVE: To describe cases of human rabies in Ceará State, Brazil between 1970 and 2019. METHODS: This was a descriptive study using secondary data from the Ceará State Department of Health and the state reference hospital. RESULTS: Of 171 cases, 75.7% occurred in males, 60.0% in <19-year-olds, and 56.0% in urban areas. Rabies was transmitted by dogs in 74.0% of cases, marmosets in 16.7% and bats in 7.3%. Between 1970 and 1978, there was an increase of cases (using the Joinpoint Regression Program, annual percentage change [APC] = 13.7 - 95%CI 4.6;41.5), while between 1978 and 2019 there was a decrease (APC = -6.7 - 95%CI -8.8;-5.9). There was a reduction in transmission by dogs (71 cases, last case in 2010) and an increase by sylvatic animals (5 cases since 2005). CONCLUSION: This study demonstrates changes in rabies transmission dynamics during the period studied, with a reduction in transmission by dogs and an increase of transmission by sylvatic animals.

Epidemiologia da raiva humana no estado do Ceará, 1970 a 2019 / Epidemiología de la rabia humana en el estado de Ceará, Brasil, 1970 a 2019 / Epidemiology of human rabies in the state of Ceará, Brazil, 1970 to 2019

Objetivo: Descrever os casos de raiva humana no estado do Ceará, Brasil, no período 1970-2019. Métodos: Estudo descritivo, sobre dados secundários da Secretaria da Saúde e do hospital de referência do Ceará. Resultados: Dos 171 casos, 75,7% ocorreram em homens, 60,0% nas idades até 19 anos e 56,0% em áreas urbanas. O cão foi agente transmissor em 74,0% dos casos; sagui em, 16,7%; e morcego, em 7,3%. Entre 1970 e 1978, houve crescimento do número de casos (pelo Joinpoint Regression Program, percentual da mudança anual [APC] = 13,7 - IC95% 4,6;41,5); e entre 1978 e 2019, redução (APC = -6,7 - IC95% -8,8;-5,9). Houve redução da transmissão por cães (71 casos; último caso em 2010) e aumento relativo por mamíferos silvestres (5 casos a partir de 2005). Conclusão: O estudo evidencia mudança na dinâmica da transmissão da raiva no período observado, com redução da transmissão por cão e incremento de casos por animais silvestres.

Objetivo: Describir los casos de la rabia humana en Ceará, Brasil, 1970-2019. Métodos: Estudio descriptivo con datos secundarios de la Secretaría de Salud y del hospital de referencia de Ceará. Resultados: De los 171 casos, 75,7% ocurrió en hombres, el 60,0% en los 19 años y el 56,0% en áreas urbanas. El perro fue transmisor en 74,0%, el mono tití en 16,7% y el murciélago el 7,3%. Entre 1970 y 1978, hubo un aumento de casos (por el Joinpoint Regression Program, cambio porcentual anual [APC] = 13,7 - IC95% 4,6; 41,5), entre 1978 y 2019 una disminución (APC= -6,7 - IC95% -8,8; -5,9). Hubo una reducción de la transmisión por perros (71 casos, el último en 2010) y un aumento por mamíferos salvajes (5 casos, desde 2005). Conclusión: El estudio muestra un cambio en la dinámica de la transmisión de la rabia en los últimos años, con reducción de la transmisión por perros y aumento de casos por animales salvajes.

Objective: To describe cases of human rabies in Ceará State, Brazil between 1970 and 2019. Methods: This was a descriptive study using secondary data from the Ceará State Department of Health and the state reference hospital. Results: Of 171 cases, 75.7% occurred in males, 60.0% in <19-year-olds, and 56.0% in urban areas. Rabies was transmitted by dogs in 74.0% of cases, marmosets in 16.7% and bats in 7.3%. Between 1970 and 1978, there was an increase of cases (using the Joinpoint Regression Program, annual percentage change [APC] = 13.7 - 95%CI 4.6;41.5), while between 1978 and 2019 there was a decrease (APC = -6.7 - 95%CI -8.8;-5.9). There was a reduction in transmission by dogs (71 cases, last case in 2010) and an increase by sylvatic animals (5 cases since 2005). Conclusion: This study demonstrates changes in rabies transmission dynamics during the period studied, with a reduction in transmission by dogs and an increase of transmission by sylvatic animals.

Clinical aspects of human rabies in the state of Ceará, Brazil: an overview of 63 cases

Abstract INTRODUCTION Rabies is considered one of the most relevant public health problems owing to its high fatality rate and the high number of deaths worldwide. METHODS We included patients with human rabies who attended a reference hospital in the state of Ceará during 1976-2019. RESULTS Data were available for 63 out of 171 (36.8%) patients. Of these patients, 48 (76.2%) were attacked by dogs. In recent years, wild animals have been the most common aggressor species (marmosets and bats). Only 39 (70%) patients were initially correctly suspected with rabies. Bites were the most frequent exposure (56; 96%), most commonly on the hands (21; 42%) and the head (9; 18.4%). Only 14 (22%) patients had sought medical assistance before the onset of symptoms, and only one completed post-exposure prophylaxis. The most prevalent signs and symptoms included aggressiveness/irritability (50; 79.4%), fever (42; 66.7%), sore throat/dysphagia (40; 63.5%), and myalgia (28; 44.4%). Hydrophobia was present in 17 patients (22.0%). CONCLUSIONS Most cases of human rabies in Ceará occurred due to the failure to seek medical assistance and/or the failure of the health system in initiating early post-exposure prophylaxis. There is a need for specific information and education campaigns focusing on the cycle of sylvatic rabies as well as prevention measures. Health professionals should undergo refresher training courses on the signs and symptoms of rabies and on the specific epidemiological features of the disease in Brazil.

O lúdico como instrumento de preservação de animais selvagens / The ludic as an instrument of preservation of animals wild

O Projeto BEAGUARAS realiza atividades de educação humanitária para crianças e adolescentes, visando à informação, preservação e combate ao tráfico, além do bem-estar animal. Este trabalho tem como objetivo analisar os desenhos produzidos pelos alunos da ONG Lar Domingos Sávio após ação de educação humanitária. Foi realizado um estudo descritivo tendo como base os desenhos produzidos por alunos do 6° ao 8° ano e idade entre 8 a 12 anos após as atividades de orientação e sensibilização realizadas pelos integrantes. Considerou-se a quantidade de animais domésticos e selvagens, as espécies, o tipo de alimentação, a concepção das crianças sobre os animais selvagens e se aprenderam sobre a ação de conscientização. Dos 54 desenhos, 35 (64,81%) foram de cães e gatos, 13 (24,07%) de selvagens e 6 (11,11%) apresentavam cães e gatos e selvagens. As figuras produzidas podem representar o real, o que foi percebido e o imaginário, e na análise foi constatado que alguns alunos têm proximidade com espécies selvagens, o que abre espaço para a reflexão sobre riscos de agressões e transmissão de zoonoses. Assim, com as ações de conscientização do projeto, essas crianças e adolescentes irão tornar-se adultos conscientes e responsáveis voltados para a causa animal e ambiental.(AU)

The BEAGUARAS Project carries out humanitarian education activities for children and adolescents, aiming at information, preservation and fight against trafficking, as well as animal welfare. This work aims to analyze the drawings produced by the students of the NGO Lar Domingos Sávio after humanitarian education action. A descriptive study was carried out based on the drawings produced by students from 6th to 8th year and age between 8 and 12 years after the orientation and awareness activities carried out by the members. The number of domestic and wild animals, the species, the type of feeding, the conception of the children about the wild animals and the awareness of the awareness were considered. Of the 54 designs, 35 (64.81%) were from dogs and cats, 13 (24.07%) from wild and 6 (11.11%) presented dogs and cats and wild. The figures produced can represent the real, what was perceived and the imaginary, and in the analysis it was verified that some students have proximity to wild species, which opens space for the reflection on the risks of aggression and the transmission of zoonoses. Thus, through project awareness actions, these children and adolescents will become conscious and responsible adults focused on the animal and environmental cause. (AU)

Osteossíntese de ulna com fixação de Doyle em canário-da-terra (Sicalis flaveola) / Ulnar osteosynthesis with Doyles fixation in a canary - Sicalis flaveola

Esse trabalho tem objetivo por relatar um caso de osteossíntese de ulna com fixação de Doyle em Canário-da-terra (Sicalis flaveola). A ave sofreu uma fratura na ulna devido a ataque deum gato. Após a avaliação clínica, foi escolhido a Técnica de Doyle para o tratamento cirúrgico. Dessa forma, demonstrou que a técnica utilizada obteve um bom prognóstico parao paciente.(AU)

This present study is a case report of an ulnar osteosynthesis with Doyles fixation in a canary (Sicalis flaveola). The bird/patient suffered an ulnar fracture after being attacked by a cat. After clinical evaluation, Doyle´s fixation was chosen for surgical treatment. Thus, this technique demonstrated to be beneficial to the patient, improving its prognosis.(AU)

Osteossíntese de ulna com fixação de Doyle em canário-da-terra (Sicalis flaveola) / Ulnar osteosynthesis with Doyle’s fixation in a canary - Sicalis flaveola

Esse trabalho tem objetivo por relatar um caso de osteossíntese de ulna com fixação de Doyle em Canário-da-terra (Sicalis flaveola). A ave sofreu uma fratura na ulna devido a ataque deum gato. Após a avaliação clínica, foi escolhido a Técnica de Doyle para o tratamento cirúrgico. Dessa forma, demonstrou que a técnica utilizada obteve um bom prognóstico parao paciente.

This present study is a case report of an ulnar osteosynthesis with Doyle’s fixation in a canary (Sicalis flaveola). The bird/patient suffered an ulnar fracture after being attacked by a cat. After clinical evaluation, Doyle´s fixation was chosen for surgical treatment. Thus, this technique demonstrated to be beneficial to the patient, improving its prognosis.

O lúdico como instrumento de preservação de animais selvagens / The ludic as an instrument of preservation of animals wild

O Projeto BEAGUARAS realiza atividades de educação humanitária para crianças e adolescentes, visando à informação, preservação e combate ao tráfico, além do bem-estar animal. Este trabalho tem como objetivo analisar os desenhos produzidos pelos alunos da ONG Lar Domingos Sávio após ação de educação humanitária. Foi realizado um estudo descritivo tendo como base os desenhos produzidos por alunos do 6° ao 8° ano e idade entre 8 a 12 anos após as atividades de orientação e sensibilização realizadas pelos integrantes. Considerou-se a quantidade de animais domésticos e selvagens, as espécies, o tipo de alimentação, a concepção das crianças sobre os animais selvagens e se aprenderam sobre a ação de conscientização. Dos 54 desenhos, 35 (64,81%) foram de cães e gatos, 13 (24,07%) de selvagens e 6 (11,11%) apresentavam cães e gatos e selvagens. As figuras produzidas podem representar o real, o que foi percebido e o imaginário, e na análise foi constatado que alguns alunos têm proximidade com espécies selvagens, o que abre espaço para a reflexão sobre riscos de agressões e transmissão de zoonoses. Assim, com as ações de conscientização do projeto, essas crianças e adolescentes irão tornar-se adultos conscientes e responsáveis voltados para a causa animal e ambiental.

The BEAGUARAS Project carries out humanitarian education activities for children and adolescents, aiming at information, preservation and fight against trafficking, as well as animal welfare. This work aims to analyze the drawings produced by the students of the NGO Lar Domingos Sávio after humanitarian education action. A descriptive study was carried out based on the drawings produced by students from 6th to 8th year and age between 8 and 12 years after the orientation and awareness activities carried out by the members. The number of domestic and wild animals, the species, the type of feeding, the conception of the children about the wild animals and the awareness of the awareness were considered. Of the 54 designs, 35 (64.81%) were from dogs and cats, 13 (24.07%) from wild and 6 (11.11%) presented dogs and cats and wild. The figures produced can represent the real, what was perceived and the imaginary, and in the analysis it was verified that some students have proximity to wild species, which opens space for the reflection on the risks of aggression and the transmission of zoonoses. Thus, through project awareness actions, these children and adolescents will become conscious and responsible adults focused on the animal and environmental cause.

Achados anatomopatológicos em serpente Boa constrictor vítima de atropelamento / Anatomopathological findings in snake Boa constrictor victim of run over

Acidentes automobilísticos em animais silvestres são cada vez mais comuns. Isso acontece devido ao aparecimento desses animais em áreas urbanas, como consequência da perda de seu habitat natural, que sofre influências do homem, como o desmatamento e o uso econômico dessas áreas. O presente relato descreve o caso de uma jiboia (Boa constrictor) de vida livre, vítima de atropelamento, e seus achados anatomopatológicos decorrentes do acidente. Na necropsia foi observado na região lateral uma laceração na pele de aproximadamente 6 cm de comprimento. Além disso, havia evisceração de segmento de alças intestinais. No subcutâneo e na musculatura evidenciou-se áreas multifocais de hemorragia, e as costelas estavam fraturadas. Ressalta-se a importância da preservação dessas espécies, através de medidas que minimizem as chances de ocorrência de acidentes causados pelo homem, que repercutem na queda da biodiversidade.(AU)

Automobile accidents in wild animals are becoming more common. This is due to the appearance of these animals in urban areas as a consequence of the loss of their natural habitat, which is influenced by human, such as deforestation and the economic use of these areas. The present report describes the case of a jiboia (Boa constrictor) victim of trampling and his anatomopathological findings resulting from the accident. At the necropsy a laceration in the skin of approximately 6 cm in length was observed in the lateral region. In addition, there was evisceration of segment of intestinal loops. In the subcutaneous and in the musculature multifocal areas of hemorrhage were evidenced, and the ribs were fractured. The importance of the preservation of these species is emphasized through measures that minimize the chances of human-induced accidents, which affect the decline of biodiversity.(AU)

Achados anatomopatológicos em serpente Boa constrictor vítima de atropelamento / Anatomopathological findings in snake Boa constrictor victim of run over

Acidentes automobilísticos em animais silvestres são cada vez mais comuns. Isso acontece devido ao aparecimento desses animais em áreas urbanas, como consequência da perda de seu habitat natural, que sofre influências do homem, como o desmatamento e o uso econômico dessas áreas. O presente relato descreve o caso de uma jiboia (Boa constrictor) de vida livre, vítima de atropelamento, e seus achados anatomopatológicos decorrentes do acidente. Na necropsia foi observado na região lateral uma laceração na pele de aproximadamente 6 cm de comprimento. Além disso, havia evisceração de segmento de alças intestinais. No subcutâneo e na musculatura evidenciou-se áreas multifocais de hemorragia, e as costelas estavam fraturadas. Ressalta-se a importância da preservação dessas espécies, através de medidas que minimizem as chances de ocorrência de acidentes causados pelo homem, que repercutem na queda da biodiversidade.

Automobile accidents in wild animals are becoming more common. This is due to the appearance of these animals in urban areas as a consequence of the loss of their natural habitat, which is influenced by human, such as deforestation and the economic use of these areas. The present report describes the case of a jiboia (Boa constrictor) victim of trampling and his anatomopathological findings resulting from the accident. At the necropsy a laceration in the skin of approximately 6 cm in length was observed in the lateral region. In addition, there was evisceration of segment of intestinal loops. In the subcutaneous and in the musculature multifocal areas of hemorrhage were evidenced, and the ribs were fractured. The importance of the preservation of these species is emphasized through measures that minimize the chances of human-induced accidents, which affect the decline of biodiversity.