Rabies Mortality Research Articles

Rabies death in a prisoner: necessity for medical history documentation

Rabies is a zoonotic illness with a high mortality rate that attacks mammals' central nervous systems. It is a viral illness that may be avoided with immunization. Up to 99% of the human rabies transmissions occur in dogs, making them the primary cause of rabies mortality in humans. It is a case-report of rabies death in a 55-years old male, a prisoner from Phulbani Jail (Kandhamal), who was presented to MKCG Medical College and Hospital casualty with with chief complaints of difficulty in breathing and difficulty in drinking water since last night on 17 July 2023, at 11:19 pm. The patient had a history of dog bite exposure four years ago, for which he had not received any post-exposure prophylaxis. The patient was identified as having a likely case of rabies based on his previous history of animal bite and clinical manifestations. Patient was declared dead on 18 July 2023 at 10:30 am. Rabies diagnosis was confirmed by pathological examination of brain sample which showed presence of Negri bodies. This case-report focuses on the importance of proper medical history information including any animal bite exposure especially for convicts before admitting in prison so as to avoid later morbidity and its legal consequences. Such kind of incident also shows that there is lack of awareness regarding rabies in community. In this instance, mortality may have been prevented if the patient had finished the anti-rabies vaccine regimen and made it to a higher center in time for immunoglobulin. Increasing rabies vaccination awareness among the general public can help reduce rabies-related deaths.

Eliminating invisible deaths: the woeful state of global rabies data and its impact on progress towards 2030 sustainable development goals for neglected tropical diseases

Like other neglected diseases, surveillance data for rabies is insufficient and incompatible with the need to accurately describe the burden of disease. Multiple modeling studies central to estimating global human rabies deaths have been conducted in the last two decades, with results ranging from 14,000 to 74,000 deaths annually. Yet, uncertainty in model parameters, inconsistency in modeling approaches, and discrepancies in data quality per country included in global burden studies have led to recent skepticism about the magnitude of rabies mortality. Lack of data not only limits the efficiency and monitoring of rabies elimination strategies but also severely diminishes abilities to advocate for support from international funding agencies. Meanwhile, the most vulnerable communities continue to suffer from deaths that could have been prevented through more robust reporting. The Zero by 30 global strategy to eliminate dog-mediated human rabies by 2030 recommends endemic countries adopt the intersectoral approach, Integrated Bite Case Management (IBCM), as a cost-effective method to enhance surveillance. However, effective implementation of IBCM is impeded by challenges such as limited capacity, resources, knowledge, skills, and attitudes toward compliance. To address this, the World Health Organization and United Against Rabies Forum have developed several open-access tools to guide national control programs in strong data collection practices, and online data repositories to pragmatically streamline reporting and encourage data sharing. Here, we discuss how current and future initiatives can be best employed to improve the implementation of existing surveillance tools and prioritization of effective data reporting/sharing to optimize progress toward 2030 elimination.

A Notable Increase in Human Rabies Mortality After Ten Years in Iran in 2022: A Case Series Study

Rabies virus is responsible for 60000 deaths annually worldwide, and over 95% of all human rabies deaths occur in developing countries. In Iran, the annual number of animal bites is 180 per 100000 people, and rabies control programs focus more on post-exposure prophylaxis (PEP). In this study, the data on people whose death was caused by rabies were obtained from the WHO Collaborating Center (CC) for Reference and Research on Rabies (Pasteur Institute of Iran) from 2011 to 2022. Data analysis showed a remarkable increase in human rabies mortality rate after 10 years in Iran in 2022, with 14 cases. Then, the causes were investigated despite prevention measures. The increase in human rabies cases in Iran indicates that the currently used control methods are insufficient. Controlling the population of stray dogs, sterilization, and vaccination coverage of 70% are the most essential and basic steps in preventing rabies.

No Evidence of Rabies Exposure in Wild Marmosets (Callithrix jacchus) of Northeast Brazil.

Rabies transmitted by wildlife is the main source of human rabies mortality in Latin America and considered an emerging disease. The common marmoset Callithrix jacchus of Brazil is the only known primate reservoir of rabies worldwide. We tested whether alive free-ranging C. jacchus were exposed to rabies in four northeast states that have previously reported rabies-positive dead C. jacchus (Pernambuco and Bahia) or not (Paraíba and Rio Grande do Norte). Our results show no evidence of rabies antibodies or infection in the sampled C. jacchus, suggesting that apparently healthy marmosets are not widely exposed to rabies over their natural range.

Neuroimmunology of rabies: New insights into an ancient disease.

Rabies is an ancient neuroinvasive viral (genus Lyssavirus, family Rhabdoviridae) disease affecting approximately 59,000 people worldwide. The central nervous system (CNS) is targeted, and rabies has a case fatality rate of almost 100% in humans and animals. Rabies is entirely preventable through proper vaccination, and thus, the highest incidence is typically observed in developing countries, mainly in Africa and Asia. However, there are still cases in European countries and the United States. Recently, demographic, increasing income levels, and the coronavirus disease 2019 (COVID-19) pandemic have caused a massive raising in the animal population, enhancing the need for preventive measures (e.g., vaccination, surveillance, and animal control programs), postexposure prophylaxis, and a better understanding of rabies pathophysiology to identify therapeutic targets, since there is no effective treatment after the onset of clinical manifestations. Here, we review the neuroimmune biology and mechanisms of rabies. Its pathogenesis involves a complex and poorly understood modulation of immune and brain functions associated with metabolic, synaptic, and neuronal impairments, resulting in fatal outcomes without significant histopathological lesions in the CNS. In this context, the neuroimmunological and neurochemical aspects of excitatory/inhibitory signaling (e.g., GABA/glutamate crosstalk) are likely related to the clinical manifestations of rabies infection. Uncovering new links between immunopathological mechanisms and neurochemical imbalance will be essential to identify novel potential therapeutic targets to reduce rabies morbidity and mortality.

Quantifying Spillover Risk with an Integrated Bat-Rabies Dynamic Modeling Framework

Vampire bat-transmitted rabies has recently become the leading cause of rabies mortality in both humans and livestock in Latin America. Evaluating risk of transmission from bats to other animal species has thus become a priority in the region. An integrated bat-rabies dynamic modeling framework quantifying spillover risk to cattle farms was developed. The model is spatially explicit and is calibrated to the state of São Paulo, using real roost and farm locations. Roost and farm characteristics, as well as environmental data through an ecological niche model, are used to modulate rabies transmission. Interventions aimed at reducing risk in roosts (such as bat culling or vaccination) and in farms (cattle vaccination) were considered as control strategies. Both interventions significantly reduce the number of outbreaks in farms and disease spread (based on distance from source), with control in roosts being a significantly better intervention. High-risk areas were also identified, which can support ongoing programs, leading to more effective control interventions.

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

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...

Quantifying the interconnectedness between poverty, health access, and rabies mortality.

The global 2030 goal set by the World Organization for Animal Health (WOAH), the World Health Organization (WHO), and the Food and Agriculture Organization (FAO), to eliminate dog-mediated human rabies deaths, has undeniably been a catalyst for many countries to re-assess existing dog rabies control programmes. Additionally, the 2030 agenda for Sustainable Development includes a blueprint for global targets which will benefit both people and secure the health of the planet. Rabies is acknowledged as a disease of poverty, but the connections between economic development and rabies control and elimination are poorly quantified yet, critical evidence for planning and prioritisation. We have developed multiple generalised linear models, to model the relationship between health care access, poverty, and death rate as a result of rabies, with separate indicators that can be used at country-level; total Gross Domestic Product (GDP), and current health expenditure as a percentage of the total gross domestic product (% GDP) as an indicator of economic growth; and a metric of poverty assessing the extent and intensity of deprivation experienced at the individual level (Multidimensional Poverty Index, MPI). Notably there was no detectable relationship between GDP or current health expenditure (% GDP) and death rate from rabies. However, MPI showed statistically significant relationships with per capita rabies deaths and the probability of receiving lifesaving post exposure prophylaxis. We highlight that those most at risk of not being treated, and dying due to rabies, live in communities experiencing health care inequalities, readily measured through poverty indicators. These data demonstrate that economic growth alone, may not be enough to meet the 2030 goal. Indeed, other strategies such as targeting vulnerable populations and responsible pet ownership are also needed in addition to economic investment.

Electronic application for rabies management improves surveillance, data quality, and investigator experience in Haiti.

Integrated bite case management (IBCM) is a multi-sectoral response to animal-bites which reduces human and canine rabies mortality through animal quarantine, bite-victim counseling, and vaccination tracking. Haiti's national rabies surveillance program was established in 2013 using paper-based IBCM (pIBCM) with adoption of an electronic smartphone application (eIBCM) in 2018. We evaluated the feasibility of implementing the electronic app in Haiti and compared pIBCM and eIBCM data quality collected January 2013-August 2019. Deaths prevented, cost-per-death averted, and cost-per-investigation during use of pIBCM and eIBCM were estimated using a previously validated rabies cost-effectiveness tool that accounted for bite-victim demographics; probability of acquiring rabies; post-exposure prophylaxis; and costs including training, supplies, and salaries. We compared pIBCM and eIBCM based on data comprehensiveness, completeness, and reporting efficiency. Surveys were administered to IBCM staff to evaluate the usefulness, simplicity, flexibility, and acceptability of eIBCM. Of 15,526 investigations, 79% were paper-based and 21% electronic. IBCM prevented 241 (estimated) human rabies deaths. Using pIBCM, cost-per-death averted was $2,692 and the cost-per-investigation was $21.02; up to 55 data variables were collected per investigation; data transmission took 26 days to reach national staff, and 180 days until analysis. Using eIBCM, the cost-per-death averted was $1,247 and the cost-per-investigation was $22.70; up to 174 data variables were collected per investigation; data transmission took 3 days to reach national staff, and 30 days until analysis. Among 12,194 pIBCM investigations, 55% were mappable by commune, compared to 100% of eIBCM investigations mappable by GPS. Animal case definitions were incorrectly ascribed by investigators in 5.5% of pIBCM investigations and zero for eIBCM; typically, errors were in determining probable vs. suspect case assignments. Overall, eIBCM was well-accepted by staff, who reported the app is easy-to-use, facilitates investigations, and compared to pIBCM hastens data reporting. In Haiti, eIBCM showed improved data completeness, data quality, and shorter notification times with minimal increase in operational cost. The electronic app is simple-to-use and facilitates IBCM investigations. Rabies endemic countries could refer to eIBCM in Haiti as a cost-effective means to reduce human rabies mortality and improve surveillance capacity.

Assessing six decades of rabies in the Philippines

<p>Despite initiatives to address the disease, rabies remains a public health threat in the Philippines. To determine the trend of rabies infections in the country and provide possible interventions to reduce or eliminate deaths of the affected, we evaluated rabies morbidity and mortality statistics over sixty years. Over the last six decades, rabies mortality rates in the Philippines have steadily decreased. The Philippines' rabies sex-specific mortality rate trend from 1960 to 2019 showed that males account for higher rabies mortality than females. People aged 70 and up have the highest mortality rate, while children under the age of 1 have the lowest. The region with the highest mortality rate in the Philippines is region II (Cagayan Valley), with 39.5. The region with the highest morbidity rate is XI (Davao region), with 148.7. The correlation value was 0.197, indicating a weak correlation between regional morbidity and mortality rates in the Philippines over the years. Hence, those who have contracted rabies are less likely to die over time. Comprehensive control measures by both the national and local government units should be strengthened to eliminate rabies in the Philippines within the next few years.</p>

A Cost-Effectiveness Analysis of Pre-Exposure Prophylaxis to Avert Rabies Deaths in School-Aged Children in India.

Children contribute to one-half of the total painful rabies mortalities in India. The state-of-the-art rabies mortality averting strategies need exploration for the effective implementation of pre-exposure prophylaxis (PrEP) in India. This study reports on the economic evaluation of various PrEP and post-exposure prophylaxis (PEP) strategies to avert rabies mortalities in school-aged children in India. A decision tree model has been developed for children in the age group of 5-15 years to evaluate various PrEP + PEP and PEP only regimens. The 2-site intradermal regimen administered on day zero and seven was chosen as the intervention [PrEP (I)]. ICER was calculated from the quasi-societal and quasi-health systems' perspectives for the base case analysis, along with one-way sensitivity, and scenario analyses for each regimen. The incremental DALYs averted per million population with the implementation of PrEP (I) ranged between 451 and 85,069 in 2020. The ICER was reported in the range of USD 384-352/DALY averted (non-dominant) in comparison to PEP regimens from a quasi-societal perspective. PrEP (I) is reported to be 'very cost effective' in comparison with PEP regimens from the quasi-societal and quasi-health systems' perspectives and reduce deaths by up to 89.9%. This study concludes that the PrEP (I) regimen is a cost-effective and life-saving strategy to avert painful mortalities due to rabies in school-aged children in India.

A STUDY ON AWARENESS ATTITUDE & PRACTICE REGARDING RABIES AMONG GENERALAND SLUM POPULATION IN KOLKATA

Introduction: Rabies is such a disease, which is nearly 100% preventable, but once rabies develops, it would denitely lead to highly painful death, even in this era of medical marvel. India is the second largest contributor to Rabies mortality in the world. According to a recent report of World Health Organization (WHO), approximately 55,000 human deaths are reported every year worldwide due to rabies, with an overwhelming majority of 32,000 cases reported in Asia of which 20,000 occur in India. Aims: To know the general awareness about the rabies in general population and to identify the level of general awareness and knowledge of wound management among the cases of dog or animal bite. Material and Method: The study was observational, questionnaire-based study between 1 January 2019 to 30 June 2019. For the purpose of this thesis, a descriptive correlational analytical survey was used, in which a qualitative approach was undertaken to determine the answers of mentioned research questions. After collection of the available data, it was analysed in Medical College, Kolkata. 150 patients were included in this study Result: We found that 77(51.3%) patients answered that bite from an infected animal people and animals can get rabies, 46(30.7%) patients answered that several sorts of contact with an infected animal (e.g. bite, lick, scratch) people and animals can get rabies and 27(18.0%) patients had don't know how can people and animals get rabies. It was found that 113(75.3%) patients had answered that the person who is infected with rabies gets crazy/mad/dangerous, 10(6.7%) patients had answered that the person who is infected with rabies of some can get better/get treatment/do not die and 27(18.0%) patients do not know. Proportion of upper class patients was signicantly higher than others. It was found that 60(40.0%) patients had answered rabies treatable, 63(42.0%) patients had answered no and 27(18.0%) patients had answered do not know. Conclusion: The knowledge, attitude and practices with respect to prevention and treatment of rabies were found adequate amongst the urban population. Thus, community-based health education may be increased in these areas to create awareness regarding rabies.

Rabies mortality and morbidity associated with animal bites in Africa: a case for integrated rabies disease surveillance, prevention and control: a scoping review

ObjectiveThe objective of this scoping review was to map the current situation and available evidence and gaps on rabies morbidity, mortality, integrated rabies surveillance programmes, and existing prevention and control...

Epidemiological Analysis of the Effectiveness of Rabies Post-Exposure Prophylaxis in the Russian Federation (2001–2018)

Relevance. Post-exposure prophylaxis (PEP) is the most effective method for reducing the morbidity and mortality of human rabies. Since 2000, in Russia, domestically produced cultural purified and concentrated rabies vaccine (COCAV) and equine immunoglobulin (AIG) are used as the main drugs for PEP.Aims. To assess the epidemiological effectiveness of post-exposure rabies prophylaxis and possible causes of failure in the Russian Federation in 2001–2018.Materials & methods. A comprehensive retrospective epidemiological study of 167 cases of rabies in humans and PEP statistics in the Russian Federation was carried out. To test the hypotheses about the relationship between PEP failures and risk factors, namely (gender, age, place of residence of the sick, nature of the injuries received, source of infection), two main comparison groups were formed: «vaccinated» (n = 28) and «not vaccinated» (n = 139). In addition, we compared the groups who received PEP correctly and those vaccinated with violations of instructions. The failure rate was assessed in relation to the total number of vaccinated and the number of vaccinated after contact with rabid animals.Results. During the analyzed period, the incidence of human rabies decreased from 0.015 to 0.0013 per 100 thousand population. Of the patients, 83.2% did not receive PEP (did not apply, vaccinations were not prescribed, refused). In the group «vaccinated» in 53.6% (n = 15), the schemes of PEP prescribing and administering were violated, including in 35.7% (n = 10) of cases AIG was not administered. The rest 46.4% (n = 13), received vaccinations in accordance with the instructions. Before the end of the vaccination course, 85.7% (n = 24) fell ill; the rest fell ill with an incubation period of more than three months. Only one person received AIG and all 6 vaccine injections. The group «vaccinated» differed from the group «not vaccinated» by a higher frequency of category III injuries (χ2 = 9.99, p = 0.019) and injuries caused by wild animals, especially wolves (χ2 = 22.24, p < 0.001).Conclusions. Among people who developed rabies in 2001–2018, 16.8% received PEP. The proportion of the number of cases and the total number of those who received PEP was 1: 240.0 thousand. The failure rate of PEP after contact with rabid animals was 0.03% (excluding the nature of the contact and the animal species). More than 70% of all failures are associated with wolf and fox bites, more than 85% with category III injuries.

A retrospective analysis of emerging rabies: a neglected tropical disease in Sarawak, Malaysia.

Rabies, a neglected tropical disease (NTD), is a viral infection which is often fatal. Since 2017, a rabies epidemic has been declared in Sarawak, Malaysia. However, there is a lack of local epidemiological data and descriptions of local presentations of this disease. This was a retrospective analysis of a series of rabies cases encountered in Sibu Hospital, Sarawak from March 2020 to February 2021. Six cases of rabies were identified in this series, all with a mixture of upper motor neuron and lower motor neuron findings. Most cases did not seek medical attention upon dog bite and therefore effective post-exposure prophylaxis was not given. The incubation period varied from 17 days to 2 years. All cases died, with five cases succumbing to the illness within two weeks of symptom onset. The cumulative incidence for rabies in Sibu was estimated at 1.7 per 100,000 population. The lack of public awareness of the implication of animal bites and the immediate management in rabies-endemic regions are factors contributing to high rabies mortality.

How geographic access to care shapes disease burden: The current impact of post-exposure prophylaxis and potential for expanded access to prevent human rabies deaths in Madagascar.

Post-exposure prophylaxis (PEP) is highly effective at preventing human rabies deaths, however access to PEP is limited in many rabies endemic countries. The 2018 decision by Gavi to add human rabies vaccine to its investment portfolio should expand PEP availability and reduce rabies deaths. We explore how geographic access to PEP impacts the rabies burden in Madagascar and the potential benefits of improved provisioning. We use spatially resolved data on numbers of bite patients seeking PEP across Madagascar and estimates of travel times to the closest clinic providing PEP (N = 31) in a Bayesian regression framework to estimate how geographic access predicts reported bite incidence. We find that travel times strongly predict reported bite incidence across the country. Using resulting estimates in an adapted decision tree, we extrapolate rabies deaths and reporting and find that geographic access to PEP shapes burden sub-nationally. We estimate 960 human rabies deaths annually (95% Prediction Intervals (PI): 790-1120), with PEP averting an additional 800 deaths (95% PI: 640-970) each year. Under these assumptions, we find that expanding PEP to one clinic per district (83 additional clinics) could reduce deaths by 19%, but even with all major primary clinics provisioning PEP (1733 additional clinics), we still expect substantial rabies mortality. Our quantitative estimates are most sensitive to assumptions of underlying rabies exposure incidence, but qualitative patterns of the impacts of travel times and expanded PEP access are robust. PEP is effective at preventing rabies deaths, and in the absence of strong surveillance, targeting underserved populations may be the most equitable way to provision PEP. Given the potential for countries to use Gavi funding to expand access to PEP in the coming years, this framework could be used as a first step to guide expansion and improve targeting of interventions in similar endemic settings where PEP access is geographically restricted and baseline data on rabies risk is lacking. While better PEP access should save many lives, improved outreach, surveillance, and dog vaccination will be necessary, and if rolled out with Gavi investment, could catalyze progress towards achieving zero rabies deaths.

A STUDY ON KNOWLEDGE ATTITUDE AND PRACTICE REGARDING ANIMAL BITE AMONG GENERALAND SLUM POPULATION IN KOLKATA

INTRODUCTION: India is the second largest contributor to Rabies mortality in the world. According to a recent report of World Health Organization (WHO), approximately 55,000 human deaths are reported every year worldwide due to rabies, with an overwhelming majority of 32,000 cases reported in Asia of which 20,000 occur in India. AIMS: The general awareness about the rabies in general population, awareness of people about anti rabies vaccines and health services utilization. MATERIAL AND METHOD: The study was an observational, questionnaire-based study. For the purpose of this thesis, a descriptive co relational analytical survey was used, in which a qualitative approach was undertaken to determine the answers of mentioned research questions. st st The study was slum to the general people. The expected duration of the study was approximately six months between 1 January 2019 to 30 Dec 2019. RESULTAND DISCUSSION:We found that 77(51.3%) patients answered that on being bitten from an infected animal, both people and animals can get rabies, 46(30.7%) patients answered that on several sorts of contact with an infected animal (e.g. bite, lick, scratch) people and animals can get rabies and 27(18.0%) patients don't know how can people and animals get rabies. It was found that 113(75.3%) patients had answered that the person who is infected with rabies gets crazy/mad/dangerous, 10(6.7%) patients had answered that the person who is infected with rabies of some can get better/get treatment/do not die and 27(18.0%) patients had answered they don't know about the outcome of the treatment. It was found that 60(40.0%) patients had answered rabies treatable, 63(42.0%) patients had answered no and 27(18.0%) patients had answered do not know. We found that 145(96.7%) patients preferred to take Anti-rabies vaccine. 75(50.0%) patients answered yes, these vaccines available free of cost in govt. hospitals, 82.0% of the study populations were found to have heard about rabies; Most of them had good knowledge regarding rst-aid measures. Our ndings indicate that the urban community has good knowledge about rabies but unfortunately, they are unaware about rabies fatality. Hence, there is need to create awareness regarding wound management and post-exposure immunization. CONCLUSION:The knowledge, attitude and practices with respect to prevention and treatment of rabies were found adequate amongst the urban population. Thus, community based health education may be increased in these areas to create awareness regarding rabies.

Modeling Mongoose Rabies in the Caribbean: A Model-Guided Fieldwork Approach to Identify Research Priorities.

We applied the model-guided fieldwork framework to the Caribbean mongoose rabies system by parametrizing a spatially-explicit, individual-based model, and by performing an uncertainty analysis designed to identify parameters for which additional empirical data are most needed. Our analysis revealed important variation in output variables characterizing rabies dynamics, namely rabies persistence, exposure level, spatiotemporal distribution, and prevalence. Among epidemiological parameters, rabies transmission rate was the most influential, followed by rabies mortality and location, and size of the initial infection. The most influential landscape parameters included habitat-specific carrying capacities, landscape heterogeneity, and the level of resistance to dispersal associated with topography. Movement variables, including juvenile dispersal, adult fine-scale movement distances, and home range size, as well as life history traits such as age of independence, birth seasonality, and age- and sex-specific mortality were other important drivers of rabies dynamics. We discuss results in the context of mongoose ecology and its influence on disease transmission dynamics. Finally, we suggest empirical approaches and study design specificities that would provide optimal contributing data addressing the knowledge gaps identified by our approach, and would increase our potential to use epidemiological models to guide mongoose rabies control and management in the Caribbean.

Rabies post-exposure prophylaxis in Germany − What are the challenges?

Rabies post-exposure prophylaxis (R-PEP) including wound treatment, vaccination and application of rabies immunoglobulin (RIG) is essential in preventing rabies mortality. Today, Germany is officially declared free from terrestrial rabies and rabies is only found in bats. However, physicians in A&E Departments are frequently consulted on the need for R-PEP. We retrospectively analysed patients who received R-PEP at the A&E Department of the University Hospital Bonn between 01.01.2013 and 30.06.2019. Demographic data, travel history, clinical and laboratory findings, previous rabies vaccinations and R-PEP vaccination regimen were recorded. During the study period, 90 patients received R-PEP at the University Hospital Bonn, in 10 cases without indication for R-PEP. Altogether, we found deviations from R-PEP guidelines in 51% (n = 41/80). Infiltration of RIG was missed in 12 patients and incorrectly administrated in 24 patients. Furthermore, vaccination scheme was incorrect in 11 patients. Correct wound washing and documentation of tetanus status was missing in 14% and 63% of patients, respectively. Despite rabies elimination in Germany patients frequently seek advice for R-PEP, the majority returning from foreign travel. Our data show that there is a high need for education on indication for R-PEP before and after travel and for implementation of precise R-PEP guidelines in daily clinical practice.

Regional and age difference of human rabies prevalence of the past fourteen years in China

ObjectiveThe aim of this study is to describe the epidemiological characteristics about regional and age difference of human rabies in the past fourteen years in China, and provide a reliable epidemiology basis for further control and prevention of human rabies. MethodsThe database of “China Public Health Science Data Center” affiliated Chinese CDC was searched with the key words of “rabies” or “epidemiology” or “morbidity” or “mortality” from 2004 to 2018 and the corresponding data about human rabies cases was collected referred to regional and age difference for describing the epidemiological characteristics of human rabies. ResultsIn this study, a total of nearly 26,315 rabies cases (1754 ± 253) and 25,691 rabies-related deaths (1712 ± 255) (Mean ± SE) were reported, and a decreasing trend about the morbidity and mortality of human rabies existed from 0.2039 and 0.2039 (1/100,000) in 2004 to 0.0304 and 0.0295 in 2018. Otherwise, regional difference of human rabies prevalence significantly existed, and juvenile and middle-aged population especially in 50–60 years old were more easily attacked and infected with rabies (all p < 0.05). ConclusionThis study proved that human rabies still is a major public health problem in China though a decreasing trend about the morbidity and mortality of human rabies existed in the past fourteen years.