Evaluation of Rabies Suspected Bites in an Immunization Center

2016-04-12T02-23-17Z
Source: TAF Preventive Medicine Bulletin
Duran Tok, Mutahher Akçaer, Ömer Çoşkun, Ahmet Karakaş, Yavuz Çekli.
Rabies is a fatal viral disease. Timely and appropriate vaccination is of vital importance in preventing this disease. The Rabies Field Guide has been prepared by the Ministry of Health of Turkey and implemented in 20214. This guide has developed a standardized nationwide approach to injuries with a rabies risk. The present study explored characteristics of patients that presented to our vaccination center for rabies prophylaxis, reasons for prophylaxis, prophylaxis approach employed, and the rate of compliance to prophylaxis. Materials and Methods: The study included patients who presented to our vaccination center between 2010 and 2012 due to contact with mammals suspected of rabies. Age, gender, site of the bite, previous vaccination status, adherence to vaccination schedule, vaccination schedule employed, type and vaccination status of the attacking animal were recorded on the forms. Results: A total of 591 patients (444 males, 75.1%), who were admitted for vaccination between 2010 and 2012, and who had accessible data, were included in the study. The mean age was 23.82±14.86 years (minimum-maximum: 1-83 years). Of these patients, 97.5% presented after exposure, while 2.5% presented for prophylaxis before exposure. The animals involved in these injuries were dogs in 50.9% and cats in 42.1%. Three cases were medical personnel at the department of forensic medicine that presented for prophylaxis after performing an autopsy to a patient who died from rabies. When the patients were evaluated according to age groups, 48.2% were in the 16-30 years age group. The affected body site was upper extremity in 63.8% of the injuries, lower extremity in 26.1%, head-neck region in 3.2%, and trunk in 1.9%. When the time between the injury and presentation to the hospital was evaluated, 73.6% of the cases presented in the same day, 25% presented between days 1 and 6, and 1.3% presented between days 7 and 15. After exposure, 54% of the patients received 5 doses, 46% received 3 doses, and 4.2% of the patients additionally received rabies hyperimmunoglobulin. Conclusion: The patients presented to our center due to suspected exposure to rabies mostly consisted of young individuals. Dogs were the most frequent animals involved in these injuries. Vaccination of the petted cats and dogs using a particular vaccination schedule, and breeding of stray animals are particularly important in combat with rabies. One fourth of the cases presented to our center days after the exposure. Public awareness campaigns must be conducted by the health authorities due to the fact that administration of prophylaxis as soon as possible after exposure.


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