Rabies Cases Research Articles

Spatiotemporal patterns of rabid dogs and cats and the opinions of personnel responsible for disease control in Thailand

The aim of this study was to evaluate the patterns of rabies cases in dogs and cats in Thailand from 2013 to 2016 via spatiotemporal analysis. We also assessed the opinions of responsible district-level personnel regarding risk factors and control measures for rabies. Evaluation of rabies case patterns was based on secondary data from a national online database, and a structured questionnaire was used to obtain the opinions of district-level personnel. A total of 1202 cases (1202/13058, 9.21 %) of rabid dogs and cats were documented between 2013 and 2016, with the majority of cases involving dogs (1165/13058; 8.92 %). The spatiotemporal analysis indicated that most of the cases were recorded in central Thailand and that there was a general trend of an increase in rabies cases from the beginning of 2013 to the end of 2016. Month-by-month analysis for each year suggested that the number of rabies cases tended to increase over the course of the year in 2013 and 2016. Results from the autocorrelation indicated that the correlation coefficient tended to be similar in adjacent time lags. In terms of the opinion analysis, only one factor (i.e., the presence of a forest that served as a habitat for carrier animals in the district) was statistically significant (P < 0.05) in the final binary logistic regression model. The results of this study may facilitate planning for effective rabies control in Thailand.

Tracking lethal threat: in-depth review of rabies.

An infectious disease known as rabies (family Rhabdoviridae, genus Lyssavirus) causes severe damage to mammals' central nervous systems (CNS). This illness has been around for a very long time. The majority of human cases of rabies take place in underdeveloped regions of Africa and Asia. Following viral transmission, the Rhabdovirus enters the peripheral nervous system and proceeds to the CNS, where it targets the encephalon and produces encephalomyelitis. Postbite prophylaxis requires laboratory confirmation of rabies in both people and animals. All warm-blooded animals can transmit the Lyssavirus infection, while the virus can also develop in the cells of cold-blooded animals. In the 21st century, more than 3 billion people are in danger of contracting the rabies virus in more than 100 different nations, resulting in an annual death toll of 50,000-59,000. There are three important elements in handling rabies disease in post exposure prophylaxis (PEP), namely wound care, administration of anti-rabies serum, and anti-rabies vaccine. Social costs include death, lost productivity as a result of early death, illness as a result of vaccination side effects, and the psychological toll that exposure to these deadly diseases has on people. Humans are most frequently exposed to canine rabies, especially youngsters and the poor, and there are few resources available to treat or prevent exposure, making prevention of human rabies challenging.

Reemergence of arctic-like rabies virus in a rabies-free area in the Amur river basin

Background: A descriptive epidemiological study of the rabies outbreak in the Amur Region of Russia (ARR), which remained rabies-free from 1972 to 2017, was carried out. During 2018-2022, 49 animal rabies cases and one human rabies death were documented in the ARR. This study aimed to detect possible ways of incursion and features of the spatial spread of rabies virus (RABV) in ARR, which was considered rabies-free for 45 years. Methods: After the beginning of the outbreak, 1,450 animal brain samples were tested using a direct fluorescent antibody test. Genetic analysis of RABV isolates was carried out (n = 9). GIS was used to analyze the spatial spread of rabies in ARR and adjacent territories. Results: Rabies has been confirmed in red foxes (Vulpes vulpes ) - 38.8%, raccoon dogs (Nyctereutes procyonoides ) - 10.2%, wolves (Canis lupus ) - 14.3%, dogs - 18.4% and farm animals - 18.3% (n = 49). The first cases were detected south of the ARR, 30 km from the state border between Russia and China. In 2018-2022, the RABV spread within the forest-steppe landscapes of the Zeya-Bureya Plain northwesterly; the maximum distance from the first recorded event was 192.4 km (Me = 77.6). According to a phylogenetic analysis, the isolates from ARR belonged to the Acrtic-like-2 RABV lineage and showed the maximum similarity to the isolates recovered in the province of Heilongjiang (China, 2011, 2018) and the Jewish Autonomous Region (Russia, 1980). Conclusion: Rabies was most likely introduced by wild carnivores from the adjacent territories of Russia or China, located downstream of the Amur River.

RABIES IN RODENTS AND LAGOMORPHS IN THE USA, 2011-20.

Rabies is an acute progressive encephalitis caused by infection with rabies viruses, with reservoirs among bats and mesocarnivores, but all mammals are susceptible. Despite its distribution and abundance, cases of rabies are much less common in rodents and lagomorphs. Familiarity with current rabies prevalence data is important for informed decisions on human postexposure prophylaxis after rodent and lagomorph bites. This study is an update of rabies cases reported in rodents and lagomorphs in the US from 2011 to 2020. Rabies reports were collected passively from laboratory testing agencies in the US and Puerto Rico from 2011 to 2020. Descriptive analysis was conducted to determine the percent positivity of rabies cases by species. A total of 401 cases of rabies in rodents and lagomorphs were reported from 2011 to 2020. Most reported cases were in groundhogs (Marmota monax), representing >90% of cases, and the trend closely aligned with rabies in raccoons (Procyon lotor). In any given year, the percent positivity of rabies in rodents and lagomorphs was <2.5%, and the trend of percent positivity from 2011 to 2020 was stable. Groundhog and North American beaver (Castor canadensis) percent positivity was significantly higher than the rest of the rodents and lagomorphs. Most rabies cases occurred during the months of May-September. Documented cases of rabies in rodents and lagomorphs are generally rare, but with variation between species. Groundhogs and North American beavers had rabies percent positivity similar to high-risk species, such as bats and raccoons, and constituted 97% of all rodent and lagomorph positive cases. Since 1993, the trend in rabies cases in groundhogs has significantly declined. These results can be used to help inform public health officials on rodent and lagomorph prevention and control efforts, as well as rabies postexposure prophylaxis.

RABIES VIRUS SEROSURVEY OF THE SMALL INDIAN MONGOOSE (URVA AUROPUNCTATA) ACROSS MULTIPLE HABITATS IN PUERTO RICO, 2014-21.

The small Indian mongoose (Urva auropuncata) is a rabies reservoir in Puerto Rico and accounts for over 70% of reported animal rabies cases annually. The presence of rabies virus-neutralizing antibodies (RVNA) is often used as a tool to measure exposure to rabies virus in wildlife populations. We conducted a serosurvey of mongooses at 11 sites representing six habitat types across Puerto Rico. We collected a serum sample from 464 individual mongooses during 2014-21. Overall, 80/464 (17.0%; 95% confidence interval, 14.1-20.9%; 55 male, 23 female, and two sexes not recorded) of individual mongooses sampled across all habitats were RVNA positive. The geometric mean (SD) RVNA titer for 80 unique seropositive animals was 0.58 (2.92) IU/mL. Our models indicated that the probability of mongooses being RVNA seropositive mostly varied by habitat, with some influence of sex in the individual-level analyses. Population-level RVNA seroprevalence is dynamic in mongoose populations, but these data may shed light on rabies virus transmission across regions to help inform rabies management activities in Puerto Rico.

Measuring the impact of an integrated bite case management program on the detection of canine rabies cases in Vietnam.

Dog-mediated rabies is enzootic in Vietnam, resulting in at least 70 reported human deaths and 500,000 human rabies exposures annually. In 2016, an integrated bite cases management (IBCM) based surveillance program was developed to improve knowledge of the dog-mediated rabies burden in Phu Tho Province of Vietnam. The Vietnam Animal Rabies Surveillance Program (VARSP) was established in four stages: (1) Laboratory development, (2) Training of community One Health workers, (3) Paper-based-reporting (VARSP 1.0), and (4) Electronic case reporting (VARSP 2.0). Investigation and diagnostic data collected from March 2016 to December 2019 were compared with historical records of animal rabies cases dating back to January 2012. A risk analysis was conducted to evaluate the probability of a rabies exposure resulting in death after a dog bite, based on data collected over the course of an IBCM investigation. Prior to the implementation of VARSP, between 2012 and 2015, there was an average of one rabies investigation per year, resulting in two confirmed and two probable animal rabies cases. During the 46 months that VARSP was operational (2016 - 2019), 1048 animal investigations were conducted, which identified 79 (8%) laboratory-confirmed rabies cases and 233 (22%) clinically-confirmed(probable) cases. VARSP produced a 78-fold increase in annual animal rabies case detection (one cases detected per year pre-VARSP vs 78 cases per year under VARSP). The risk of succumbing to rabies for bite victims of apparently healthy dogs available for home quarantine, was three deaths for every 10,000 untreated exposures. A pilot IBCM model used in Phu Tho Province showed promising results for improving rabies surveillance, with a 26-fold increase in annual case detection after implementation of a One Health model. The risk for a person bitten by an apparently healthy dog to develop rabies in the absence of rabies PEP was very low, which supports the WHO recommendations to delay PEP for this category of bite victims, when trained animal assessors are available and routinely communicate with the medical sector. Recent adoption of an electronic IBCM system is likely to expedite adoption of VARSP 2.0 to other Provinces and improve accuracy of field decisions and data collection.

Human rabies encephalomyelitis in the background of rabies outbreak in animals in Gelephu, Bhutan, 2023: a case report

BackgroundRabies continues to pose significant public health challenges in many developing countries including Bhutan. A probable case of rabies was admitted to our hospital and its reporting led to the uncovering of an outbreak in domestic and wild animals. We discuss the challenges in the diagnosis and management of rabies in a resource-limited setting.Case presentationA 35-year-old male presented with intermittent fever, bilateral lower limb weakness that was rapidly progressive, urinary incontinence with episodes of palpitations and sweating. He had sustained a Category III bite on the right lower thigh with four bite marks, inflicted by a stray dog. He had received post-exposure prophylaxis with intra-dermal anti-rabies vaccine. On initial examination, the patient was in distress but cooperative for the interview. He had pulse rate ranging from 60 to 100/min with episodes of diaphoresis and palpitations, but with normal capillary blood glucose. In the lower limb, the muscle power was zero with absent tendon reflexes in the lower limb and impaired abdominal reflex below T10 level. He had hyperaesthesia below T8, hydrophobia, aerophobia and photophobia. He had multiple spontaneous fasciculations in both the thighs and right deltoid and these later involved the intercostal muscles, neck and face muscles. He had altered sensorium and desaturation for which he required mechanical ventilation. Polymerase chain reaction for rabies virus was negative in cerebrospinal fluid and saliva. Rabies virus neutralizing antibody was negative in cerebrospinal fluid but had high titres in the serum. He received Human Rabies Immunoglobulin after admission. He was managed in the intensive care unit and died 23 days later. After this case was notified, a rapid response team was deployed in the field, and uncovered rabies outbreak in animals in the locality.ConclusionsThis case called for a serious evaluation of the country’s efforts in achieving zero rabies deaths by 2030. The management of this case identified several critical areas of context-specific interventions in Bhutan. There is also an urgent need to improve diagnostic capabilities at the national reference laboratory and enhance the technical competencies of healthcare workers in the management of dog bite cases.Graphical

Rabies surveillance in Madagascar from 2011 to 2021: can we reach the target?

Rabies is endemic in Madagascar and a neglected disease. The aim of this study was to summarize human and animal rabies surveillance activities in Madagascar from 2011 to 2021. Samples from terrestrial mammals and humans were tested for rabies virus infection using direct fluorescent antibody, RT-PCR and virus isolation by the National Reference Laboratory (NRL) for rabies at the Institut Pasteur de Madagascar. Among 964 animal and 47 human samples tested, 66.7 and 70.2% were positive, respectively. The NRL received these suspect rabies samples from 48 of 114 districts of Madagascar. Most of them were submitted from the district of the capital city Antananarivo (26.3%) and mainly from its region Analamanga (68.9%). Animal samples were mainly from dogs (83%), cats (9.5%) and cattle (5.8%). Pigs, lemurs, goats accounted for less than 1%. During the 11 years of surveillance, 48 human skin and/or brain biopsy samples were received from 20 districts, mainly from Antananarivo and its surroundings (N = 13), Toamasina and its surroundings (N = 8) and Moramanga (N = 6). The high positivity rate for all species and the non-homogeneous spatial distribution of samples suggests substantial underreporting of rabies cases. There is a clear need to better understand the reasons for underreporting and prioritize rabies surveillance, prevention and control in Madagascar, with improvements in budget, education and infrastructure. A joint animal and human health rabies control program including vaccination of at least 70% of the dog population, is needed to achieve the goal of eliminating dog-transmitted human rabies by 2030 from Madagascar.

Guarding Against Rabies: The Power of Vaccination in Rabies Disease Management

Rabies, a lethal viral disease caused by the rabies virus, presents a critical public health challenge globally. The disease's etiology involves transmission through the bite or scratch of infected animals, primarily dogs, with the virus targeting the central nervous system and leading to devastating neurological symptoms. Early diagnosis is crucial but challenging due to the disease's non-specific initial manifestations. Vaccination strategies serve as the cornerstone of rabies prevention, encompassing pre-exposure prophylaxis for high-risk individuals and post-exposure prophylaxis for those bitten or scratched by potentially rabid animals. In this article we provide an in-depth exploration of vaccination therapy as a pivotal strategy in the deterrence and management of rabies. The evolution of rabies vaccines, particularly inactivated virus vaccines, is explored, underscoring their role in reducing human rabies cases. The article concludes by emphasizing the significance of continuous research to enhance vaccine effectiveness and promote a comprehensive approach to rabies prevention.

Evolution and divergence of the genetic lineage Desmodus rotundus/Artibeus lituratus of rabies virus in São Paulo State.

The last record of a rabies case caused by the dog-specific rabies virus (RABV) lineage in dogs or cats in São Paulo State was in 1998. From 2002 to 2021, 57 cases of rabies in these animals were reported, and the vast majority (51) were genetically characterized as belonging to theDesmodus rotundus/Artibeus lituratusRABV lineage. However, it is not currently possible to infer which of these bats is the source of infection by genome sequencing of RABV isolates. The aims of this study were (a) to characterize the Desmodus rotundus/Artibeus lituratus lineage to determine the relationships between the RABV lineages and each reservoir, (b) to assess the phylogeny and common ancestors of the RABV lineages found in D. rotundus and A. lituratus, and (c) to further understand the epidemiology and control of rabies. In this study, we genetically analyzed 70 RABV isolates from São Paulo State that were received by the Virology Laboratory of the Pasteur Institute of São Paulo between 2006 and 2015. Of these isolates, 33 were associated with the hematophagous batD. rotundus and 37 with the fruit bat A. lituratus. A genomic approach using phylogenetic analysis and nucleotide sequence comparisons demonstrated that these isolates belonged to the same genetic lineage of RABV. We also found that, in São Paulo State, the D. rotundus/A. lituratus lineage could be subdivided into at least four phylogenetic sublineages: two associated with D. rotundus and two with A. lituratus. These results are of importance for the epidemiological surveillance of rabies in São Paulo.

A passive ‘One Health’ surveillance system to track canine rabies in urban India

Abstract Robust and widely implementable ‘One Health’ surveillance systems are required to detect and control the spread of zoonotic infectious diseases. Using technological tools coupled with a rapid field response and rapid diagnostics can help in the surveillance of deadly diseases such as rabies, even in densely populated urban areas. Here, we describe the use of an animal rescue system (Hawk Data Pro) that was adapted as a passive surveillance tool for rabies in a large metropolis in India. We used a Webline and helpline that reported injured or sick animals to an animal rescue facility to determine possible rabies cases in street animals in Pune city in western India. Suspected rabid animals were tested using lateral flow assays and this information was used to direct awareness materials on rabies as well as in conducting mass dog vaccinations in areas that reported multiple cases. Over a ~4-year period, we received over 90,700 calls or reports, of which 1162 calls were for suspected rabies cases in dogs, and 6 for other animals (cats, goats and cattle). Of these, 749 dogs and 4 other animals tested positive for rabies. Most of the cases were reported from the densely human-populated central Pune region. In response, ~21,000 people were provided with educational materials on post-bite management, and ~23,000 dogs were vaccinated. We show that the adoption of the Hawk Data Pro system as a passive surveillance tool allowed us to document an ongoing outbreak of rabies in a large metropolis in India. Such systems can be modified or adapted to other areas as well to meet the surveillance and reporting requirements of the WHO’s Zeroby30 strategy to eliminate rabies globally. One Health impact statement India is a priority country for the action plan for rabies elimination by 2030. Yet, systematic surveillance for rabies in the primary reservoir remains weak. Here, we showcase a collaboration with an animal welfare organization and adaptation of their bespoke animal rescue system for passive surveillance of rabies in dogs and other animals in Pune city in western India. This method allowed us to improve the detection of potentially rabid animals, rapidly ensure post-exposure prophylaxis and provide awareness materials for exposed human victims. To the best of our knowledge, this collaboration between scientists and civil society organizations resulted in the detection of the largest number of rabies cases reported in an urban area anywhere in the world. The use of this system highlights the scope of the problem in urban India and also provides practical guidance on how to improve surveillance using basic technological tools.

Spatio-temporal investigation of reported cases of animal rabies in Ghana from 2010 to 2017.

Rabies is a zoonotic disease transmitted mainly by animals, especially dogs. The aim of the article was to examine reported cases of animal rabies in Ghana for trends to provide information that could be helpful to control the disease. Retrospective analyses of reported cases of rabies in Ghana from 2010 to 2017. In all, 328 rabies cases were recorded in animals in the period under review. The predominant species involved were dogs (299; 91.2%) and cats (12; 3.7%). Other species included pigs (4; 1.2%), goats (4; 1.2%), monkeys (4; 1.2%), sheep (2; 0.6%), bats (2; 0.6%) and cattle (1; 0.3%). The numbers of reported cases in animals were markedly higher than those in humans except in 2013 and 2017. There was a positive but weak correlation between cases in animals and humans which could be due to lack of reporting collaboration between institutions responsible for these. Greater Accra and Ashanti Regions were identified as hotspots in the period under review, while January and August were the months with the highest peaks for cases reported. Cases reported in rainy season were significantly higher than those in dry season. Poisson regression for spatio-temporal analyses showed no statistical significance in predicting number of rabies cases (response variable) from year, month, season, region and affected species (predictor variables). Rabies remained endemic in Ghana during 2010-2017 with cases reported in nearly every month of the year during this period. There was a significant seasonal pattern with higher proportion of cases reported in the rainy/wet season compared to the dry season.

Analysis of the rabies epizootic in the Central Federal District of Russia in 2018–2022

Relevance. At present, a complex epizootic situation with rabies persists in Russia. Every year, foci of rabies are registered in many subjects of the Russian Federation, with the largest number of cases occurring in the Central and Volga Federal Districts, on the territory of which a high level of the episodic index has been maintained for almost a decade (0.99 and 0.978, respectively).Metods. The purpose of the study was to spatiotemporally analyze the results of the development of the epizootic process and identify the main causes of rabies outbreaks in the Central Federal District (CFD) of the Russian Federation over the past five years (2018–2022). The work used information on the epizootic situation of rabies in official reports (FGBU «Center for Veterinary Medicine» of the Ministry of Agriculture of Russia), data from published scientific sources and the results of our own research. Analysis of the development of epizootics in the CFD was carried out descriptively and retrospectively.Results. Persistent epizootic trouble in the CFD is confirmed by the annual detection of cases of rabies in all subjects of the district. It has been established that the formation of rabies virus foci is due to the presence of favorable landscape and natural and climatic conditions for maintaining a high number of wild animals, the main reservoir and source of rabies, and periodic introductions of infection from adjacent regions. The spread of rabies in the CFD mainly depends on the control of the number of neglected animals and on the regularity of preventive vaccination of wild and domestic carnivores.

How knowledgeable are people in Nepal about rabies?

Eliminating dog-mediated human rabies cases by 2030 is a collective global pledge. Rabies is a vaccine-preventable, zoonotic, and fatal viral disease tormenting human beings and animals for at least four thousand years. An average annual fatality of 59,000 people has been reported from rabies in more than 150 countries, including Nepal. Understanding people's knowledge towards rabies is paramount to preventing this disease. A cross-sectional study was conducted in three districts, namely, Siraha, Parsa, and Parasi in Nepal, from October to December 2021 to assess the level of public awareness of rabies. Information was obtained using a structured questionnaire among 308 household heads. Study findings show that some of the respondents were unfamiliar with the term ‘rabies’. They knew major carriers or sources of rabies, but the majority of them (87.3%) did not know its causative agent. They had some idea of how rabies is transmitted from animals to humans, but they lacked a clear understanding of the fate of the animals and humans once affected cases are symptomatic. Only 35.1% of respondents knew that rabies pathogens attack and multiply in the brain tissues. Rabies vaccination in pets is critical for rabies eradication, yet only 26.3% of respondents were aware of the vaccination schedule. Nearly 90% of respondents thought post-exposure prophylaxis (PEP) to be effective immediately after a suspected animal bite. The findings show that there was a significant relationship between independent variables viz. pet ownership (X2 = 20.273, p < 0.001), level of education (X2 = 39.215, p < 0.001), household income (X2 = 13.574, p < 0.001), family size (X2 = 15.053, p < 0.001), main occupation (X2 = 11.618, p = 0.020), age (X2 = 6.982, p = 0.008) with dependent variable i. e., knowledge category (good and poor knowledge). Education to invoke awareness among rural people about rabies, its transmission and prevention, including making anti-rabies vaccines freely available, should be the priority for municipalities, public health and veterinary health authorities in the study districts and throughout the country.

Genomic Surveillance of Rabies Virus in Georgian Canines.

Rabies is a fatal zoonosis that is considered a re-emerging infectious disease. Although rabies remains endemic in canines throughout much of the world, vaccination programs have essentially eliminated dog rabies in the Americas and much of Europe. However, despite the goal of eliminating dog rabies in the European Union by 2020, sporadic cases of dog rabies still occur in Eastern Europe, including Georgia. To assess the genetic diversity of the strains recently circulating in Georgia, we sequenced seventy-eight RABV-positive samples from the brain tissues of rabid dogs and jackals using Illumina short-read sequencing of total RNA shotgun libraries. Seventy-seven RABV genomes were successfully assembled and annotated, with seventy-four of them reaching the coding-complete status. Phylogenetic analyses of the nucleoprotein (N) and attachment glycoprotein (G) genes placed all the assembled genomes into the Cosmopolitan clade, consistent with the Georgian origin of the samples. An amino acid alignment of the G glycoprotein ectodomain identified twelve different sequences for this domain among the samples. Only one of the ectodomain groups contained a residue change in an antigenic site, an R264H change in the G5 antigenic site. Three isolates were cultured, and these were found to be efficiently neutralized by the human monoclonal antibody A6. Overall, our data show that recently circulating RABV isolates from Georgian canines are predominantly closely related phylogroup I viruses of the Cosmopolitan clade. Current human rabies vaccines should offer protection against infection by Georgian canine RABVs. The genomes have been deposited in GenBank (accessions: OQ603609-OQ603685).

Dynamic analysis of rabies transmission and elimination in mainland China

Rabies is an acute zoonotic infectious disease caused by rabies virus. In 2015, the World Health Organization proposed the goal of eliminating dog-induced human rabies by 2030. In response to this goal positively, China has been dedicated to the control and elimination of rabies mainly caused by dogs, for nearly 10 years. By applying infectious disease dynamics, in this paper, we establish a dog-human rabies transmission model to forecast future epidemic trends of rabies, assess whether the goal of eliminating dog-induced human rabies cases in China can be achieved in 2030, and further evaluate and suggest the follow-up sustained preventive measures after the elimination of human rabies. By analyzing and simulating above dynamic model, it is concluded that rabies has been well controlled in China in recent years, but dog-induced human rabies cannot be eliminated by 2030 according to current situation. In addition, we propose to improve rabies control efforts by increasing the immunization coverage rate of rural domestic dogs, controlling the number of stray dogs and preventing the import of rabies virus in wild animals. Immunization coverage rate of rural domestic dogs which is currently less than 10% is far from requirement, and it needs to reach 50%–60% to meet the goal of 2030. Since it is difficult to immunize stray dogs, we suggest to control the number of stray dogs below 15.27 million to achieve the goal. If the goal of eliminating human rabies is reached in 2030, the essential immunization coverage needs to be maintained for 18 years to reduce the number of canine rabies cases to zero. Lastly, to prevent transmission of rabies virus from wild animals to dogs, the thresholds of the number of dogs and the immunization coverage rate of dogs after eliminating canine rabies cases are also discussed.

Assessment of Community Knowledge and Practices towards Rabies Prevention: A Cross-Sectional Survey in Bharatpur, Chitwan, Nepal

In many developing countries, where rabies is prevalent among dog populations, humans are at risk of contracting the disease. Recent reports from Nepal suggest that around 30,000 cases of pet and more than 100 human rabies cases occur each year, with the highest risk being in the Terai, although these numbers may be underestimated. Knowledge and practices related to rabies prevention are crucial in combating the disease. However, there is not enough data on the understanding and preventive measures of rabies among the local population in Nepal. Therefore, this study aimed to evaluate the knowledge and practices regarding rabies prevention among the people of Bharatpur-12, Chitwan, Nepal. The study, conducted in February 2022, involved a cross-sectional survey of 271 respondents selected through systematic random sampling. A semi-structured questionnaire was used for one-on-one interviews. Among the surveyed respondents, a significant proportion (81.50%; n = 221/271) correctly understood rabies is zoonotic disease. Furthermore, 73.10% (n = 198/271) could correctly identify the animals susceptible to rabies, while 39.9% (n = 108/271) knew the causative agent. Additionally, 46.5% accurately listed the modes of transmission, and a majority (86.70%; n = 235/271) recognized the signs and symptoms of rabies in animals and humans. Overall, 42.06% (n = 114/271) of the respondents demonstrated satisfactory knowledge. Out of the 271 respondents, 22.9% (n = 62) owned pets, and 39.11% (n = 106) reported incidents of animal bites within their families, with dog bites being the most commonly mentioned (92.46%; n = 98/106). The majority (81.14%; n = 86/106) sought treatment on the same day as the incident occurred. About half of them (50%; n = 53/106) cleaned the wound with soap and water, while a small percentage (5.66%; n = 6/106) relied on traditional medicine as immediate first aid after an animal bite. The level of knowledge was found to be associated with gender (p = 0.04), educational status (p = 0.05), and family monthly income (p = 0.007). These findings highlight the importance of educating the community in Nepal about rabies control and prevention measures and underscore the need for targeted educational interventions to improve rabies awareness and the potential of effective awareness campaigns to save lives. Raising awareness about health-seeking behavior and community members’ role in controlling, preventing, and eliminating rabies is crucial.

Spread of rabies in the Kyiv Oblast during 2020-2022

In Ukraine, there is a prominent level of rabies circulation among domestic and wild carnivores. Consequently, the epizootic situation of rabies in Ukraine requires studying the spread of this infection using modern surveillance tools, which allow for territorial assessment and identification of risk zones during analysis. The purpose of this research was to describe the spatial characteristics of the rabies epizootic in the Kyiv Oblast during 2020-2022, focusing on both wild and domestic animals. Official reporting data were analysed to examine the total number of samples of pathological material (brain tissue) collected from various animal species with suspected rabies. Positive samples were georeferenced and visualized using software to form clusters of rabies cases based on years and types of animals, creating point layers and density mapping of cases. The analysis revealed that in the Kyiv Oblast, 1788 samples of pathological brain material from animals with suspected rabies were examined, of which 237 were positive. The largest number of samples belonged to wild animals (primarily foxes), acting as a reservoir of the infection. The proportion of wild animals accounted for 64.4% of the total examined, but the number of positive samples varied between 1.7% and 5.5%. Compared to domestic animals (cats and dogs), this figure reached up to 30.0% of the total number of samples examined. Other animal species accounted for 3.2% of positive cases among the total examined. Thus, the highest morbidity rate was observed in domestic animals, representing 72.1% of the total identified positive cases. The highest density of rabies cases in the Kyiv Oblast was observed in the southwest and centre. Persistent clusters of rabies cases were in the Bila Tserkva district and the western outskirts of Kyiv. In the western part of Kyiv, the cluster was formed by cases in wild animals, cats, and dogs. In the Bila Tserkva district, the cluster was formed by cases in wild animals, cats, dogs, and cattle. The highest density of rabies cases in wild animals was registered on the western outskirts of Kyiv

Rabies: Diagnostic, Treatment, and Prevention

Rabies is a neurological disease with fatal impacts because it has a high mortality rate. Animals, primarily dogs, mediate the spread of rabies. Clinical findings of rabies are divided into two categories: classic rabies (furious type) and paralytic type. Furious rabies has many cardinal features, such as fluctuating consciousness, aerophobia or hydrophobia, inspiratory spasm, and autonomic dysfunction. Ascending paralysis with a lower motor neuron lesion is the initial sign of paralytic rabies. The rabies virus invades and lives in neurons. It is virulent. Besides clinical findings, the diagnostic approach can involve radiology, microbiology, and histopathology. There are not only symptomatic treatments for rabies patients but also vaccines, immunoglobulin, and antivirals to decrease the progressivity of the disease. Vaccination programs and animal control have become essential in reducing rabies cases in Indonesia.

Inventory management practices: implications on the pharmaceuticals expenditure of rabies vaccine in public health facilities, Namibia

BackgroundTo achieve well-regulated distribution, storage, and utilization of the rabies vaccine, health facilities should adhere to standard operating procedures. In Namibia, information on inventory management, utilization, monitoring, and reporting of rabies vaccine adherence to standard operating procedures in public healthcare facilities is insufficient. The aim of this study was to assess adherence to rabies vaccine standard operating procedures and inventory management and to compare rabies vaccine expenditure to the number of patients who received rabies vaccination at the Ministry of Health and Social Services’ public healthcare facilities from 2018 to 2020.MethodsA cross-sectional, web-based questionnaire consisting of closed-ended questions was sent to 147 pharmacy staff and warehouse managers working in the 14 regions of Namibia during the period of May 1, 2021, to June 2, 2021. The overall expenditure and the total number of patients vaccinated from 2018 to 2020 were obtained from national-level logistic and vaccination program coordinators. Data were coded and transcribed into Microsoft® Excel® 2013 and analyzed using SPSS® version 27.ResultsOne hundred and thirty-three completed questionnaires were received from sixty-nine public health centers and hospitals. The group of respondents consisted of pharmacist assistants (50%), pharmacy technicians (12%), pharmacists (36.8%), senior pharmacists (0.8%), and chief pharmacists (1.5%). Overall, adherence to standard operating procedures was poor (27.1%). Rabies vaccine distributed to public health facilities from 2018 to 2020 was worth N$75,381,419.91 (~ US$4,074,671.46) and was expected to vaccinate 87,269 patients; however, only 95 cases of both rabies and rabid dog-bite patients were reported. The major inventory management challenges for public healthcare facilities include an inadequate number of pharmacy staff, poor adherence to standardized pharmaceutical warehousing, lack of regular supervision, and inadequate staff training.ConclusionInventory management practices in public healthcare facilities were not in compliance with standard operating procedures. There is a significant discrepancy between rabies vaccine expenditure and the number of patients that were vaccinated. Therefore, there is a need for adequate staff training on inventory management and regular facility supervision to enforce optimal rabies vaccine inventory management practices.