Global & Disaster Medicine

Archive for the ‘Rabies’ Category

Destined to die – the price for contact with a puppy in India.

NBC

“…..The patient had been on a seven-week-long yoga retreat in India just weeks before. “Tour members confirmed that the patient was bitten by a puppy outside her hotel in Rishikesh, India, and that the wound was washed with water, but no further treatment was administered,” Virginia’s chief veterinarian, Dr. Julia Murphy…..the patient’s husband reported that she had been bitten on the right hand by a puppy approximately six weeks before symptom onset while touring in India…….”


A five-year-old boy died Saturday in a Santo Domingo hospital from rabies, the fourth such case of the year in the Dominican Republic

Outbreak News

“…..The boy was bitten by a dog on November 19….and ten days later he was subjected to an antirabies vaccination scheme, receiving four doses…..”

CDC:  Vaccination after an exposure

“….Anyone who has been bitten by an animal, or who otherwise may have been exposed to rabies, should clean the wound and see a doctor immediately. The doctor will determine if they need to be vaccinated.

A person who is exposed and has never been vaccinated against rabies should get 4 doses of rabies vaccine – one dose right away, and additional doses on the 3rd, 7th, and 14th days. They should also get another shot called Rabies Immune Globulin at the same time as the first dose…..”


Rabies in a Dog: From Egypt to Connecticut (2017)

Hercules Y, Bryant NJ, Wallace RM, et al. Rabies in a Dog Imported from Egypt — Connecticut, 2017. MMWR Morb Mortal Wkly Rep 2018;67:1388–1391. DOI: http://dx.doi.org/10.15585/mmwr.mm6750a3.

“……Since 2007, three cases of canine rabies virus variant were reported in dogs imported into the United States, one each from India (2007), Iraq (2008), and Egypt (2015) (13). On December 20, 2017, a dog imported into the United States from Egypt was identified with rabies, representing the second case from Egypt in 3 years. An Egyptian-based animal rescue organization delivered four dogs from Cairo, Egypt, to a flight parent (a person solicited through social media, often not affiliated with the rescue organization, and usually compensated with an airline ticket), who transported the dogs to the United States. The flight parent arrived at John F. Kennedy International Airport (JFK) in New York City and, via transporters (persons who shuttle dogs from one state to another), transferred the dogs to foster families; the dogs ultimately were adopted in three states. The Connecticut Department of Public Health Laboratory (CDPHL) confirmed the presence of a canine rabies virus variant in one of the dogs, a male aged 6 months that was adopted by a Connecticut family. An investigation revealed the possibility of falsified rabies vaccination documentation presented on entry at JFK, allowing the unvaccinated dog entry to the United States. This report highlights the continuing risk posed by the importation of dogs inadequately vaccinated against rabies from high-risk countries and the difficulties in verifying any imported dog’s health status and rabies vaccination history.….”

 


Asia: The dog meat industry & rabies

Express

‘……The Centres for Disease Control and Prevention of the United States said: “There are reports that dog-meat markets have a higher rate of rabies than the general dog population, as people often sell dogs to the markets when they act sick; some of these sick dogs have rabies.

“Furthermore, there are at least three published reports of humans acquiring rabies from activities associated with the dog meat market, emphasizing that the risk is very real.”…….’

2018 World Rabies Day Banner: Share the Message, Save a Life!


The Philippines: 8 people died of dog rabies in Western Visayas from January until August, 2018 and 4 of the deaths recorded were children below 15 years of age.

Philippine News Agency

 

 


9/28/18: World Rabies day


Yangon General Hospital, Myanmar: Eighteen people died from rabies in the first eight months of this year

Myanmar Times

  • That number could increase if other hospitals across the country are included in the total.
  • Last year, the hospital treated and vaccinated 16,274 people for dog bites. Of those patients, 32 died from rabies.

Diagram of the rabies virion

 


WHO, the UN Food and Agriculture Organization (FAO), the World Organisation for Animal Health (OIE), and the Global Alliance for Rabies Control (GARC) are joining forces to support countries as they seek to accelerate their actions towards the elimination of dog-mediated rabies by 2030.

LANCET

“……The Global Strategic Plan set three objectives for affected countries, development partners, and key stakeholders: (1) to effectively use vaccines, medicines, tools, and technologies that will stop dog rabies transmission and reduce the risk of human rabies deaths; (2) to generate evidence-based guidance and high-quality data to measure impact and inform policy decisions; and (3) to harness multistakeholder engagement to sustain commitment and resources...…”

basket of puppies


PHILIPPINES: Twelve residents who ate dog meat are under observation for rabies

GMA News

 

“….The residents….ate the dog meat which was cooked by the owner of the dog, who also slaughtered the animal himself…..

The owner reportedly did this after the dog bit him.

After 15 days, the owner passed away……”


Rabies Deaths Among Pregnant and Breastfeeding Women — Vietnam

CDC MMWR

Nguyen HT, Tran CH, Dang AD, et al. Rabies Vaccine Hesitancy and Deaths Among Pregnant and Breastfeeding Women — Vietnam, 2015–2016. MMWR Morb Mortal Wkly Rep 2018;67:250–252. DOI: http://dx.doi.org/10.15585/mmwr.mm6708a4.

“…..Despite widespread availability of PEP in Vietnam, in 2015 the Ministry of Health (MoH) received reports of pregnant and breastfeeding women with clinically diagnosed rabies. MoH investigated factors associated with these rabies cases. MoH found that, during 2015–2016, among 169 cases reported in Vietnam, two probable cases of rabies were reported in breastfeeding mothers and four in pregnant women, all of whom had been bitten by dogs. All six patients died. Three of the four pregnant women had cesarean deliveries. One of the three newborns died from complications believed to be unrelated to rabies; the fourth pregnant woman contracted rabies too early in pregnancy for the fetus to be viable. Two of the patients sought care from a medical provider or traditional healer; however, none sought PEP after being bitten. In each case, families reported the patient’s fear of risk to the fetus or breastfed child as the primary barrier to receiving PEP. These findings highlight the need for public health messaging about the safety and effectiveness of PEP in preventing rabies among all persons with exposures, including pregnant and breastfeeding women.……”

Selected characteristics, animal exposure, signs and symptoms, and treatment for six fatal rabies cases in pregnant and breastfeeding women — Vietnam 2015–2016Return to your place in the text
Characteristic No.
Education
Junior high school 5
Senior high school 1
Dog bite 6
Status of dog at time of patient exposure
Normal* 2
Stray 3
Ill 1
Dog rabies vaccination status
Yes 0
No 2
Unknown 4
Bite location
Foot or leg 5
Hand or arm 1
Rabies signs and symptoms
Aerophobia (sensitivity to movement of air) 6
Anorexia 3
Anxiety 2
Fever 4
Headache 5
Hydrophobia 4
Insomnia 3
Malaise or fatigue 5
Muscle pain or spams 3
Paresthesia or localized pain 2
Wound treatment
None 2
At home 2
Medical center 1
Traditional healer 1
Received any postexposure prophylaxis 0

* Family reported that the dog appeared normal at the time of exposure. No information was available regarding the status of the dog after 10 days.
Patients could have multiple symptoms.


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