The Story of Post-exposure Rabies Prophylaxis at the Pediatric Emergency Department

Abstract

Abstract Objectives This study aimed to determine the epidemiological and medical features of suspected rabies exposures at a pediatric emergency department in a small city center in middle-northern Turkey. Methods Data were abstracted from a standard “Rabies Suspected Animal Contact Cases Examination Form.” The following information was recorded: sociodemographic and clinical features of the victim, history of rabies vaccination, date of event, time to hospital administration, animal species and its vaccination history with owner records, type of suspected contact, wound care, tetanus prophylaxis, rabies vaccination, and forensic notifications. Immunoprophylaxis was determined as “appropriate” or “inappropriate” in accordance with the Rabies Field Guideline (2014). Discussion A total of 306 cases were evaluated at the emergency department of the hospital. The age of the victims ranged between 1.5 and 17 years old, and 61.4% of them were males. Cat scratches were the most common source of suspected rabies exposure. Meanwhile, primary wound care and tetanus immunoprophylaxis were the frequent inappropriate medical applications. Rabies prophylaxis was completed in 76.5% of the cases. However, forensic notifications were missing. In addition, the rate of animal immunization was lower than it should be. Conclusion Our city is rabies free; however, risky exposures are frequent among children. Lack of knowledge about first aid and animal vaccination is revealed to be a major public health problem. Health care workers should follow current guidelines to provide a holistic approach to the treatment of potential rabies exposures.