Five Year Experience of Preexposure and Postexposure Rabies Prophylaxis in Korean Children at the National Medical Center

Noh, Jin Chul; Park, Hyang Mi; Park, Jong Hyun; Won, Youn Kyung; Lee, Chang Hyu; Kim, Jae Yoon

doi:10.14776/kjpid.2013.20.1.9

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Meanwhile, there were relatively few children younger than 15 years, who are known to be most susceptible to rabies, with only 10 cases (9.4%). Among these cases, 5 cases, including the data of rabies vaccination-related studies, were published in the Korean Journal of Pediatric Infectious Diseases in 2013 [ 8 ]. This percentage is consistent with the results of a study in the UK but higher than that reported in Thailand and Nepal [ 9 , 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Rabies Post-Exposure Prophylaxis of Overseas Travelers in the International Travel Clinic of the National Medical Center from 2006 to 2012, Korea

et al. 2014

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BackgroundRabies is an acute fatal viral disease generally transmitted from infected animals to humans through bites. It is distributed worldwide. The number of Korean people traveling to rabies-endemic countries and being bitten by infected animals has been increasing recently. Therefore, we investigated international travelers who received rabies post-exposure prophylaxis (PEP) at the National Medical Center (NMC) and compared the data with those of other clinics.Materials and MethodsThis study was a retrospective review of 106 patients who visited the International Travel Clinic of the NMC and received rabies PEP between July 2006 and December 2012. During that period, we used the Essen intramuscular regimen protocol. Complete rabies PEP was defined as 5 doses of rabies vaccination with or without rabies immunoglobulin (RIG) administration according to the World Health Organization guidelines.ResultsA total 106 cases documented within the period of 6 years were selected, including 10 children younger than 15 years and 96 older than 15 years. The mean age of the patients who received PEP was 33.4 years. Of the patients, 53 were male and another 53 were female. Most of the exposures occurred in Southeast Asia, predominantly from dog bites (71, 66.9%). The lower extremities were the most frequent site of exposure (37, 34.9%). All the patients began receiving rabies vaccination for prophylaxis after exposure, and 51 received rabies vaccination with RIG. Meanwhile, 74 cases (69.8%) initiated rabies vaccination overseas, but only 10 of them received RIG while overseas; the remaining 32 (30.2%) initiated rabies vaccination after returning to Korea. Within 7 days, all the children and 74 adults received their first rabies vaccination. Six adults initiated first rabies vaccination after 1 week. Eleven of the 106 patients stopped PEP before 5 doses, among whom 4 (1 child and 3 adults) discontinued vaccination after confirming that the biting animal remained healthy throughout 10 days of observation. None of the patients had been previously vaccinated against rabies.ConclusionsMost of the overseas travelers who visited our clinic after being bitten by suspected rabid animals received appropriate rabies PEP. However, the interval between exposure and first rabies vaccination was often delayed. Tourists who plan to travel in rabies enzootic regions need to be aware that prompt initiation of PEP is important to reduce the risk for developing human rabies.

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Section: Discussionmentioning

confidence: 99%

Rabies Post-Exposure Prophylaxis of Overseas Travelers in the International Travel Clinic of the National Medical Center from 2006 to 2012, Korea

et al. 2014

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Animal bite injuries and vaccination

Kang

2015

J Korean Med Assoc

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Animal bites are a common problem managed by primary physicians and often involve wound infection, neurovascular injury, poor cosmetic outcome, and high medical costs. During clinical assessment, a thorough medical history is acquired, including details of the bite circumstances and the patient's immune status and vaccination history. A meticulous physical examination should be performed in order to identify any injuries to deep structures, in addition to exploring the wound by creating a narrow opening and using diagnostic tools such as radiograph and ultrasound where necessary. Infection is the most problematic complication after a bite injury. Cleaning, irrigation, and debridement are the most important steps in preventing infection. The use of prophylactic antibiotics is controversial, but probably indicated in immunocompromised individuals and in anatomical areas that are more likely to be infected, such as the hand and foot. The decision to close a bite wound must be based on consideration of the benefit of a good cosmetic outcome and the increased risk of infection. In Korea, human rabies has not occurred since 2005, but the transmission of rabies is still a concern with animal bites. The transmission of viral hepatitis, herpes virus and human immunodeficiency virus can occur following human bites. To prevent the transmission of various viruses, healthcare providers should know the guidelines for post-bite exposure prophylaxis.

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Five Year Experience of Preexposure and Postexposure Rabies Prophylaxis in Korean Children at the National Medical Center

Cited by 2 publications

References 14 publications

Rabies Post-Exposure Prophylaxis of Overseas Travelers in the International Travel Clinic of the National Medical Center from 2006 to 2012, Korea

Rabies Post-Exposure Prophylaxis of Overseas Travelers in the International Travel Clinic of the National Medical Center from 2006 to 2012, Korea

Animal bite injuries and vaccination

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