Epidemiological Characteristics of Post-exposure Prophylaxis of Rabies in Varna Region for the Period 2014-2018

Abstract

Introduction: Rabies is a viral zoonosis still posing a significant threat to public health worldwide, especially in developing countries. The disease can be controlled by animal vaccination and appropriate post-exposure prophylaxis in humans administered in the earliest possible time. Aim: To study and analyze animal-related injuries and post-exposure prophylaxis for rabies. Materials and methods: Between 2014 and 2018, a retrospective epidemiological study was conducted in Varna region, which included 1462 persons who suffered injuries from animals. The study was based on the official data in the annual analysis of the Regional Health Inspectorate (RHI) in Varna. The information was summarized, analyzed, and graphically illustrated. The results were statistically analysed using SPSS v. 20 employing variational and comparative (χ2) analyses. The statistical significance level was set at p <0.05. Results: Of 1462 registered post-injury care seekers, 642 (42.7%) had to be given post-exposure prophylaxis on an emergency basis. The latter were mainly city residents (91.8%). Immunization against rabies was given in the first two days after exposure in 477 (76.4%) subjects. The average number of doses per immunized person was 3.63. The injuries were mainly from stray dogs (58.14%), followed by domestic (37.41%) and wild (4.45%) animals. According to the anatomical site of injury, limb injuries predominated in 88.65% (lower limbs 45% and upper limbs 43.64%). Most of the injuries were light (71.54%), followed by moderate (18.91%) and severe injuries (9.61%). Conclusions: Rabies prevention can be much more facilitated by the combined efforts of doctors, veterinarians, animal welfare organizations and, last but not least, responsible population behavior. Post-exposure prophylaxis is an integral part of successfully curbing rabies programs but effective disease control can be achieved only through health education and vaccination of animals.