Firouzeh Farahtaj1, Ahmad Fayaz2, Nader Howaizi3, Peyvand Biglari3, Alirez Gholami2. 1. Doctor, Rabies Department, Pasteur Institute of Iran, Tehran, Iran farahtaj@pasteur.ac.ir. 2. Doctor, Rabies Department, Pasteur Institute of Iran, Tehran, Iran. 3. Technical Staff, Rabies Department, Pasteur Institute of Iran, Tehran, Iran.
Abstract
BACKGROUND: Like most Asian and African countries, Iran is highly endemic for rabies, which is a preventable disease with the timely utilisation of post-exposure prophylaxis (PEP). With the availability of affordable vaccination in Iran, there are still several rabies deaths which are assumed misdiagnosed or received ineffective PEP. METHODS: We reviewed the files of 16 human rabies deaths, consisting of two groups: 1, ineffective treatment; and 2, erroneous PEP. RESULTS: Most of the studied cases were male and were from rural areas. Stray dogs were found to be the common biting animal (68.75%). Of the patients, 10/16 (62.5%) who had injuries on their head and/or face demonstrated shorter incubation periods. The incubation period was longer in a 4-year-old boy who sustained injuries in his abdomen and back. All the patients in group 1 received four doses of vaccine and administration of human rabies immune globulin (HRIG), and death occurred with the mean of 49 days after the bite. This mean was 27 days in three patients in group 2, who received vaccine without administration of HRIG. CONCLUSION: In a total of 1,188,579 cases of PEP given in Iran during: 2002-2011, it is not known whether all PEPs were correctly administered by World Health Organization standards. Extending rabies awareness programmes and timely PEP education in the community in accordance with the implementation of rabies control measures might lead to a decrease in these unfortunate scenarios and heavy financial burden of vaccination required due to the prevalence of rabies.
BACKGROUND: Like most Asian and African countries, Iran is highly endemic for rabies, which is a preventable disease with the timely utilisation of post-exposure prophylaxis (PEP). With the availability of affordable vaccination in Iran, there are still several rabies deaths which are assumed misdiagnosed or received ineffective PEP. METHODS: We reviewed the files of 16 humanrabies deaths, consisting of two groups: 1, ineffective treatment; and 2, erroneous PEP. RESULTS: Most of the studied cases were male and were from rural areas. Stray dogs were found to be the common biting animal (68.75%). Of the patients, 10/16 (62.5%) who had injuries on their head and/or face demonstrated shorter incubation periods. The incubation period was longer in a 4-year-old boy who sustained injuries in his abdomen and back. All the patients in group 1 received four doses of vaccine and administration of human rabies immune globulin (HRIG), and death occurred with the mean of 49 days after the bite. This mean was 27 days in three patients in group 2, who received vaccine without administration of HRIG. CONCLUSION: In a total of 1,188,579 cases of PEP given in Iran during: 2002-2011, it is not known whether all PEPs were correctly administered by World Health Organization standards. Extending rabies awareness programmes and timely PEP education in the community in accordance with the implementation of rabies control measures might lead to a decrease in these unfortunate scenarios and heavy financial burden of vaccination required due to the prevalence of rabies.
Authors: Daniel L Horton; Lorraine M McElhinney; Conrad M Freuling; Denise A Marston; Ashley C Banyard; Hooman Goharrriz; Emma Wise; Andrew C Breed; Greg Saturday; Jolanta Kolodziejek; Erika Zilahi; Muhannad F Al-Kobaisi; Norbert Nowotny; Thomas Mueller; Anthony R Fooks Journal: PLoS Negl Trop Dis Date: 2015-03-26
Authors: Ali Chegeni Sharafi; Mohammad Javad Tarrahi; Mohammad Saki; Mohammad Mirza Sharafi; Elham Nasiri; Hamid Mokhayeri Journal: Int J Prev Med Date: 2016-09-08