DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20192167

Epidemiological and clinical profile of dog bitten children and side effects of anti rabies vaccine

P. Ramkumar, S. Balamurugan

Abstract


Background: Rabies is one of the commonest zoonotic diseases due to Lyssa virus. Rabies is a 100% fatal disease. Understanding the epidemiological and clinical profile of the victims helps in the prevention of dog bite. But rabies is 100% preventable by pre and post exposure prophylaxis vaccination. Evaluation of side effects of anti-rabies vaccine (ARV) is helpful in the pre and post exposure prophylaxis.

Methods: Authors did a descriptive study of 1450 dog-bitten children. Using the pro-forma, authors interviewed the parents, examined the children. Using W.H.O classification, authors classified the dog bite wounds. Anti-rabies vaccination was administered to category 2 dog bite wounded children. Side effects of vaccination are recorded.

Results: Out of 1450 children, significantly more number of boys (67%) in the age group of 10-12 years (31%), from class IV socioeconomic category (52%), nuclear families (80%), sustained category III dog bite (52%) in the lower limb (48%) by unvaccinated (82%) stray dogs (60%) while playing or walking (52%) in the street (60%) during night (72%). Purified Vero cell culture rabies vaccine is having rare mild local side effects (2%), rare mild systemic side effects (4.16%) and very rare systemic allergic reaction (0.14%) but no major side effects.

Conclusions: Dog bites can be prevented by not allowing the children to play or walk alone in the street especially during night. The severity of wound can be minimized by wearing fully covered extremities. Vaccination of dogs and population control of stray dogs will reduce rabies. There were no major side-effects or adverse events following vaccination (AEFI) with anti-rabies vaccination. Rare mild local side effects and very rare mild systemic side effects may happen.


Keywords


Adverse events following immunization, Dog bitten children, Post exposure prophylaxis, WHO classification of dog bite wounds

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References


Nelson Text book of paediatrics. 20th ed. Elsever. 1269.

Taylor E, Banyard AC, Bourhy H, Cliquet F, Ertl H, Fehlner-Gardiner C, et al. Avoiding preventable deaths: The scourge of counterfeit rabies vaccines. Vaccine; 2019:25.

Walker PJ, Blasdell KR, Calisher CH, Dietzgen RG, Kondo H, Kurath G, et al. ICTV virus taxonomy profile: Rhabdoviridae. J General Virol. 2018;99(4):447-8.

Chen HA, Neumeier AT, Davies BW, Vikram D. Durairaj VD. Analysis of pediatr facial Dog Bites. Craniomaxillofac Trauma Reconstr. 2013;6:225-32.

WHO expert consultation on rabies 3rd report, Geneva, 2018.WHO technical report series.no.1012, page-6. Accessed at: https://apps.who.int/iris/bitstream/handle/10665/272364/9789241210218-eng.pdf.

Shayam C, Duggal AK, Kamble U, Agarwal AK. Post exposure prophylaxis for rabies. JIACM. 2006;7(1):39-46.

Forfar & Arneil text book of Pediatrics. 17th ed. Churchill Livingstone.1293.

Menezes R. Rabies in India. CMAJ. 2008;178(5):564.

Singh J, Jain DC, Bhatia R, Ichhpujani RL, Harit AK, Panda RC, et al. Epidemiological characteristics of rabies in Delhi and surrounding areas, 1998. Indian Pediatr. 2001;38(12):1354-60.

Parthasarathy A, Joseph L, Narmadha R, Vaidhyanathan C, Santhanakrishnan BR, Thirugnanasambandam C. Study of dog bitten children. Indian Paediat. 1984;21:549-4.

Gershman KA, Sacks JJ, Wright JC. Which dogs bite? A case-control study of risk factors. Pediatr Eng Ed. 1994;93(6):913-7.

Weiss HB, Friedman DI, Coben JH. Incidence of dog bite injuries treated in emergency departments. JAMA. 1998;279(1):51-3.

Peng J, Lu S, Zhu Z, Zhang M, Hu Q, Fang Y. Safety comparison of four types of rabies vaccines in patients with WHO category II animal exposure: an observation based on different age groups. Med. 2016;95(47).