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Exposure history, post-exposure prophylaxis use, and clinical characteristics of human rabies cases in China, 2006-2012

Exposure history, post-exposure prophylaxis use, and clinical characteristics of human rabies cases in China, 2006-2012
Exposure history, post-exposure prophylaxis use, and clinical characteristics of human rabies cases in China, 2006-2012

Rabies is still a public health threat in China. Evaluating the exposure history, clinical characteristics, and post-exposure prophylaxis (PEP) of the cases could help in identifying approaches to reducing the number of these preventable deaths. We analysed data collected from 10,971 case-investigations conducted in China from 2006 to 2012. Most cases (n = 7,947; 92.0%) were caused by animal bites; 5,800 (55.8%) and 2,974 (28.6%) exposures were from domestic and free-roaming dogs, respectively. Only 278 (4.8%) of these domestic dogs had previously received rabies vaccination. Among all cases, 5,927 (59.7%) cases had category III wounds, 1,187 (11.7%) cases initiated the rabies PEP vaccination and 234 (3.9%) cases with category III wounds received rabies immunoglobulin. In our adjusted logistic regression model, male cases (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI]: 1.09-1.44) and farmers (aOR = 1.39, 95% CI: 1.10-1.77) and person older than 55 years (aOR = 1.48, 95% CI: 1.01-2.17) were less likely than females and persons in other occupations or younger than 15 years to initiate PEP vaccination. The median incubation period was 66 days (interquartile range (IQR): 33-167 days). To reduce the number of human deaths due to rabies, rabies prevention campaigns targeting males and farmers and older people should be conducted. Increasing routine rabies vaccination among domestic dogs will be essential in the long term.

Journal Article
2045-2322
Guo, Chun
a80c0934-0752-4676-843b-abcc5b6bda13
Li, Yu
8c604553-ec11-4e26-b58f-f7d52fcd7e76
Huai, Yang
61e36884-07c8-401b-bcde-463a26ccb3a6
Rao, Carol Y
467f025a-6794-494f-a226-8c3916ac1c03
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Mu, Di
e58d130e-3c45-4641-9b80-a8f0bf7e8c5e
Yin, Wenwu
08baf5f0-df1b-4e67-b251-427ba3bce1b4
Yu, Hongjie
f6a43c0c-0da8-4124-bd15-cd832d6fee7c
Nie, Shaofa
657547a3-4350-49be-9139-d397f0122cae
Guo, Chun
a80c0934-0752-4676-843b-abcc5b6bda13
Li, Yu
8c604553-ec11-4e26-b58f-f7d52fcd7e76
Huai, Yang
61e36884-07c8-401b-bcde-463a26ccb3a6
Rao, Carol Y
467f025a-6794-494f-a226-8c3916ac1c03
Lai, Shengjie
b57a5fe8-cfb6-4fa7-b414-a98bb891b001
Mu, Di
e58d130e-3c45-4641-9b80-a8f0bf7e8c5e
Yin, Wenwu
08baf5f0-df1b-4e67-b251-427ba3bce1b4
Yu, Hongjie
f6a43c0c-0da8-4124-bd15-cd832d6fee7c
Nie, Shaofa
657547a3-4350-49be-9139-d397f0122cae

Guo, Chun, Li, Yu, Huai, Yang, Rao, Carol Y, Lai, Shengjie, Mu, Di, Yin, Wenwu, Yu, Hongjie and Nie, Shaofa (2018) Exposure history, post-exposure prophylaxis use, and clinical characteristics of human rabies cases in China, 2006-2012. Scientific Reports, 8 (1). (doi:10.1038/s41598-018-35158-0).

Record type: Article

Abstract

Rabies is still a public health threat in China. Evaluating the exposure history, clinical characteristics, and post-exposure prophylaxis (PEP) of the cases could help in identifying approaches to reducing the number of these preventable deaths. We analysed data collected from 10,971 case-investigations conducted in China from 2006 to 2012. Most cases (n = 7,947; 92.0%) were caused by animal bites; 5,800 (55.8%) and 2,974 (28.6%) exposures were from domestic and free-roaming dogs, respectively. Only 278 (4.8%) of these domestic dogs had previously received rabies vaccination. Among all cases, 5,927 (59.7%) cases had category III wounds, 1,187 (11.7%) cases initiated the rabies PEP vaccination and 234 (3.9%) cases with category III wounds received rabies immunoglobulin. In our adjusted logistic regression model, male cases (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI]: 1.09-1.44) and farmers (aOR = 1.39, 95% CI: 1.10-1.77) and person older than 55 years (aOR = 1.48, 95% CI: 1.01-2.17) were less likely than females and persons in other occupations or younger than 15 years to initiate PEP vaccination. The median incubation period was 66 days (interquartile range (IQR): 33-167 days). To reduce the number of human deaths due to rabies, rabies prevention campaigns targeting males and farmers and older people should be conducted. Increasing routine rabies vaccination among domestic dogs will be essential in the long term.

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Submitted date: 11 April 2018
Accepted/In Press date: 31 October 2018
e-pub ahead of print date: 21 November 2018
Published date: 21 November 2018
Keywords: Journal Article

Identifiers

Local EPrints ID: 426636
URI: https://eprints.soton.ac.uk/id/eprint/426636
ISSN: 2045-2322
PURE UUID: 9bc730b6-3b9a-49d4-82db-91e2281cf2c0
ORCID for Shengjie Lai: ORCID iD orcid.org/0000-0001-9781-8148

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Date deposited: 06 Dec 2018 17:30
Last modified: 03 Dec 2019 01:23

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Contributors

Author: Chun Guo
Author: Yu Li
Author: Yang Huai
Author: Carol Y Rao
Author: Shengjie Lai ORCID iD
Author: Di Mu
Author: Wenwu Yin
Author: Hongjie Yu
Author: Shaofa Nie

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