Letter to the Editor

Kamoltham, Thavatchai; Wilde, Henry; Hemachudha, Thiravat

doi:10.1016/s0264-410x(03)00223-8

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…A number of PEP failures have been associated to insufficient or lack provision of RIG, as the immunoglobulin is critical in immediately neutralizing the virus prior to developing an immunological response after receiving the vaccine. This emphasizes the importance of RIG for the most effective rabies prevention following exposure to the virus [ 10 , 12 ]. Surveillance forms for animal bites did not include additional information such as nature and severity of the wound, other treatments given including RIG, details of biting animal such as age, breed or species, circumstances resulting in the bite, rabies vaccination history of the animal, outcome of the animal, and whether the animal was tested for rabies virus.…”

Section: Discussionmentioning

confidence: 99%

“…Animal bite surveillance on the human side should inform proper dog population management and vaccination against rabies. Vaccinating owned dogs against rabies has been shown to be the most cost-effective intervention in the medium and long term; costs are typically recouped within 5-10 years, mainly through decreased expenditure on human post-exposure treatment [ 10 , 16 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Management after potential exposure to the rabies virus consists of post exposure prophylaxis (PEP)[ 10 ]. The level of exposure risk guides PEP recommendations, as per the World Health Organization (WHO) guidelines [ 3 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Investigation to determine staff exposure and describe animal bite surveillance after detection of a rabid zebra in a safari lodge in Kenya, 2011

Obonyo¹,

Arvelo²,

Kadivane³

et al. 2014

Pan Afr Med J

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IntroductionRabies is a fatal viral infection, resulting in >55,000 deaths globally each year. In August 2011, a young orphaned zebra at a Kenyan safari lodge acquired rabies and potentially exposed >150 tourists and local staff. An investigation was initiated to determine exposures among the local staff, and to describe animal bite surveillance in the affected district.MethodsWe interviewed lodge staff on circumstances surrounding the zebra's illness and assessed their exposure status. We reviewed animal bite report forms from the outpatient department at the district hospital.ResultsThe zebra was reported bitten by a dog on 31st July 2011, became ill on 23rdAugust, and died three days later. There were 22 employees working at the lodge during that time. Six (27%) had high exposure due to contact with saliva (bottle feeding, veterinary care) and received four doses of rabies vaccine and one of immune-globulin, and 16 (73%) had low exposure due to casual contact and received only four doses of rabies vaccine. From January 2010 to September 2011, 118 cases of animal bites were reported in the district; 67 (57%) occurred among males, 65 (57%) in children <15 years old, and 61 (52%) were inflicted in a lower extremity. Domestic and stray dogs accounted for 98% of reported bites.ConclusionDog bites remains the main source of rabies exposure in the district, but exposure can result from wildlife. This highlights the importance of a one health approach with strong communication between wildlife, veterinary, and human health sectors to improve rabies prevention and control.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Investigation to determine staff exposure and describe animal bite surveillance after detection of a rabid zebra in a safari lodge in Kenya, 2011

Obonyo¹,

Arvelo²,

Kadivane³

et al. 2014

Pan Afr Med J

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Public health implication towards rabies elimination in Sri Lanka: A systematic review

Kanda

Jayasinghe

et al. 2021

Acta Tropica

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Current and future tools for global canine rabies elimination

et al. 2013

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Even though rabies is almost uniformly fatal, it is readily preventable with currently available tools. Vaccination is highly efficacious for the pre-exposure prophylaxis (PrEP) of rabies in humans and animals, and prompt postexposure prophylaxis (PEP) with vaccine and rabies immune globulin (RIG) can reliably prevent disease in humans. However, access to these tools and knowledge of their proper use are often limited, especially in impoverished, rabies-enzootic countries with the highest disease burden. In the absence of reliable diagnostic capacity and risk assessments, vaccines and RIG are often administered inappropriately, leading to chronic supply shortages and otherwise preventable deaths. Rather than focusing solely on human prophylaxis, it is more cost-effective over the long term to eliminate canine rabies in its natural terrestrial reservoirs. Because more than 99% of human rabies deaths result from dog bites, prevention efforts should focus on dogs. A versatile "One Health" strategy for canine rabies elimination should aim to create sustainable herd immunity in dogs, using proven vaccination strategies at the local level, coupled with community education and humane population management. Such strategies have succeeded in both developed and developing countries, and can be adapted to any locality. Numerous examples in Africa, Asia, and Latin America have shown that community-based, locally guided vaccination and education programs, based on a shared vision and long-term commitment, can eliminate canine rabies. Such programs should have specific goals and measurable outcomes, and should be conducted under the guidance of supportive governments, in collaboration with international partners and nongovernmental organizations. In addition to currently available tools, rabies prevention can be augmented by new dose-sparing human vaccine schedules, alternative routes of vaccine administration, monoclonal antibodies as an alternative to RIG, sensitive and specific point-of-care diagnostics and the development of canine immunocontraceptive methods. Accurate risk assessments of potential human exposures and support for decentralized laboratory capacity will be essential to ensure the most effective utilization of vaccines and RIG until canine rabies has been eliminated.

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Letter to the Editor

Cited by 3 publications

References 5 publications

Investigation to determine staff exposure and describe animal bite surveillance after detection of a rabid zebra in a safari lodge in Kenya, 2011

Investigation to determine staff exposure and describe animal bite surveillance after detection of a rabid zebra in a safari lodge in Kenya, 2011

Public health implication towards rabies elimination in Sri Lanka: A systematic review

Current and future tools for global canine rabies elimination

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