661. Surveillance of Rabies Prophylactic Treatments after Exposure to Animals: 5 years Experience
Session: Poster Abstract Session: Public Health: Epidemiology and Outbreaks
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • poster rabies IDWEEK_4.pdf (439.9 kB)
  • Background: Rabies re-emerged in Greek fauna in October 2012, 25 years after the last report in animals. Hellenic Center for Disease Control & Prevention developed a semi-active surveillance system to monitor the medical management of potentially exposed persons to rabies. This study aims to providing insight on the biologicals administered and the epidemiological characteristics of the cases where post-exposure prophylaxis was initiated after contact with animals.

     

    Methods: Data received from November 2012 to December 2017 on demographics, exposure event, animal species involved, category of exposure (COE) according to W.H.O., vaccination history, the veterinary evaluation of the animal & the type of treatment administered, were analyzed with Epidata Analysis V.2.2.2.180.

     

    Results: A total of 1616 cases (63.2% males) received rabies post-exposure prophylaxis. In 94.7% of cases cleansing of the wound before visiting a medical practitioner took place during the first three hours after the exposure whereas 75.1% of victims presented at a health care setting during the first 24 hours; COE III cases had shorter time interval (p<0.01), before arrival at a hospital (mdn=1.3 hours) compared with COE II (mdn=3.6 hours) or COE I (mdn= 88.2 hours) (Figure1);

    55.1% were initiated on a vaccine series, 43.1% received both vaccine & immunoglobulin and 1.7% immunoglobulin alone. Exposure to stray dogs represented 67.3 % of all incidents (Table 1).

    Table 1. Post-exposure prophylaxis (PEP) by animal involved, Greece, 2012-2017

    Species

    Status

    PEP

    %

    Dog

     

    Ownerless

    1087

    67.3

    With owner

    252

    15.6

    Unknown

    20

    1.2

    Cat

     

    Ownerless

    120

    7.4

    Companion

    17

    1.1

    Unknown

    1

    0.1

    Fox

    48

    3.0

    Bat

    33

    2.0

    Other domestic species

    6

    0.4

    Other wildlife species

    18

    1.1

    Unidentified

    14

    0.9

    Total

    1616

    100

    No human case was recorded.

    Conclusion: The vast majority of the reported treatments involved stray dogs as Greek legislation permits free roaming of ownerless companion animals in urban settings. Bat was the 4th most frequently reported species in our treatment series. Surveillance of post-exposure prophylaxis represents a valuable tool for outlining the epidemiological profile of treated cases and for planning of effective policies for the management of rabies.

     

    Georgios Dougas, DVM1, Vasileia Konte, MD, MSc1, Konstantinos Mitrou, RN, MSc1, Emmanuel Christodoulou, MD2, Michail Stavrakakis, DVM2, Agoritsa Baka, MD1, Theano Georgakopoulou, MD, MSc, MPH, PhD1, Symeon Metallidis, MD, PhD3, Ioannis Istikoglou, RN, MSc4, Chrysa Pargiana, MD5, Aikaterini Liona, Adm.1, Foteini Tsalikoglou, MD, MSc6, Myrsini Tzani, DVM, MSc7, Marilina Korou, DVM, MSc, PhD7, Konstantia Tasioudi, DVM, MSc, PhD8, Maria Mavrouli, Biologist, MSc, PhD9, Georgia Vrioni, MD, PhD9 and Sotirios Tsiodras, MD, MSc, PhD, FIDSA10, (1)Hellenic Center for Disease Control and Prevention, Athens, Greece, (2)Department of Internal Medicine, Papanikolaou General Hospital of Thessaloniki, Thessaloniki, Greece, (3)Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece, (4)Infection Control Committee, “AHEPA” University Hospital, Thessaloniki, Greece, (5)Infectious Diseases Hospital of Thessaloniki, Thessaloniki, Greece, (6)Ministry of Health, ATHENS, Greece, (7)Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece, (8)Virology Laboratory - National Reference Laboratory for Rabies in animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece, (9)Department of Microbiology, Medical School, University of Athens, Athens, Greece, (10)National and Kapodistrian University of Athens Medical School, Athens, Greece

    Disclosures:

    G. Dougas, None

    V. Konte, None

    K. Mitrou, None

    E. Christodoulou, None

    M. Stavrakakis, None

    A. Baka, None

    T. Georgakopoulou, None

    S. Metallidis, None

    I. Istikoglou, None

    C. Pargiana, None

    A. Liona, None

    F. Tsalikoglou, None

    M. Tzani, None

    M. Korou, None

    K. Tasioudi, None

    M. Mavrouli, None

    G. Vrioni, None

    S. Tsiodras, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.