Eco-Epidemiological Characteristics of Human Rabies in Côte d’Ivoire, 2012-2017

Introduction: Human rabies is a major public health problem in many African countries, including Côte d’Ivoire. The present work aims at describing the eco-epidemiological characteristics of human rabies cases recorded in Côte d’Ivoire. Methods: This was a retrospective and prospective cross-sectional descriptive study based on epidemiological surveillance data that ran from september 2014 to december 2017. The clinical data were extracted from the database of the human rabies epidemiological surveillance management service of the National Institute of Public Hygiene’s rabies centre. These data cover the period from 1 January 2012 to 31 December 2017. Results: Human rabies is endemic in Côte d’Ivoire, with most people exposed in the south and especially in the west of the country. There was no association between any of the climatological parameters (temperature, humidity, rainfall) and the occurrence of human rabies during the months of exposure to rabies infection. Conclusion: Ultimately, effective prevention and control of human rabies requires a thorough understanding of the links between climatological parameters and rabies. Health authorities must take ownership of these results if we are to achieve our goal of eliminating rabies by 2030.

Analysis of Epidemiological Investigations and Responses to Human Rabies Deaths in Côte d’Ivoire, 2021

Rabies is an infectious disease that almost always leads to death as soon as the first signs appear, and is still endemic in several regions, including Côte d’Ivoire. Epidemiological investigations are carried out and response measures implemented in the event of any death from human rabies. However, the quality of these investigations does not always allow the adoption of response measures. The aim of this work was to evaluate the reports of epidemiological investigations and response actions carried out during the occurrence of human rabies deaths from 2016 to 2018. This was a cross-sectional study that took place from April to September 2021 at the National Institute of Public Hygiene and focused on human rabies deaths notified from 206 to 2018. Of sixty-one (61) human rabies deaths recorded, sixty (60) were investigated, among which fifty-nine (59) deaths had been subject to response. Most deaths occurred in rural areas (75%), and the main vector was the dog (98%). Several shortcomings were noted: response actions were not carried out promptly;joint interventions bringing together human and animal health professionals were rare, there was little communication about rabies to communities (36%), and very little vaccination of the vector, the source of the disease (12%);an almost total absence of capacity-building for local players (7%);the health districts of Abobo-Ouest, Bondoukou, Divo and Fresco, which had regularly recorded human rabies deaths, had not benefited from dog vaccination, which is supposed to break the circulation of the virus. The persistence of rabies deaths in the health districts could probably be linked to these shortcomings. Faced with these realities, it is essential to strengthen the epidemiological investigation capacities of the players involved, in order to improve the quality of investigations and ensure an effective response.

Analysis of Epidemiological Investigations and Responses to Human Rabies Deaths in Côte d’Ivoire, 2021

Rabies is an infectious disease that almost always leads to death as soon as the first signs appear, and is still endemic in several regions, including Côte d’Ivoire. Epidemiological investigations are carried out and response measures implemented in the event of any death from human rabies. However, the quality of these investigations does not always allow the adoption of response measures. The aim of this work was to evaluate the reports of epidemiological investigations and response actions carried out during the occurrence of human rabies deaths from 2016 to 2018. This was a cross-sectional study that took place from April to September 2021 at the National Institute of Public Hygiene and focused on human rabies deaths notified from 206 to 2018. Of sixty-one (61) human rabies deaths recorded, sixty (60) were investigated, among which fifty-nine (59) deaths had been subject to response. Most deaths occurred in rural areas (75%), and the main vector was the dog (98%). Several shortcomings were noted: response actions were not carried out promptly;joint interventions bringing together human and animal health professionals were rare, there was little communication about rabies to communities (36%), and very little vaccination of the vector, the source of the disease (12%);an almost total absence of capacity-building for local players (7%);the health districts of Abobo-Ouest, Bondoukou, Divo and Fresco, which had regularly recorded human rabies deaths, had not benefited from dog vaccination, which is supposed to break the circulation of the virus. The persistence of rabies deaths in the health districts could probably be linked to these shortcomings. Faced with these realities, it is essential to strengthen the epidemiological investigation capacities of the players involved, in order to improve the quality of investigations and ensure an effective response.

Rabies Virus Neutralizing Activity,Safety,and Immunogenicity of Recombinant Human Rabies Antibody Compared with Human Rabies Immunoglobulin in Healthy Adults

Objective Preliminary assessment of rabies virus neutralizing activity,safety and immunogenicity of a recombinant human rabies antibody(NM57)compared with human rabies immunoglobulin(HRIG)in Chinese healthy adults.Methods Subjects were randomly(1:1:1)allocated to Groups A(20 IU/kg NM57),B(40 IU/kg NM57),or C(20 IU/kg HRIG).One injection was given on the day of enrollment.Blood samples were collected on days-7 to 0(pre-injection),3,7,14,28,and 42.Adverse events(AEs)and serious AEs(SAEs)were recorded over a period of 42 days after injection.Results All 60 subjects developed detectable rabies virus neutralizing antibodies(RVNAs)(>0.05 IU/mL)on days 3,7,14,28,and 42.The RVNA levels peaked on day 3 in all three groups,with a geometric mean concentration(GMC)of 0.2139 IU/mL in Group A,0.3660 IU/mL in Group B,and0.1994 IU/mL in Group C.At each follow-up point,the GMC in Group B was significantly higher than that in Groups A and C.The areas under the antibody concentration curve over 0-14 days and 0-42 days in Group B were significantly larger than those in Groups A and C.Fifteen AEs were reported.Except for one grade 2 myalgia in Group C,the other 14 were all grade 1.No SAEs were observed.Conclusion The rabies virus neutralizing activity of 40 IU/kg NM57 was superior to that of 20 IU/kg NM57 and 20 IU/kg HRIG,and the rabies virus neutralizing activity of 20 IU/kg NM57 and 20 IU/kg HRIG were similar.Safety was comparable between NM57 and HRIG.

Laboratory Confirmation of Human Rabies by RT-PCR and qRT-PCR Bamako: Report of a Case in a 4-Year-Old Girl at the Mali Hospital

Rabies is a zoonotic disease of viral origin transmitted mainly to humans by biting or licking the injured skin of sick animals. It is an untreatable disease that is fatal once it has been declared. Worldwide, 59,000 cases of rabies-related deaths are recorded each year. The diagnosis of rabies is clinical, biological, and anatomopathological. The aim was to establish the laboratory confirmation capacity for human rabies in Mali. The patient, a Malian female, aged four years, was bitten by a dog around her house in district sixth of Bamako near national road number six in 2020. The patient visited the doctor after a two-month bite. However, she was neither referred to the health center for an effective therapeutic measure nor vaccination (post-exposure prophylaxis). The patient was presented with psychomotor excitation, hypersalivation, aerophobia, and hydrophobia symptoms and visited a Malian hospital named “Hospital of Mali”. The patient was admitted with a history of animal bites and symptoms of rabies, and the patient was classified as a probable rabies case. The patient was then referred to an infectious disease physician and hospitalized. After referring the patient to the infectious disease physician, the physician sent oral swab and cerebrospinal fluid (CSF) samples to confirm to the Laboratory of Applied Molecular Biology. Human rabies was confirmed (RT-PCR) by the zoonotic unit of the Laboratory of Applied Molecular Biology. Diagnosis and therapy of human rabies without post-exposure management after a dog bites were still challenging. It was possible to confirm the human rabies case in Mali by RT-PCR and qRT-PCR.

Spontaneous Rabies in a Stray Bitch after Parturition Induced Immunosuppression —Investigating an Impending Outbreak of Rabies with One Health Approach

Background: Rabies is endemic in India and every half an hour a person dies of this dreaded disease. Stray roaming dogs, mostly unvaccinated, are most dangerous host in spread of rabies in India and in our state of Himachal Pradesh. Timely prophylaxis is the only method to save animal bite victims, including that of rabid dog bite patients. Objectives: Objective of this study was to investigate an impending outbreak of rabies in Shimla town in the absence of life saving rabies immunoglobulins (RIGs) in the market, and to know the source of infection by using one health approach and using epidemiological tools. Methods: On April 7, 2015, there was a sudden surge in cases of suspected rabid dog bites. Impending rabies outbreak was suspected as there were no RIGs available in the market. A rapid Response Team (RRT) consisting of the author, veterinary doctor, dog squad of Municipal Corporation (MC) Shimla along with the vehicles to impound rabid dogs was constituted to investigate the terror spread by two rabid dogs on biting spree in the Shimla Municipality. Results: A total of 18 people were bitten by suspected rabid dogs within three days period. A black bitch and a brown dog, on the identity of affected people, were captured by the dog squad of Municipality next day on April 8, 2015 and taken to Dog Sterilization Centre, Animal Birth Control (ABC) programme, MC Shimla for observation. The most furious Black bitch died of clinically confirmed symptoms of furious rabies after three days. The second rabid dog, brown in color, died after a month of observation due to paralytic dumb rabies. The brain of the brown dog was extracted for Fluorescent Antibody Testing (FAT) at central research Institute (CRI) Kasauli and was found to be positive for FAT. Follow up of patients was 100% by house to house visit and over telephone and no casualty was reported. Conclusion: While we were working on hypothesis of rabid dogs getting the infection from nearby forest about 8 - 10 KM away but on follow up of the patients, they reported that both the dog and bitch used to stay in the compound of their colony since the bitch was pregnant and there was no history of the bitch moving for away to forests neither any outside dog which was seen near them in the compound. This led us to think of other causes of what must had happened to the bitch that caused her to be rabid as for the past 9 years we had observed bitches becoming rabid after litter birth (Whelping) and making their pups rabid due to licking. Since the carrier state for rabies virus in bitches/dogs is known and a state of immunosuppression after whelping/parturition is also known, therefore there is a possibility of latent rabies virus getting activated due to immunosuppression after litter birth and it is thought to be as one of the probable causes of black bitch getting rabid and inflicting the infection to accompanying brown dog. We need to do further studies to ascertain this phenomenon before coming to a definite conclusion and suspect such a possibility in case a dam suddenly becomes rabid among a pack of stray dogs in rabies endemic countries like ours.