rabies situation in cambodia狂犬病柬埔寨局势.pdfVIP

Rabies Situation in Cambodia 1 2 1 2 3 ´ 4 Sowath Ly , Philippe Buchy , Nay Yim Heng , Sivuth Ong , Nareth Chhor , Herve Bourhy , Sirenda Vong1* 1 Epidemiology and Public Health Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia, 2 Virology Unit, Institut Pasteur in Cambodia, Phnom Penh, Cambodia, 3 Calmette Hospital, Phnom Penh, Cambodia, 4 Lyssavirus Unit, UPRE Lyssavirus Dynamics and Host Adaptation, WHO Collaborating Center for Reference and Research on Rabies, Institut Pasteur, Paris, France Abstract Background: Rabies, a fatal but preventable zoonosis, is a major public health problem in developing countries. In Cambodia the disease burden is largely underestimated because patients with encephalitis following dog bites are rarely hospitalized and die at home. Since 1998 Institut Pasteur in Cambodia (IPC), Phnom Penh has been the only source of free post-exposure prophylaxis (PEP) and post-mortem diagnosis. Methods: The 1998–2007 data compiled by IPC was analyzed to describe all treated patients for PEP, results of human testing and confirmed rabies cases, and results of animal testing. From dog bites’ characteristics, we defined a suspected rabid dog bite injury (SRDBI) in humans as a bite that was unprovoked, from a dog that died spontaneously, or from a dog that was reported sick. We applied a deterministic probability model to estimate 2007 rabies human mortality nationwide from the estimated incidence of rabid dog bites, the body distribution of bite wounds, and the probability of PEP access. Results: During 1998–2007, 124,749 patients received PEP at IPC (average 12,470; range 8,907–14,475), and 63 fatal human cases presenting with encephalitis following a dog bite were reported,