Raiva humana no Brasil: estudo descritivo, 2000-2017*

Abstract

Objective: to describe the epidemiological profile of human rabies in Brazil. Methods: this is a descriptive study of human rabies cases reported in 2000-2017, with an estimate of incidence and spatial distribution. Results: 188 cases were studied, mostly males (66.5%), rural residents (67.0%), children under 15 years (49.6%), with biting being the most frequent form of exposure (81.9%); frequency was highest in the period 2000-2008 (85.6%), with 46.6% of cases involving dogs and 45.9% bats; median incubation was 50 days, followed by, predominantly, symptoms of fever (92.6%), agitation (85.2%), paresthesia (66.7%), and dysphagia/paralysis (51.9%); the majority (70.2%) did not have prophylaxis and for the rest (29.8%) who did have prophylaxis, it was untimely and/or incomplete; 13 patients were treated according to the Recife Protocol, and two survived. Conclusion: human rabies incidence reduced and its epidemiological profile changed, with predominance of cases transmitted by bats; we suggest that secondary cases be investigated, and that pre-exposure prophylaxis be made available to populations at greater risk of accidents involving bats.

Using Surveillance of Animal Bite Patients to Decipher Potential Risks of Rabies Exposure From Domestic Animals and Wildlife in Brazil

“…Following our previous work on dogs (24), this study provides a first estimate of bites from cats and wildlife species in Brazil, showing the uneven incidence across the country and the relatively low level of adequate PEP administration. Despite thousands of bites per year from domestic and wild animals, <10 human rabies cases were reported annually to SINAN during the same period (22). The public health risk of rabies could therefore be limited by low circulation of rabies in these animal reservoirs.…”

“…These reports suggest the circulation of rabies among different wildlife populations in several regions of the country, posing risks to humans and domestic animals that will depend upon contacts between these populations. Between 2000 and 2017, Brazil reported 188 human rabies cases (22). Among the 46 cases where the rabies variant was identified, 27 cases originated from the common vampire bat variant including three that were transmitted by cats, three cases were from the marmoset variant and 16 cases were from the fox variant (22).…”

“…Between 2000 and 2017, Brazil reported 188 human rabies cases (22). Among the 46 cases where the rabies variant was identified, 27 cases originated from the common vampire bat variant including three that were transmitted by cats, three cases were from the marmoset variant and 16 cases were from the fox variant (22).…”

Clinical aspects of human rabies in the state of Ceará, Brazil: an overview of 63 cases

“…The recovered patients had mild to severe sequelae, with the exception of three cases in the United States who had only mild sequelae 17 . Dogs, especially stray dogs, are the most common aggressor species in many settings 14,[18][19][20] . This is a consequence of the lack of public policies related to the control of stray dog populations and the fact that pet dogs have the closest relationship with humans.…”

“…On the day she was attacked, she sought health services, but no recommendation for post-exposure prophylaxis was given by the health professional 31 . Human cases still occur and are related to the lack of awareness of the population followed by inadequate healthcareseeking behavior, and by the failure of the health care system, leading to missed opportunities to save lives 14,34 . There is a clear need to update professionals working in rabies surveillance and treatment.…”