Clinical, epidemiological, and spatial features of human rabies cases in Metro Manila, the Philippines from 2006 to 2015

Guzman, Ferdinand de; Iwamoto, Yuta; Saito, Nobuo; Salva, Eumelia P.; Dimaano, Efren M.; Nishizono, Akira; Suzuki, Motoi; Oloko, Oladeji; Ariyoshi, Koya; Smith, Chris; Parry, Christopher M.; Solante, Rontgene

doi:10.1371/journal.pntd.0010595

Cited by 7 publications

(12 citation statements)

References 36 publications

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“…The overall progress was associated with greater veterinary services involvement, broad public support, communal advocacy, increased health communications, focused community education, and One Health linkages (Medina et al 2016 ; Valenzuela et al 2017 ; Barroga et al 2018 ; Deray et al 2018 ; Amparo et al 2019 ). However, in the Metro Manila area, between 2006 and 2015, there was no decline in deaths or in the catchment area from which human rabies cases occurred (Guzman et al 2022 ). The COVID-19 pandemic also played a prominent role in setbacks.…”

Section: Progress and Attempted Quick Returns In The Face Of Recurren...mentioning

confidence: 99%

Rabies in a postpandemic world: resilient reservoirs, redoubtable riposte, recurrent roadblocks, and resolute recidivism

et al. 2023

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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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Section: Progress and Attempted Quick Returns In The Face Of Recurren...mentioning

confidence: 99%

Rabies in a postpandemic world: resilient reservoirs, redoubtable riposte, recurrent roadblocks, and resolute recidivism

et al. 2023

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“…The incidence rate of human rabies per 100 000 population in 2007, 2010 and 2015 was 0.1305, 0.1356 and 0.1708 in the National Capital Region; 0.2890, 0.2965 and 0.1961 in Region III; and 0.1449, 0.1272 and 0.1041 in Region IV–A, respectively. 28 …”

Section: Resultsmentioning

confidence: 99%

“…Overall, the incidence of rabies ranged between 0.1 per 100 000 population in the Philippines28 and 117.2 per 100 000 population in Vietnam 18. The average monthly number of rabies cases in Vietnam was 429 during the period from 2011 to 2015, with the incidence ranging from 1.7 to 117.2 per 100 000, with higher incidences observed in the Red River, South Central Coast (SCC) and Mekong River Delta (MRD) regions 29.…”

Section: Resultsmentioning

confidence: 99%

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Rabies in Southeast Asia: a systematic review of its incidence, risk factors and mortality

et al. 2023

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ObjectiveRabies 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.DesignSystematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020.Data sourcesScopus, Web of Science and PubMed were searched from 1 January 2012 to 21 February 2023.Eligibility criteriaOriginal English language articles published between 2012 and 2023 were included.Data extraction and synthesisNine 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.ResultsA 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%.ConclusionThis 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 numberCRD42022311654.

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“…7 Recently experts have advocated the introduction of category IV for severe bites/ exposure, especially on the head and neck. 15,16 We have given Rabies PEP to thousands of bite victims who were bitten on sensitive innervated areas like the head and neck, even the scrotum (Figure 1). There has been only one confirmed PEP failure at Theog Government Hospital, 30 km away from our clinic in Shimla, where a facial nerve was torn by a rabid dog.…”

Section: Discussionmentioning

confidence: 99%

WHO Needs to Re-look at Animal Bite Wound Classification for Rabies Post Exposure Prophylaxis to Save People from Deadly Rabies!

Bharti¹

2022

EpidemInt

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Rabies is a deadly zoonotic disease that is largely caused by bites or scratches of an infected dog. WHO has defined wound classifications for taking decisions on Rabies Post Exposure Prophylaxis (PEP) after bites. Some experts have suggested a change in WHO classification to include another category IV in severe wounds. As we work in the rabies endemic country contributing the highest number of rabies deaths annually, we discuss what changes in Rabies PEP classification are actually required based on our clinical practice. We discuss here how the lives of victims of rabid animals were saved and what factors led to the failures of PEP. We also discuss why there is no need to expand existing wound classification to category IV and no need to use higher concentrations of RIG for severe wounds like those on the head and neck. We recommend omitting category II and keeping only categories I and III for wound classification for rabies PEP based on our clinical experience with rabid dog bites and scratches i.e. either there is exposure or no exposure using spirit test in doubtful abrasions without bleeding. Moreover, because the rabies virus attaches to the nerve at the site of the bite and there is no viraemia in rabies infection, therefore, to classify a scratch or abrasion with or without bleeding is not rational.

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Clinical, epidemiological, and spatial features of human rabies cases in Metro Manila, the Philippines from 2006 to 2015

Cited by 7 publications

References 36 publications

Rabies in a postpandemic world: resilient reservoirs, redoubtable riposte, recurrent roadblocks, and resolute recidivism

Rabies in a postpandemic world: resilient reservoirs, redoubtable riposte, recurrent roadblocks, and resolute recidivism

Rabies in Southeast Asia: a systematic review of its incidence, risk factors and mortality

WHO Needs to Re-look at Animal Bite Wound Classification for Rabies Post Exposure Prophylaxis to Save People from Deadly Rabies!

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