Animal contact and rabies prophylaxis experience: evaluation of 625 pediatric cases

Abstract

Objective: Rabies is a zoonotic disease that infects mammals and can be fatal. Many people in the world are bitten by rabies suspected animals. However, it is possible to prevent the disease by vaccination of animals and pre-and post-exposure prophylaxis measures. The aim of this study was to evaluate the clinical and demographic characteristics of pediatric patients admitted to our hospital for rabies suspected contact. Material and Methods: Patients aged 0-18 years who were admitted to our hospital between January 1 and December 31, 2018 due to contact with animals at risk of rabies such as licking, scratching or biting were included into the study. Demographic and clinical data of the patients were obtained retrospectively. SPSS 22.0 program was used for statistical analysis of the data. Results: Of the 625 children included into the study, 64.5% were males. Mean age of the patients was 8.9 ± 5.1 (9; 0-18) years. When the patients were classified according to age groups, the highest number of children was between 12-18 years (34.1%). Most of the patients (60.2%) were living in urban areas. The most frequent contact was with cats (57.4%). Often, bite/scratching occurred from a single site. Most of these were contacted from the hand region (26.7%). Prior to admission, 71.4% of the patients had undergone wound care. Intramuscular rabies immunoglobulin (40 IU/kg) was administered to 113 (18.1%) patients admitted to hospital at the appropriate time. In post-exposure period, 145 (23.2%) animals could be observed for at least 10 days. After rabies vaccination, fever occurred in 1.1% of the patients within the first 24 hours. There were no other local or systemic complications related to the vaccine. Oral antibiotic prophylaxis was given to 8.3% of the patients. In addition 1.4% of the patients received parenteral antibiotic treatment for severe wound infection. None of the patients developed signs and symptoms of rabies during the study period. Conclusion: Although rabies suspected contact constitutes an important public health problem in our region, our study supports that it is possible to obtain low morbidity and mortality rates with the prophylaxis practices recommended in the guidelines for patients in contact with risky animals. In addition to proper prophylaxis, vaccination of animals is important for disease control.