Trends of Animal Bite Cases and Comparison of Cases Reported during Pre-COVID-19 and COVID-19 Period in a Dedicated Anti-Rabies Clinic from a Tertiary Care Hospital, Hassan, Karnataka, India: A Retrospective Cohort Study

Abstract

Introduction: Rabies causes 100% case fatality in animal bite victims if left untreated, and it ranks as the 10th leading cause of death due to infectious diseases worldwide. India alone reports 20,000 human rabies deaths annually, accounting for one-third of global mortalities related to the disease. However, rabies is 100% preventable. The nationwide lockdown imposed from March 25, 2020, to curb the spread of the Coronavirus Disease-2019 (COVID-19) disrupted various essential health services, including Post-Exposure Prophylaxis (PEP) for rabies. Aim: to describe the socio-demographic profile of animal bite cases and assess the burden of animal bites during the pre and post COVID-19 Pandemic, specifically in patients reporting to the dedicated Anti-Rabies Clinic (ARC) of a tertiary care hospital in Hassan, Karnataka, India. Materials and Methods: A retrospective record-based study was conducted from January 2019 to November 2021 among animal bite cases reporting to the ARC at Hassan Institute of Medical Sciences, Hassan, Karnataka, India. Data on age, gender, locality, and socio-economic status were collected from the records maintained at the ARC. All subjects with complete data in the records were included in the study. All animal bite cases were managed according to the World Health Organisation (WHO) guidelines, with necessary COVID-19 precautions taken. A total of 3,706, 3,303, and 2,144 subjects were considered for the years 2019, 2020, and 2021, respectively. Results: There was a decreasing trend in the reported cases during the pandemic. The proportion of animal bite cases among those less than 19 years old was 1,146 (30.9%), 1,124 (34.1%), and 711 (33.1%) in the years 2019, 2020, and 2021, respectively. The majority of animal bite victims were males: 2,489 (67.2%), 2,240 (67.8%), and 1,173 (54.7%) in the years 2019, 2020, and 2021, respectively. The majority belonged to the rural population, with 2,668 (72.0%), 1,057 (32%), and 1,586 (74%) in the years 2019, 2020, and 2021, respectively. However, there was an increase in the number of victims from the urban population in the year 2020, with nearly 2,246 (68%). Most of them, 2,299 (62%), 2,114 (64%), and 1,441 (67.2%) in the years 2019, 2020, and 2021, respectively, belonged to a lower socio-economic status. Category-III bites made up the majority representation in all the years 2019, 2020, and 2021. Conclusion: The number of animal bite cases reported during the pandemic was lower compared to the pre-pandemic phase. This highlights either missed reporting of cases or a reduction in exposure to animals, which decreased the risk of animal bites.