Analysis on factors related to rabies epidemic in China from 2007–2011

Abstract

To analyze features of the rabies epidemic in China between 2007 and 2011, identify factors influencing the epidemic and to provide a scientific basis for further control and prevention of rabies, Descriptive epidemiological methods and statistical analysis was used on data collected from the National Disease Reporting Information System between 2007 to 2011 and the National Active Surveillance System between 2007 and 2010. Our analysis shows that while the number of human rabies cases decreased year by year, the number of districts reporting cases did not show significant change. The situations in Guangdong, Guangxi, Guizhou and Hunan provinces clearly improved over the period but they remain provinces with high-incidence, and consequently influence the epidemic situation of surrounding provinces and possibly the whole country. Summer and autumn were high-incidence seasons. Farmers, students and pre-school children represent the high-risk populations, and rates of cases in farmers increased, those for students decreased, and pre-school children remained unchanged. Provinces with active surveillance programs reported a total of 2346 individual cases, of which 88.53% were associated with canines. Postexposure prophylaxis (PEP) of rabies cases was not significantly improved, whereas PEP in post-exposure population was good. In rural regions of China, canine density was reduced somewhat, and the immunization rate increased slightly. Finally we show that while the epidemic decreased 2007 to 2011 in China, cases continued to be diffused in certain regions. Lack of standardization of PEP on rabies cases was the main reason of morbidity. The high density and low immunization of dog in rural areas and the defective situation of PEP are still continuous occurrences in China and remain a cause for concern.

Community based cross-sectional study on knowledge, attitudes and practices towards rabies in Munesa District, Arsi Zone, Southeastern Ethiopia

“…In Four-Year Retrospective Study by Teklu et al (2017) in Northwestern Tigray the incidence of human rabies exposure cases calculated per 100,000 populations was 35.8, 63.0, 89.8 and 73.1 in 2012, 2013, 2014 and 2015, respectively. The proximity of the site of the virus entry to the CNS increases the likelihood of a short incubation period (Yin et al, 2012). Following the bite of rabid animal the incubation period varies from 5 days to several years (usually 2 to 3 months; rarely more than 1 year) depending on the amount of virus in the inoculum, the density of motor endplates at the wound site and the proximity of virus entry to the central nervous system (WHO, 2013).…”

Zagreb Regimen, an Abbreviated Intramuscular Schedule for Rabies Vaccination

“…Data issued by the Chinese Center for Disease Control and Prevention showed that the incidence of rabies was 0.1058 per million population, with 1,425 deaths attributable to rabies in 2012. Within China, the three provinces with the highest incidence of rabies were Guangxi, Guizhou, and Hainan, with 0.4995, 0.3257, and 0.3077 cases/million, respectively (3,7). The 2012 Chinese Yearbook of Health Statistics revealed that, in 2011, rabies was the fourth most common cause of death among category A and B notifiable infectious diseases, following AIDS, infant tetanus, and tuberculosis (8).…”

“…Males are more likely to develop rabies than females (the male/female ratio is 2.32:1). Farmers represent a high-risk population, accounting for 66.27% of all rabies cases in China, and rabies is most commonly seen in individuals between the ages of 5 and 15 years and 35 and 70 years (3,7). Canines (88.53% to 95.00%) remain the primary source of rabies infection in China, followed by cats (1% to 7%) (3, 9, 10), and Chinese ferret-badgers play an important role as a reservoir and in the transmission of rabies in the southeast of China (11).…”

“…Postexposure prophylaxis (PEP) includes thorough washing and flushing of the bite wound site (for about 15 min, if possible) with soap or detergent and copious amounts of water, immediate vaccination with rabies vaccine, and passive immunization with human rabies immunoglobulin (HRIG) when appropriate. Lack of a standardized PEP regimen for rabies has been the major reason for the morbidity and mortality associated with rabies in China (3). Globally, it is estimated that Ն15 million people receive rabies prophylaxis annually, and the majority live in China and India (2,4).…”

Brief communication (Original). Rabies postexposure vaccination in Thailand: is it performed according to international guidelines?

“…Dog and animal bites are still a common problem in Thailand and in other canine endemic developing countries. Dog bites accounted for 5.3% of injuries in a major emergency room in Thailand [3], while animal bites were 0.3%−1% in other countries [4][5][6][7][8][9][10]. WHO has published guidelines for postexposure rabies vaccination [11].…”