A Study of Human Rabies in Adults Admitted At Infectious Diseases Hospital of Tertiary Care Centre

P. Shingade, M. Vyawahare, M. Abhaykumar
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Abstract

Aims and Objectives: To study epidemiological characteristics and clinical profile with specific attention to non classical/atypical clinical presentation and deficiencies/lacunae in post exposure prophylactic management as per WHO guidelines in adult rabies patients. Method: In this observational study, 96 cases of adult human rabies admitted at IDH of parent institute in 5 years duration (1/11/2008 to 31/10/2013) were studied. Data were collected and analyzed statistically. Results: Majority (95.9 %) of victim’s belonged to lower and lower middle socioeconomic class predominantly males (76.05 %) in age group of 12- 50 years (70.8 %) with WHO category III exposure (72.92 %). Principal biting animals was dog (95.84%). Majority (44.79%) cases had incubation period between 31-90 days post-exposure. Hydrophobia is the main pathognomonic feature of human rabies was present in 88.54 % cases. Majority (91.7 %) of cases had not received any rabies vaccination. 8.3 % victims received anti-rabies vaccine, 7.3 % received PCECV and 1% received PDEV. 1% had completed the course of PCECV (5 doses as relevant) and another 4.2% had received the 3 doses PCECV, 2.1% cases received 2 doses of PCECV. One case (1%) received 1 dose of PDEV. Conclusion: Human rabies is a major health problem, equally affecting rural as well urban population. The epidemiological characteristics and clinical profile of the disease are not much different from other studies and have not changed much over the decades. Hence, there are need to educate the community and health workers about the importance of immediate and adequate post-exposure treatment, to start effective control program for dog and to make availability of TCV as well as RIG.
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在三级保健中心传染病医院住院的成人狂犬病研究
目的和目的:研究成人狂犬病患者的流行病学特征和临床概况,特别关注非典型/非典型临床表现和暴露后预防管理的缺陷/空白。方法:对2008年11月1日至2013年10月31日5年期间,我院收治的96例成人狂犬病患者进行观察性研究。收集数据并进行统计分析。结果:绝大多数(95.9%)患者属于社会经济中下阶层,以男性为主(76.05%),年龄在12 ~ 50岁之间(70.8%),暴露于WHO III类人群(72.92%)。咬伤动物以狗为主(95.84%);大多数(44.79%)病例的潜伏期为接触后31-90天。人类狂犬病的主要病理特征是恐水,占88.54%。绝大多数(91.7%)病例未接种狂犬病疫苗。8.3%的受害者接种了抗狂犬病疫苗,7.3%接种了PCECV, 1%接种了PDEV。1%的病例完成了5剂PCECV疗程,4.2%的病例接受了3剂PCECV治疗,2.1%的病例接受了2剂PCECV治疗。1例(1%)接受1剂PDEV。结论:人狂犬病是一个重大的健康问题,城乡人口均受影响。该疾病的流行病学特征和临床特征与其他研究没有太大不同,几十年来也没有太大变化。因此,有必要对社区和卫生工作者进行教育,使其了解立即和适当的接触后治疗的重要性,启动有效的犬类控制规划,并提供TCV和RIG。
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