- Estimating the burden of rabies in Ethiopia by tracing dog bite victims. [Journal Article]
- PlosPLoS One 2018; 13(2):e0192313
- In developing countries where financial resources are limited and numerous interests compete, there is a need for quantitative data on the public health burden and costs of diseases to support interv...
In developing countries where financial resources are limited and numerous interests compete, there is a need for quantitative data on the public health burden and costs of diseases to support intervention prioritization. This study aimed at estimating the health burden and post-exposure treatment (PET) costs of canine rabies in Ethiopia by an investigation of exposed human cases. Data on registered animal bite victims during the period of one year were collected from health centers in three districts, i.e. Bishoftu, Lemuna-bilbilo and Yabelo, to account for variation in urban highland and lowland areas. This data collection was followed by an extensive case search for unregistered victims in the same districts as the registered cases. Victims were visited and questioned on their use of PET, incurred treatment costs and the behavioral manifestations of the animal that had bitten them. Based on the collected data PET costs were evaluated by financial accounting and the health burden was estimated in Disability-Adjusted Life Years (DALYs). In total 655 animal bite cases were traced of which 96.5% was caused by dog bites. 73.6% of the biting dogs were suspected to be potentially rabid dog. Annual suspected rabid dog exposures were estimated per evaluated urban, rural highland and rural lowland district at, respectively, 135, 101 and 86 bites, which led, respectively, to about 1, 4 and 3 deaths per 100,000 population. In the same district order average costs per completed PET equaled to 23, 31 and 40 USD, which was significantly higher in rural districts. Extrapolation of the district results to the national level indicated an annual estimate of approximately 3,000 human deaths resulting in about 194,000 DALYs per year and 97,000 exposed persons requiring on average 2 million USD treatment costs per year countrywide. These estimations of the burden of rabies to the Ethiopian society provide decision makers insights into the potential benefits of implementing effective interventions.
- Occupational Animal Allergy. [Review]
- CACurr Allergy Asthma Rep 2018 Feb 16; 18(2):11
- This review explores animal allergen exposure in research laboratories and other work settings, focusing on causes and prevention.
This review explores animal allergen exposure in research laboratories and other work settings, focusing on causes and prevention.
- Pediatric dog bites: a population-based profile. [Journal Article]
- IPInj Prev 2018 Feb 08
- CONCLUSIONS: Younger children are more likely to receive dog bites, and bites incurred are likely of greater severity. Children this young cannot yet be taught how to properly interact with a dog.Dog bites are a significant source of morbidity for children. Based on the population risk factors profile generated, this study recommends targeting live dog education towards the parents of young children.
- Rabies risk and use of post-exposure prophylaxis associated with dog bites in Tennessee. [Journal Article]
- ZPZoonoses Public Health 2018 Feb 12
- The canine variant of the rabies virus has been eliminated in the United States. Among the public and many healthcare providers, however, dog bites are still associated with risk for rabies transmiss...
The canine variant of the rabies virus has been eliminated in the United States. Among the public and many healthcare providers, however, dog bites are still associated with risk for rabies transmission. This study examined the risk of rabies in biting dogs and the use of rabies post-exposure prophylaxis (rPEP) for dog bite victims in Tennessee. The study included a retrospective analysis of laboratory testing requisitions for dogs from 2002 to 2016, collection of clinical data on confirmed rabies-positive dogs from 2008 to 2016 and analysis of hospital discharge data for rPEP from 2007 to 2014. Among dogs submitted for rabies testing, those having a recent history of biting were significantly less likely to test positive for rabies than dogs with no reported bite (OR = 0.01; 95% CI [0.003-0.04]). The most common clinical signs reported among rabies-positive dogs were anorexia, dysphagia, ataxia, limb paresis or paralysis, and lethargy; aggressiveness was uncommon. Among hospital patients with an animal-related injury who received rPEP, more than half (52%) presented with dog bites. These data show that laboratory submissions for rabies testing and prescriptions for rPEP do not reflect the epidemiology of rabies in Tennessee. Education and outreach targeting the public and healthcare providers should emphasize the animal species and situations associated with a greater risk for rabies transmission, such as bites from rabies reservoir species or animals exhibiting signs of neurologic disease.
- Characterization of rabies post-exposure prophylaxis in a region of the eastern Amazon, state of Pará, Brazil, between 2000 and 2014. [Journal Article]
- ZPZoonoses Public Health 2018 Feb 08
- Animal bites are a serious public health issue, and prevention strategies have been consistently documented worldwide. The aim of this study was to characterize human anti-rabies treatment in 11 coun...
Animal bites are a serious public health issue, and prevention strategies have been consistently documented worldwide. The aim of this study was to characterize human anti-rabies treatment in 11 counties of the Salgado microregion, Pará state, Brazil, which borders the Bragantina microregion, where exposures of human rabies were reported in 2004 and 2005. A descriptive retrospective study was conducted using anti-rabies treatment notifications registered in the Information System for Notifiable Diseases (SINAN) database of the State Department of Public Health of Pará (SESPA) from January 2000 to December 2014. In this period, 13,403 exposures were reported, with a growing annual trend (Y = 68.571x + 344.96). The years 2012 and 2013 presented the highest exposure incidence. Salinópolis was the county with the highest average annual incidence per 10,000 persons (62.83), followed by São João de Pirabas (43.28) and São Caetano de Odivelas (41.27). Most patients were males (59.6%) and were 1-19 years old (48.7%). The main species involved in aggressions were dogs (74.1%), followed by bats (13.1%) and cats (7.4%). Biting was the most common kind of exposure, mostly on the lower limbs (39.6%). This study shows that aggression by bats was the second most common cause of demand for the service in the region for the past 14 years. The low quality of records may increase the difficulty of rabies surveillance in Pará.
- Rates and risk factors for human cutaneous anthrax in the country of Georgia: National surveillance data, 2008-2015. [Journal Article]
- PlosPLoS One 2018; 13(2):e0192031
- CONCLUSIONS: This study provides eight-year trends for cutaneous anthrax in humans in the country of Georgia. A comprehensive explanation for the observed rise and fall of the incidence rates of human cutaneous anthrax in 2008-2015 remains to be clarified but is likely associated with discontinuation of mandatory national livestock vaccination in 2008 coupled with weakened human and animal national health systems which were disrupted after the Soviet Union collapsed. Our analysis identifies living near pastoralist routes, handling animal products and travel to endemic areas within two weeks before the disease onset as risk factors for cutaneous anthrax. The evidence underscores the importance of One Health recommendations to activate anthrax awareness campaigns, supervise the destruction of known anthrax carcasses, record global position system coordinates of sites and disinfect infected soils and introduce a participatory health education tool on anthrax.
- An Update on Fatalities Due to Venomous and Nonvenomous Animals in the United States (2008-2015). [Journal Article]
- WEWilderness Environ Med 2018 Jan 17
- CONCLUSIONS: Appropriate education and prevention measures aimed at decreasing injury from animals should be directed at the high-risk groups of agricultural workers and young children with dogs. Public policy and treatment pricing should align to ensure adequate available medication for those at risk of anaphylaxis from stings from Hymenoptera.
- A Case of Recurrent Pasteurella Bacteremia in an Immunocompetent Patient with No Animal Bite. [Journal Article]
- AJAm J Case Rep 2018 Jan 25; 19:95-98
- CONCLUSIONS: Pasteurella multocida bacteremia has been seen in immunocompromised patients and mostly after a cat or dog bite or scratch but might also happen in immunocompetent humans with only pet licking rather than biting, which might increase hospital and emergency department visits or admissions in the future.
- Microangiopathic Hemolytic Anemia Following Three Different Species of Hump-Nosed Pit Viper (Genus: Hypnale) Envenoming in Sri Lanka. [Journal Article]
- WEWilderness Environ Med 2018 Jan 17
- There are 3 species of hump-nosed pit vipers in Sri Lanka: Hypnale hypnale, Hypnale zara, and Hypnale nepa. The latter 2 are endemic to the country. Microangiopathic hemolytic anemia (MAHA) is a know...
There are 3 species of hump-nosed pit vipers in Sri Lanka: Hypnale hypnale, Hypnale zara, and Hypnale nepa. The latter 2 are endemic to the country. Microangiopathic hemolytic anemia (MAHA) is a known complication of hump-nosed pit viper bites. It was previously documented as a complication of general viper bites and not species specific. We report a series of 3 patients who developed MAHA after being bitten by each species of hump-nosed pit viper. The first patient was bitten by H hypnale and developed a severe form of MAHA associated with acute kidney injury and thrombocytopenia falling into the category of thrombotic microangiopathy. The other 2 developed MAHA that resolved without any complications.
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- Ticks, Ixodes scapularis, Feed Repeatedly on White-Footed Mice despite Strong Inflammatory Response: An Expanding Paradigm for Understanding Tick-Host Interactions. [Journal Article]
- FIFront Immunol 2017; 8:1784
- Ticks transmit infectious agents including bacteria, viruses and protozoa. However, their transmission may be compromised by host resistance to repeated tick feeding. Increasing host resistance to re...
Ticks transmit infectious agents including bacteria, viruses and protozoa. However, their transmission may be compromised by host resistance to repeated tick feeding. Increasing host resistance to repeated tick bites is well known in laboratory animals, including intense inflammation at the bite sites. However, it is not known whether this also occurs in wild rodents such as white-footed mice, Peromyscus leucopus, and other wildlife, or if it occurs at all. According to the "host immune incompetence" hypothesis, if these mice do not have a strong inflammatory response, they would not reject repeated tick bites by Ixodes scapularis. To test this hypothesis, histopathological studies were done comparing dermal inflammation in P. leucopus versus guinea pigs, Cavia porcellus, repeatedly infested with I. scapularis. In P. leucopus, the immune cell composition was like that seen in laboratory mouse models, with some differences. However, there was a broad sessile lesion with intact dermal architecture, likely enabling the ticks to continue feeding unimpeded. In contrast, in C. porcellus, there was a relatively similar mixed cellular profile, but there also was a large, leukocyte-filled cavitary lesion and scab-like hyperkeratotic changes to the epidermal layer, along with itching and apparent pain. Ticks attached to sensitized C. porcellus fed poorly or were dislodged, presumably due to the weakened anchoring of the tick's mouthparts cemented in the heavily inflamed and disintegrating dermal tissues. This is the first time that the architecture of the skin lesions has been recognized as a major factor in understanding tick-host tolerance versus tick bite rejection. These findings broadly strengthen previous work done on lab animal models but also help explain why I. scapularis can repeatedly parasitize white-footed mice, supporting the "immune evasion theory" but cannot repeatedly parasitize other, non-permissive hosts such as guinea pigs.