Exposure characteristics of patients presenting to an anti-rabies treatment unit

Abstract

OBJECTIVE: With increased availability, accessibility and safety of rabies post exposure treatment (PET), costs borne by the Government in the purchase of anti-rabies vaccines have increased dramatically. This study was conducted to identify exposure characteristics of patients presenting to an anti-rabies treatment unit (ARU) and to propose measures that could minimise PET use. METHOD: A hospital based descriptive study was carried out in the ARU of the National Hospital of Sri Lanka (NHSL), An interviewer administered questionnaire assessed socio-demographic characteristics and the nature of exposure of patients. Treatment received was obtained from patient records. RESULTS: All consenting, first visit patients (n-266) presented during a period of one week to the ARU with an exposure history to a suspected rabid animal were studied. Mean age of those exposed was 36.6 years (SD 16.6). Exposure to dogs (208, 78.2%) was the commonest followed by exposure to cats (33, 12.4%). Majority were exposed to domesticated animals (172, 64.7%) which were unvaccinated or did not have reliable proof of vaccination (167, 62.8%). Of the 266, 13 (4.9%) did not need PET, 51 (19.2%) needed both anti-rabies inactivated tissue culture vaccine (ARV) and anti rabies serum and202(75.9%) needed ARV only. CONCLUSION: Majority of the exposures that needed PET was to domesticated dogs which were unvaccinated or had no reliable proof of vaccination. Importance of regular vaccination of pets and safe-keeping of animal vaccination records should be stressed to the general public and awareness of responsible pet ownership should be raised among the public.