1/43. Preventing human rabies before and after exposure.Rabies is a viral disease that can be transmitted from animals to humans. Recently, most human deaths from rabies have been caused by transmission from bats, in many cases without a documented bite or exposure. Rabies is fatal if untreated prior to onset of symptoms. Deaths from human rabies in the united states are rare, largely because of animal control measures and postexposure prophylaxis of people who have been bitten or exposed to the virus. Primary care providers play a pivotal role in the prevention of rabies. Preexposure prevention involves education and immunization of persons at high risk for rabies exposure. Rabies is difficult to diagnose antemortem because of the nonspecific presentation of signs and symptoms that may mimic those of respiratory or abdominal infections. Diagnosing rabies once symptoms begin will not save the victim's life but will help to minimize exposure to others, allow for identification and prophylaxis of those who may have been exposed, and identify the animal vector.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
2/43. Survey of rabies preexposure and postexposure prophylaxis among missionary personnel stationed outside the united states.BACKGROUND: Of the 36 cases of human rabies that have occurred in the united states since 1980, 12 (33%) were presumed to have been acquired abroad. In the united states, it is recommended that international travelers likely to come in contact with animals in canine rabies-enzootic areas that lack immediate access to appropriate medical care, including vaccine and rabies immune globulin, should be considered for preexposure prophylaxis. In 1992, the death of an American missionary who had contracted rabies while stationed in bangladesh highlighted this high-risk group. methods: To assess their knowledge of rabies risk, rabies exposures, and compliance with preventive recommendations, we asked 695 missionaries and their family members to complete questionnaires about their time stationed abroad. RESULTS: Of the 293 respondents stationed in countries where rabies is endemic, 37% reported prior knowledge of the presence of rabies in their country of service. Only 28% of the personnel stationed in rabies-endemic countries received preexposure prophylaxis. Having preexposure prophylaxis specifically recommended increased the likelihood of actually receiving it (O.R. 15.6, 95%CI 7.4 - 34.9). There were 38 reported exposures (dogs = 66%, another human = 20%), proven or presumed to be rabid. Three of the people exposed received rabies immune globulin and vaccine; 11 received vaccine alone; 8 received only basic first aid, and 16 received no treatment. CONCLUSIONS: Although American missionaries stationed abroad are at an increased risk for exposure to rabies, compliance with established preventive measures was low. Prior to being stationed abroad, an educational rabies-prevention briefing, including encouragement to receive preexposure prophylaxis, could be an effective intervention for missionaries to decrease their risk of rabies.- - - - - - - - - - ranking = 0.33333333333333keywords = animal (Clic here for more details about this article) |
3/43. Rabies control in japan.In 1957 japan succeeded in eradicating rabies, which had been endemic since the 18th century, due to the registration and confinement of family dogs, the elimination of stray dogs, and the compulsory vaccination of dogs. At present, however, vaccination coverage of family dogs is far lower than the required level of 70%. The facilities that are presently able to investigate rabies are limited in number. In addition, few medical institutions keep rabies vaccine in stock or offer postexposure vaccination to travelers bitten by animals in rabies endemic areas. Moreover, rabies immunoglobulin (RIG) cannot be given to such individuals because RIG is not produced at present in japan, nor is it authorized to be imported. To keep japan free from any rabies deaths, an improvement in vaccination coverage among dogs and in the supply of postexposure prophylaxis is required, and the establishment of a rabies surveillance system is also considered to be essential.- - - - - - - - - - ranking = 0.33333333333333keywords = animal (Clic here for more details about this article) |
4/43. Rabies in israel: decades of prevention and a human case.Animal rabies is endemic in israel, with 50-80 laboratory-confirmed cases being diagnosed annually. Despite the high incidence among animals, human rabies has not occurred in israel for almost four decades. This is likely due to the highly effective prevention policy implemented by the Ministry of Health, based on pre-exposure vaccination of populations at risk, post-exposure treatment, and updated rules. Notwithstanding the previous success, a human case occurred in 1996 when a soldier was bitten, while asleep, by an unidentified small animal, which according to his description was a rat or a mouse. Since injuries by these rodents do not require antirabies treatment, no antirabies post-exposure prophylaxis was administered. Five weeks later the soldier complained of fever and nausea with interchanging periods of rage and calm, confusion, and water aversion. His condition deteriorated gradually, leading to deep coma and death. Immunofluorescence examination of a skin biopsy was positive for rabies, and PCR of saliva revealed lyssavirus genotype 1. We review the changes in the epizootiology of rabies in israel, the trends of human exposure to animals, and the pre- and post-exposure prophylaxis guidelines, and discuss possible measures that could have been undertaken to prevent the eventuality of this case. This case of rabies, the first after a long period without human disease, accentuates the importance of strict adherence to prevention guidelines. Considerations of geography, epidemiology, and the circumstances of exposure are crucial in the treatment decision-making process.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
5/43. Rabies: otolaryngologic manifestations.Rabies is a rare, fatal viral infection, usually transmitted by the bite of an infected animal. Some 30,000 Americans are immunized annually, however, so public health considerations are common. The development of a new vaccine, grown in human diploid cell culture, is discussed. It appears to have high antigenicity with no serious morbidity. A case of a patient with fatal rabies who had fever, delirium, dysphagia, and cervical and pectoral subcutaneous emphysema is presented.- - - - - - - - - - ranking = 0.33333333333333keywords = animal (Clic here for more details about this article) |
6/43. public health aspects of rabies.environmental health Services personnel are responsible for communicable disease surveillance and control, which includes rabies. They conduct contact investigation on all rabid animals reported by Veterinary Services. A patient admitted to USAF Hospital Clark with a clinical diagnosis of rabies (confirmed on autopsy) presented a more complex investigation problem. Identification of hospital personnel who had significant contact with the patient was relatively easy. There were 21 hospital personnel identified as requiring antirabies prophylaxis. Social contacts of the patient were more difficult to identify. Numerous friends and co-workers were interviewed. Only one person was determined to need prophylaxis as a result of the investigation. One of the most important aspects of any rabies investigation is coordination between all involved personnel. These personnel represent various disciplines including veterinary, medical, and public health (both military and civilian). If all individuals are to be identified, evaluated, and given complete, correct information, there must be open lines of communication between the various disciplines.- - - - - - - - - - ranking = 0.33333333333333keywords = animal (Clic here for more details about this article) |
7/43. Rabies surveillance in the united states during 2000.During 2000, 49 states, the district of columbia, and puerto rico reported 7,364 cases of rabies in nonhuman animals and 5 cases in human beings to the Centers for disease Control and Prevention, an increase of 4.3% from 7,067 cases in nonhuman animals reported in 1999. Ninety-three percent (6,855 cases) were in wild animals, whereas 6.9% (509 cases) were in domestic species (compared wth 91.5% in wild animals and 8.5% in domestic species in 1999). Compared with cases reported in 1999, the number of cases reported in 2000 increased among bats, dogs, foxes, skunks, and sheep/goats and decreased among cats, cattle, horses/mules, raccoons, and swine. The relative contributions of the major groups of animals were as follows: raccoons (37.7%; 2,778 cases), skunks (30.2%; 2,223), bats (16.8%; 1,240), foxes (6.2%; 453), cats (3.4%; 249), dogs (1.6%; 114), and cattle (1.1%; 83). Ten of the 19 states where the raccoon-associated variant of the rabies virus has been enzootic reported increases in the numbers of cases of rabies during 2000. Among those states that have engaged in extensive wildlife rabies control programs, no cases of rabies associated with the epizootic of rabies in raccoons (or in any other terrestrial species) were reported in ohio, compared with 6 cases reported in 1999. No rabies cases associated with the dog/coyote variant (compared with 10 cases in 1999, including 5 in dogs) were reported in texas, and cases associated with the gray fox variant of the virus decreased (58 cases in 2000, including 38 among foxes). Reports of rabid skunks exceeded those of rabid raccoons in massachusetts and rhode island, states with enzootic raccoon rabies, for the fourth consecutive year. Nationally, the number of rabies cases in skunks increased by 7.1% from that reported in 1999. The greatest numerical increase in rabid skunks (550 cases in 2000, compared with 192 in 1999) was reported in texas. The number of cases of rabies reported in bats (1,240) during 2000 increased 25.4% over the number reported during 1999 (989) and represented the greatest contribution (16.8% of the total number of rabid animals) ever recorded for this group of mammals. Cases of rabies reported in cattle (83) and cats (249) decreased by 38.5% and 10.4%, respectively, whereas cases in dogs (114) increased by 2.7% over those reported in 1999. Reported cases of rabies among horses and mules declined 20% from 65 cases in 1999 to 52 cases in 2000. Four indigenously acquired cases of rabies reported in human beings were caused by variants of the rabies virus associated with bats. One case of human rabies acquired outside the united states that resulted from a dog bite was caused by the canine variant of the rabies virus.- - - - - - - - - - ranking = 2keywords = animal (Clic here for more details about this article) |
8/43. Cryptogenic rabies, bats, and the question of aerosol transmission.Human rabies is rare in the united states; however, an estimated 40,000 patients receive rabies postexposure prophylaxis each year. Misconceptions about the transmission of rabies are plentiful, particularly regarding bats. Most cases of human rabies caused by bat variants have no definitive history of animal bite. Three hypotheses are proposed and reviewed for the transmission of rabies from bats to human beings. They include nonbite transmission (including aerosol transmission), the alternate host hypothesis (an intermediate animal host that acquires rabies from a bat and then transmits rabies to human beings), and minimized or unrecognized bat bites. Nonbite transmission of rabies is very rare, and aerosol transmission has never been well documented in the natural environment. The known pathogenesis of rabies and available data suggest that all or nearly all cases of human rabies attributable to bats were transmitted by bat bites that were minimized or unrecognized by the patients.- - - - - - - - - - ranking = 0.66666666666667keywords = animal (Clic here for more details about this article) |
9/43. Human rabies--california, 2002.On March 31, 2002, a man aged 28 years residing in Glenn County, california, died from rabies encephalitis caused by a rabies virus variant associated with the Mexican free-tailed bat (Tadarida brasiliensis) (Figure). This report summarizes the investigation by the Glenn County Health Department (GCHD) and the california Department of health services (CDHS). persons who observe abnormal behavior in any wildlife species should contact animal control or animal rescue agencies immediately and should avoid approaching or handling these animals.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
10/43. Human rabies--tennessee, 2002.On August 31,2002, a boy aged 13 years residing in Franklin County, tennessee, died from rabies encephalitis caused by a rabies virus variant associated with silver-haired and eastern pipistrelle bats. This report summarizes the investigation by the tennessee Department of Health (TDH). persons should avoid direct contact with bats, other wildlife, and stray or ill domestic animals; however, if direct contact with bats has occurred, exposed persons should see their health-care provider, and the exposure should be reported to local public health officials.- - - - - - - - - - ranking = 0.33333333333333keywords = animal (Clic here for more details about this article) |
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