Public health experts urge people to seek prompt medical attention if they suspect exposure to the rabies virus

According to a new study presented at this year's European Congress, there is little time left to ask for medical help before rabies becomes almost always fatal, but people wait an average of 10 days before asking for medical advice after being exposed to potentially feral animals abroad. Clinical Microbiology and Infectious Diseases (ECCMID) in Amsterdam, Netherlands (13-16 April). In the UK, the average time to treatment after bat exposure was almost three days.

"The results underscore the importance of raising public awareness of the risks of rabies, both for travelers visiting rabies-infected countries and for bat shows in the UK," said the co-author , Dr. Kevin Brown, Public Service Manager Rabies and Immunoglobulin. England Health.

Symptoms usually take 2 to 3 months to manifest, but can develop in less than a week (after a bite to the head) or up to several years after exposure. "Preventive treatments are 100% effective if they are administered soon after exposure," says Dr. Brown. "That's why it's so important to look for care quickly, even if the wound or the incident seems very trivial.If you get bitten, scratched or licked by an animal, you have to wash the wound or the site of the wound. Soapy water in abundance and get treatment – advice is urgently needed Travelers should not wait for treatment until they return to the UK. "

Rabies is a zoonotic infection (a disease that is transmitted from animals to humans) that can cause a rare but potentially fatal infection of the brain and nervous system in humans. It usually results from a bite, scratch or lick of an infected animal. It is estimated that the virus kills an estimated 59,000 people each year worldwide, most often as a result of a dog bite enraged in parts of Africa and Asia.

Rabies does not circulate in wild or domestic animals in the UK, although some bat species may carry rabies-like viruses (Lyssaviruses of European Type 1 and Type 2 bats). Every year, about 150 people in England are treated after being bitten by a bat.

People who think they have been exposed to rabies are urged to immediately seek treatment that includes a series of rabies vaccines, with or without immunoglobulin, with antibody treatment providing immediate short-term protection while the vaccines begin to work.

In England, Public Health England, which provides advice, counseling and treatment for rabies, is provided by the Rabies and Immunoglobulin Department in ten rescue centers across the country.

In this study, medical staff from one of Manchester's transmitter centers, in northwestern England, reviewed all requests for post-exposure rabies treatment in his lab between June 2015 and June 2018.

A total of 200 patients (aged 0 to 77 years) received post-exposure therapy through the virology laboratory. More than a third (69/200 patients) were aged 20 to 29 years. The vast majority of patients (92%; 183/200) had never been vaccinated against rabies.

The results showed that more than three quarters (79% (157/200) of post-exposure treatments) were administered to travelers returning to the United Kingdom from 43 different countries.

However, 1 in 5 (22%, 42/200) reported being exposed to a bat in the UK. "Although the risk of contracting rabies in the UK is extremely low, it is important that all potential bat bites are evaluated and treated as necessary." In the UK, bat bites are often left unchecked. no trace and are felt rather than felt, "says Dr. Brown.

In the UK, although prompt treatment is recommended, given the prolonged incubation period, it is never considered too late to receive post-exposure treatment.

In a separate study, Public Health England physicians found that the number of post-exposure rabies risk badessments conducted in England since 2001 was multiplied by 7.5. South and Southeast Asia, while about 1 in 10 were bat bites in England.

Of the previously unvaccinated individuals exposed to animals abroad, 40% did not seek post-exposure treatment for rabies abroad, but waited until returning home. UK. Like results in Manchester, more than 60% of bat bites required treatment within 2 days.

At the national level, in addition to advice and recommendations, Public Health England provides rabies vaccine and anti-rabies immunoglobulin for all potential rabies exposures in England. By mid-2018, guidelines for post-exposure treatment of rabies have been updated. The routine immunization schedule for non-immunized individuals was reduced from 5 doses to 4 doses. In addition, a composite risk of rabies (red, orange or green) was calculated for each exposure, taking into account the country and animal risk. and the category of exhibition. Rabies immune globulin has been recommended only in cases with a "red" composite risk, ie a category 3 exposure (bite or laceration) in a high-risk country badociation. / animal. Rabies immunoglobulin is no longer administered for bat bites in the UK, although it is still recommended for bat bites out of the UK.

Further badysis showed that, within six months of the introduction of the new guidelines, the number of appeals regarding possible cases of rabies had increased significantly compared to the same period in 2017 (1727 vs 1157). Nevertheless, the number of vaccines (2.4 versus 3) and immunoglobulin flasks (256 vs. 575) administered as treatment decreased.

"Those who conducted the risk badessment found the process easier to follow and the risk of inappropriate treatment was lower," said Dr. Brown. "The new guidelines have significantly reduced program operating costs, while ensuring appropriate treatment for those potentially at risk of rabies."

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Provided by
European Society of Clinical Microbiology and Infectious Diseases