Cutaneous leishmaniasis is a neglected and parasitic vector borne diseases that is endemic in tropical and subtropical countries, including Iran. The aim of this study was to explain the present status of CL in Iran. This report is based on data that recorded by cutaneous leishmaniasis surveillance system in 2019, and evaluated in Center for Communicable Diseases Management in Ministry of Health in Iran. Iran has been considered an endemic area for cutaneous leishmaniasis in the world. Dependent to activities for cutaneous leishmaniasis control the number of cases decreased from 23202 in 2008 (Incidence rate 32 per 100000) to 13124 in 2019 (Incidence rate 15.8 per 100000), more cases reported from September to December, in 2019, 46% of cases had one lesion and 21% had 2 lesions, 85% of cases diagnosed when the diameter of lesions had 3 centimeters and bellows. Although the Leishmania control program began in 1977, the incidence of the disease has dropped dramatically since 2008 when the new cutaneous leishmaniasis control program have been implemented. Although in some areas the incidence of the disease increased, but the implementation of the new program has reduced the number of cases, in order to continue reducing the disease, permanent support for the control programs is needed.
Background: Brucellosis is one of the most important zoonotic diseases that impose a serious public health burden on some countries in the world. Annually, the WHO reports more than 500000 new cases of human brucellosis. The disease is endemic in most parts of Iran; especially, in areas where people live in close contact with infected animals. According to data from the Iranian Ministry of Health, the average incidence of brucellosis in Iran was 22 cases per 100000 population, with a decreasing trend of surveillance. Methods: This cross-sectional survey was carried out within 2011-2020 in all provinces of Iran and from patients with clinical symptoms. Results: During the last decade, a total of 173526 cases were reported from different provinces of Iran, with a higher frequency of occurrence in males (58.2%) living in rural areas (77%), as compared to those in urban areas (23%). Moreover, brucellosis was more common in the summer season (June) and most of the cases were via contact with infected livestock (91%) and consumption of unpasteurized dairy products (78% in rural areas and 76% in the urban areas). Conclusion: The failure to effectively control brucellosis may be attributed to lack of knowledge about the disease, consumption of unpasteurized dairy and raw meat, lack of proper and safe vaccines for prevention and eradication programs, lack of rapid detection systems, and ineffective methods of isolating infected animals. Therefore, education and advancement of people’s knowledge are key to the prevention and control of the disease.
Rabies virus, as a neurotropic agent, is transmitted to humans usually after animal biting. Rabies is endemic in most Middle Eastern countries. Pre-exposure Prophylaxis (PrEP) program is recommended for high-risk populations in endemic areas. The present study reported 7 deaths from rabies infection despite human Post-Exposure Prophylaxis (PEP) and the evolution of their possible etiologies from 2014 to 2018 in Iran. In this study, 29 rabid human deaths were evaluated despite PEP in 2014-2018. Seven people deceased despite receiving PEP. The most damaged organs were hands and face (71.43%). Injecting anti-Rabies Immunoglobulin (RIG) around the wound, improper cleansing, and delayed PEP were the main causes of PEP failure. In addition, immunodeficiency in a patient was another cause of failure. Our obtained data suggested that immediate precise measures after exposure based on the World Health Organization (WHO) recommendation, maintaining the temperature integrity (cold chain) of vaccines, and RIGs during transportation, and performing detailed injection schedule could prevent PEP failure in most cases. Furthermore, society’s awareness plays a key role in controlling the disease, especially in endemic areas.
INTRODUCTION Rabies is a zoonotic viral disease caused by a neurotropic virus. The virus has a non-segmented, singlestranded, negative-sense RNA genome and belongs to the genus Lyssavirus (Family: Rhabdoviridae) [1]. It is primarily transmitted to humans via the saliva of rabid animals after bite. Scratching or licking of mucous or wounds by rabid animals are the other routes of transmission [2, 3]. Unusual transmissions, such as solid organ transplantation and inhalation of contaminated aerosol (e.g., in bat-infested caves), have also been reported in some human rabies cases [3]. The disease is almost 100% fatal within two weeks following the appearance of clinical signs [4-6]. Annually, Rabies is responsible for 59000 human deaths, and over 3.7 million disability-adjusted life years (DALYs) lost. Children less than 15 years of age constitute almost 40% of exposures to suspected rabid animals [4]. Epidemiology. The rabies virus can infect humans, domestic, and wild animals, and has a significant impact on public health and the husbandry economy, especially in endemic regions [5-9]. The virus occurs across all parts of the world except Antarctica (Fig. 1) [10]. Approximately 20,000 human cases, which account for about one-third of annual rabies cases, occur in India, mostly through canine bites. Thus, in this country, the primary control measure has focused on the elimination of rabies in animals, mainly dogs [11]. A study in 2016, showed that rabies in many regions of China is still endemic and remains uncontrolled. In the northwest of China, rabies transmission to humans commonly occurs through the bite of stray dogs and foxes, and licensed vaccines for wildlife and large domestic animals are still required [12]. In Kazakhstan, despite mass animal vaccination, the disease is also endemic, causing substantial economic costs [13]. Sultanov et al. suggested that regular annual vaccination of domestic animals would be beneficial for the control of the disease [13]. In Ethiopia, where the canines are the primary vectors, about 2,700 annual human deaths occur due to rabies [13]. The annual cost of livestock loss due to rabies infection exceeds 50 million dollars in this country [14]. In Cambodia, Rabies has a high prevalence, especially in rural areas. Circulation of the virus among stray dogs in this country makes mass vaccination of these animals necessary [15]. Rabies is a zoonotic viral disease. The causative agent is a negative-sense RNA genome virus of the genus Lyssavirus (Family: Rhabdoviridae). The disease, commonly transmitted by rabid dogs, is the cause of mortality of over 59000 humans worldwide annually. This disease can be prevented before the development of symptoms through proper vaccination even after exposure. Hence, improvement of the vaccination schedule in the countries where rabies is endemic is essential. In addition to the type of vaccine, injection routes also contribute to enhanced immune responses and increased potency of the vaccines. The vaccines approved by the World Health Organization ...
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