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Rabies exposures in thai children
C Pancharoen1, U Thisyakorn, W Lawtongkum
1Department of Pediatrics, Chulalongkorn University Hospital, and Queen Saovabha Memorial Institute, Thai Red Cross Society, Bangkok. chadapanch@usa.net
Insights
Rabies exposures in Thai children, primarily from dog bites, are a significant public health issue. Cost-effective treatments like reduced-dose intradermal vaccines and equine rabies immunoglobulin are recommended.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Prevention
Background:
- Rabies remains a critical concern, particularly for pediatric populations in endemic regions.
- Understanding the patterns of potential rabies exposure is vital for effective public health interventions.
Purpose of the Study:
- To investigate the epidemiology of potential rabies exposures among children in Thailand.
- To identify risk factors and common scenarios associated with rabies exposure in pediatric cases.
Main Methods:
- Retrospective review of medical records for children (0-14 years) with potential rabies exposures.
- Data collection included demographics, exposure source, location, and treatment administered.
Main Results:
- 2622 children studied; 86.3% of exposures were dog-related, often unprovoked attacks near homes.
- Lower extremities were the most common site of exposure.
- All received rabies vaccine; 57.5% received rabies immunoglobulin (RIG), including human (HRIG) and equine (ERIG) forms.
Conclusions:
- Pediatric rabies exposures represent a substantial public health challenge in Thailand.
- Reduced-dose, intradermal vaccination and the use of equine rabies immunoglobulin (ERIG) offer cost-effective treatment strategies.
Objective:
To determine the epidemiology of potential rabies exposures in Thai children.
Methods:
The study was carried out at the Queen Saovabha Memorial Institute of the Thai Red Cross Society during I calendar year. All charts of victims aged 0 to 14 years with possible rabies exposures were retrospectively reviewed.
Results:
Subjects were 2622 children, with a male to female ratio of 1.6:1 and a mean age of 6.7 years (range, 2 months to 14 years). Most exposures (86.3%) were related to dogs. The most common site of exposure was the lower extremity. The majority of exposures occurred in or around the home and as the consequence of unprovoked attacks rather than provoked attacks. Antirabies vaccines were given in all cases: 68.4% using the Thai Red Cross intradermal route, and 31.6% using the intramuscular route. Rabies immunoglobulin (RIG) was prescribed in 57.5% of children; 35.2% received human RIG (HRIG), and 22.3% received purified equine RIG (ERIG).
Conclusions:
This study confirms that rabies exposures, especially in children, are an important public health problem in Thailand. The reduced-dose, multiple-site intradermal rabies vaccine method and ERIG in place of HRIG reduce the cost of treatment.