Rabies In Children Research Articles

Analysis of qualification for post-exposure prophylaxis against rabies in children in Poland

ABSTRACT Background Rabies is a fatal disease caused by the rabies virus, usually transmitted by a bite by an infected animal. Because there is no effective treatment, prophylaxis is crucial. The aim of the study was to analyse the circumstances of exposure, characterise the animals that were a potential source of infection and evaluate the frequency of post-exposure prophylaxis in children. Methods This was a retrospective analysis of the medical records of 494 children who had been bitten, scratched or salivated on by an animal and were seen consecutively between 2015 and 2019 in the Department of Paediatric Infectious Diseases, Medical University of Warsaw. Results The study group was children aged 10 months to 17 years 11 months. The animals most commonly involved were dogs (347/494, 70.24%), cats (81/494 (16.40%) and squirrels (10/494, 2.02%). The contact was mainly with tame but unfamiliar animals (359/494, 72.67%, p < 0.001). The most common type of exposure was a bite (457/494, 92.51%). Surgical wound care was required most often after exposure in a town (64/90, 71.11%). A total of 412 children (80.83%) received post-exposure vaccination, including 333/412 using the Essen regimen. In 13/412 cases, the vaccination schedule (3.16%) was not completed because of an absence of signs of disease during veterinary observation of the animal. Anti-rabies immunoglobulin was administered to 13/412 (3.16%). Conclusion Most children who are referred after being bitten by an animal require post-exposure prophylaxis. Children are usually bitten by tame dogs with which they are unfamiliar, mostly on the hand. Surgical wound care is needed more often for urban patients than others.

Protection Motivation Theory and Rabies Protective Behaviors Among School Students in Chonburi Province, Thailand.

ObjectivesThe aim of this study was to predict rabies protective behaviors (RPB) based on protection motivation theory (PMT) among fourth-grade students at schools in Chonburi Province, Thailand.MethodsThis cross-sectional study was conducted from December 2020 to February 2021. A multistage sampling technique was used for sample selection. The questionnaire was divided into socio-demographic data and questions related to PMT and RPB. Descriptive statistical analysis was conducted using the EpiData program and inferential statistics, and the results were tested using the partial least squares model with a significance level of less than 5%.ResultsIn total, 287 subjects were included, of whom 62.4% were girls and 40.4% reported that YouTube was their favorite media platform. Most participants had good perceived vulnerability, response efficacy, and self efficacy levels related to rabies (43.9, 68.6, and 73.2%, respectively). However, 54.5% had only fair perceived severity levels related to rabies. Significant positive correlations were found between RPB and the PMT constructs related to rabies (β, 0.298; p<0.001), and the school variable (S4) was also a predictor of RPB (β, -0.228; p<0.001). Among the PMT constructs, self efficacy was the strongest predictor of RPB (β, 0.741; p<0.001).ConclusionsPMT is a useful framework for predicting RPB. Future RPB or prevention/protection intervention studies based on PMT should focus on improving self efficacy and response efficacy, with a particular focus on teaching students not to intervene with fighting animals. The most influential PMT constructs can be used for designing tools and implementing and evaluating future educational interventions to prevent rabies in children.

The Influence of Public Awareness on Prevention of Rabies Cases in Several Asian Countries: A Review

Rabies is a zoonotic disease caused by a viral infection. The rabies virus is often referred to as re-emerging zoonosis, which belongs to the genus lyssavirus. Rabies in humans is spread through the bite of an infected animal. Animals that are at risk of spreading the rabies virus are called HPR. Animals that are at risk of exposure to the rabies virus are all warm-blooded. For Indonesia, the source of rabies transmission comes from 3 animals, namely: dogs, cats, and monkeys. The risk of transmission through bites is speedy and occurs almost every day, primarily through dog bites. Deaths from rabies in children are generally under the age of 15 years. The South Asia region recorded the maximum incidence of rabies outbreaks, with India and Bangladesh at the highest position compared to other countries in the region and beyond. Indonesia is a country that has high rabies cases. Bali is an area that has increased rabies incidence every year. The increase in cases of dog bites is very closely related to people’s awareness patterns. The predetermined pattern of awareness includes: handling after HPR bites, HPR maintenance systems, actions taken when dealing with HPR, and treatment of products (meat or organs) from HPR. Efforts are being made to prevent rabies outbreaks, namely vaccination, depopulation, rabies prevention education for school children, and surveillance of rabies-carrying animal traffic (HPR).

A preliminary survey of knowledge, attitudes and practice regarding rabies in West Bengal, India

Introduction: This study was conducted to evaluate the knowledge, attitudes and practices (KAP) of patients attending the general outpatient department in Malda Medical College about rabies. Methods: A structured questionnaire was answered by 161 participants. The KAP score was calculated according to the response of the participant. Results: Compared to adults, children in the 10-15year age group scored much less in all components of rabies prevention and post exposure management. Conclusion: There was lack of awareness about post exposure prophylaxis of rabies in children. Awareness campaigns especially focusing on children are required to provide better medical care.

Rabies in Children: Report of 24 Cases at the Yalgado Ouedraogo University Hospital Center of Ouagadougou in Burkina Faso

Introduction/Objectives: Rabies is responsible for more than annual 55000 deaths in the world including 24000 in Africa. This study aims to study the epidemiological and clinical aspects of rabies in children at the University Hospital Center Yalgado Ouedraogo on 11 years. Patients and Methods: This was a retrospective descriptive study of rabies cases in children who were received at CHUYO (University Hospital Center Yalgado Ouedraogo) from 1st January 2003 to 31 December 2014. The diagnosis was clinical, associated with a notion of suspect animal bite; data were collected from medical files and analyzed with Epi Info version 6. Results: During the study period, 60 rabies cases were reported, including 24 children. Children average age was 08.5 ± 4 years with a sex ratio of 07. In 47.6% of cases, children were referred from other provinces of the country and 58.3% case lived in rural areas. In all cases, the animal aggressor was a dog, and in 62.5% of cases, it was a stray dog. Upper limbs were the most common site followed by the lower limbs; nevertheless, the head represented 12.5% of the reported injuries. The main clinical signs were agitation (70.8%), hydrophobia (58.3%), and fever (50%). In 30% of cases, the parents left the hospital with their child without or against medical opinion. Conclusion: Rabies frequency is significant in children and is probably under-diagnosed because of clinical signs most often confused with other diseases. Pre-exposure prevention through vaccination is the best way to fight against rabies in children.

Pre-exposure prophylaxis against rabies in children

Animal bites in humans are a public health problem. Children are the most frequently exposed, representing 50% of human exposures in canine rabies infected areas. Pre-exposure vaccination using cell culture vaccines is a safe and effective method of preventing rabies among children in these highly endemic regions. The development of immunological memory after pre exposure vaccination has established long lasting immunity against rabies in humans. The present study assessed the safety of Purified Chick Embryo cell Rabies Vaccine (Vaxirab N) administered as a three-dose intradermal pre-exposure regimen on days 0, 7, and 21 in healthy volunteered children of 5–10 y age group from an urban poor locality in Bangalore, India. One hundred fifty three apparently healthy children of both sexes between 5 and 10 y of age were enrolled in the study and 123 (80.4%) completed all three doses. A total of 405 doses of intradermal vaccine was administered, among which 25 adverse reactions were reported from 17 children. The adverse reactions were pain at the injection site 15 (3.7%), redness 2 (0.5%), itching at the site of injection 1 (0.2%), fatigue 1 (0.2%), fever 3 (0.7%), myalgia 2 (0.5%) and allergy 1 (0.2%). All reactions subsided without any complication. In conclusion, pre exposure vaccination against rabies is a useful tool for protecting children living in highly endemic regions and Vaxirab N has proved to be safe and well tolerated by intradermal route among children.

Protecting Indian schoolchildren against rabies: Pre-exposure vaccination with purified chick embryo cell vaccine (PCECV) or purified verocell rabies vaccine (PVRV)

Although rabies can be effectively prevented by means of pre-exposure or post-exposure prophylaxis, in India, an estimated 17,000 to 20,000 human rabies deaths occur annually. Tragically, 50% of these victims are children under the age of 15. In addition to immediate post-exposure prophylaxis measures, including active and passive immunization, pre-exposure vaccination using tissue culture vaccines is a safe and effective but highly underutilized method of preventing rabies in humans living or working in areas at risk. This study assessed the safety and immunogenicity of Purified Chick Embryo Cell Vaccine (PCECV) and Purified Verocell Rabies Vaccine (PVRV), administered as a three-dose intramuscular pre-exposure regimen on days 0, 7 and 28 in 175 healthy schoolchildren. PCECV was administered after reconstitution using either 1.0 mL or 0.5 mL (half the diluent volume) and PVRV was given after reconstitution with 0.5 mL. Vaccine safety was assessed observer-blind, including pain assessment with a validated visual analogue scale for children. Rabies virus neutralizing antibody (RVNA) concentrations were measured on day 49 by RFFIT. All children developed adequate RVNA concentrations above 0.5 IU/mL. Solicited local and systemic reactions were within the range expected, pain after vaccination was reported in 2 to 12% of study subjects, fever was reported in 2 to 5%. There was no statistical difference in the vaccination group or vaccination day. No unexpected or serious adverse event was reported during the study. In conclusion, PCECV and PVRV are safe and immunogenic when administered intramuscularly for pre-exposure prophylaxis of rabies in children. A 1.0 mL dilution volume for PCECV was as well tolerated as PVRV or PCECV reconstituted in half the volume.

Prophylaxis Against Rabies in Children Exposed to Bats

Rabies has become a disease of increasing concern. One reason is that bat variant rabies is a more common cause of human disease, with 1-2 deaths per year in the United States. Bat bites are much more difficult to document than bites from larger animals. Deaths from rabies encephalitis have remained undiagnosed until postmortem examination. Prophylaxis includes a series of 5 vaccinations during 28 days. Vaccine efficacy has been documented, even in young children.

Prophylaxis Against Rabies in Children Exposed to Bats

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James Parkinson (1755-1824): a pioneer of child care.

James Parkinson (1755-1824) of Parkinson's disease, is well recognized as a pioneer of clinical neurology; and is even more famous as a founder of modern palaeontology. We have reviewed from primary sources his extensive contributions to clinical child care and his pioneering advocacy for child welfare, protection and safety. His writings, outreach and advocacy for children's health characterizes him as one whose influence was an important springboard from which evolved the modern specialty of paediatrics. Parkinson was one of the first to write on child-rearing practices and in this context antedated Benjamin Spock by 150 years. Parkinson was a pioneer of child safety and the prevention of childhood trauma. He wrote of the resuscitation of near-drowned children and of first aid for injured children. This critical analysis reviews his pioneering description of child abuse and the development of post-abuse hydrocephalus. He wrote the datum description (in English) of the pathophysiology and pathology of appendicitis in children, of fatal rabies in children and highlighted the risk of death even when the biting dog was not clinically rabid. His advocacy for social reform for children's welfare was courageous and pioneering. James Parkinson, hitherto unacknowledged, was a significant founder of the evolving discipline of paediatrics and child health.

Failure of Postexposure Treatment of Rabies in Children

Five failures of postexposure treatment of rabies in small children with multiple severe bites on the face and head are discussed. All had received rabies immune globulin and a potent tissue-culture vaccine. However, not all wounds had been infiltrated with immune globulin. Surgical closure prior to wound injection with immune globulin was performed in three cases. Another patient had wounds sutured after an intramuscular injection of immune globulin, without wound infiltration.

Rabies in children (an eleven years retrospective study in Medan).

At the Department of Child Health Medical School University of North Sumatera/Dr. Pirngadi Hospital Medan, a retrospective study for analysis on Rabies in Children from 1977 - 1980 had been carried out. We found 29 cases consisting of 23 males arul 6 females. The highest incidence was between 6 - 12 years. All was bitten by dogs. Lower limbs were the most common site of dog bite. Twenty of the 29 cases were derived from Medan Munic~TJ!e. All of the cases did not received post"exposure immunization. People's alertness to dog control is still unproperly practice and stray dogs are everywhere.

PUBLIC HEALTH, NURSING AND MEDICAL SOCIAL WORK

EVERY practicing pediatrician is faced with the problem of possible rabies in children bitten by animals. This terrifying and dramatic disease, of world-wide distribution and concern, has been the object of research in many countries. Following an International Rabies Conference in Paris in 1927, data concerning 1,600,000 persons treated were collected by the Health Organization of the League of Nations. Final proof of the value of Pasteur treatment could not, however, be obtained, as no evidence was available to compare the outcome of the disease in treated and untreated individuals. After discussion at the First World Health Assembly in 1948 rabiologists all over the world were consulted by the World Health Organization through a questionnaire, and an expert committee was convened in Geneva from 17 to 22 April, 1950, to examine the replies received, review the newest developments, and make recommendations. Highlights of the report of this Expert Committee are presented in the Chronicle of the World Health Organization, vol.4, no.9, pp. 278-284, September 1950. Active Immunization Since Pasteur first used his vaccine in attempts at therapy major activity has been directed at two objectives—treatment of the exposed human beings and mass immunization of animals. "Differences which are known to exist in the biological quality of antirabies vaccines have thrown doubt on the value of current vaccination procedures.