Ann Agric Environ Med 2006, 13, 337–340
POST-EXPOSURE ANTI-RABIES PROPHYLAXIS IN LUBLIN PROVINCE (EASTERN POLAND) IN 2004-2005
Krzysztof Tomasiewicz, Hanna Fota-Markowska, Joanna Krzowska-Firych, Grażyna Krawczuk
Department of Infectious Diseases, Medical University of Lublin, Lublin, Poland
Tomasiewicz K, Fota-Markowska H, Krzowska-Firych J, Krawczuk G: Post-exposure anti-rabies prophylaxis in Lublin province (Eastern Poland) in 2004-2005. Ann Agric Environ Med 2006, 13, 337–340.
Abstract: Rabies is considered a disease of the highest mortality rate and all humans are vulnerable to infection. Specific anti-rabies immunoprophylaxis is the only efficient method of protection. The analysis of indications for active alone and active and passive immunization among patients reported to the dispensary of rabies prophylaxis in the Department of Infectious Diseases of Medical University of Lublin (eastern Poland) in 2004-2005 is presented. Prophylactic procedures were applied in 120 persons (14.98% of overall number consulted). Passive immunization, i.e. rabies immune globulin, was administered in 1 person (0.12%). In 2004, 64 persons (7.99%) received active vaccination, and 56 patients (6.99%) were vaccinated in 2005. Most of vaccinated patients lived in an urban area where the risk of rabies should be lower; however, in cities like Lublin there is a higher risk of being bitten by homeless animals. The most common species with rabies suspicion were dogs and cats. The decrease in the number of patients bitten by animals with confirmed rabies in Lublin province, and of the number of cases of animal rabies may indicate that oral vaccination of red foxes, representing a main reservoir of rabies virus in Poland, has been shown to be effective.
Address for correspondence: Dr Krzysztof Tomasiewicz, Department of Infectious Diseases, Medical University of Lublin, Biernackiego 9, 20-089 Lublin, Poland. E-mail: firstname.lastname@example.org
Key words: rabies, post-exposure antirabies prophylaxis, epizootic situation in Poland, incidence of animal rabies, human exposure.
Animal and human rabies is a consequence of an acute infection of the nervous system caused by the rabies virus (Lyssavirus), belonging to the Rhabdoviridae family. In Poland 2 genotypes of Lyssavirus were identified: genotype 1, typical for different mammals except bats, and genotype 5 isolated from insectivorous bats .
Every animal shedding the virus with saliva can be the source of infection. Man may become infected by rabid animal bites or when his/her damaged skin or mucous membranes are contaminated with animal saliva or brain tissue .
Human rabies has been reported from all continents except Australia and the Antarctica. Actually, most of wild and domestic mammals can be the reservoir of the virus. In Poland, the infection has been recognized mainly in red foxes, martens, roe-deer, and domestic cats, dogs and cattle. Extensive vaccinations of domestic dogs have caused a considerable decline in the prevalence of dog rabies [2, 12]. According to World Health Organization (WHO) data, up to 90% of human rabies cases are in consequence of the transmission of rabies virus from domestic animals, particularly from dogs [4, 15]. Nevertheless, in Poland a negative correlation between animal rabies cases and the number of persons requiring
Received: 18 September 2006 Accepted: 23 November 2006