Virología molecular de la rabia: un enfoque clínico / Rabies molecular virology: a clinical approach

Introducción: La rabia es una enfermedad zoonótica asociada al virus RABV, el cual tiene características neurotrópicas. El virus se transmite por el contacto con saliva de animales infectados; la mordedura de un perro es la causa más común. Es un virus que causa la muerte de miles de personas cada año. Objetivo: Describir a profundidad los principios moleculares de la infección por rabia, así como su patogenia, diagnóstico y tratamiento. Métodos: Se realizó una búsqueda de bibliografía en PubMed, SciELO, Scopus, Researchgate; se consultaron 163 referencias y se seleccionaron 51 fuentes que contenían la información más relevante para cumplir con el objetivo del trabajo. Conclusión: Actualmente es posible entender de mejor manera los mecanismos de transmisión y propagación del virus en el organismo; existe nuevo conocimiento sobre los receptores involucrados, así como la función de estos en la replicación viral. Sin embargo, el objetivo de la erradicación de la rabia a corto plazo es complejo. La invasión de territorios selváticos vuelve a la rabia un posible patógeno reemergente; la vacunación de especies transmisoras es el medio ideal para conseguir el control de la enfermedad.

Introduction: Rabies is a zoonotic disease associated with the RABV virus, which has neurotropic characteristics. The virus is transmitted by contact with saliva from infected animals; a dog's bite is the most common cause. This virus causes the death of thousands of people every year. Objective: To describe in depth the molecular principles of rabies infection, as well as its pathogenesis, diagnosis and treatment. Methods: A literature search was conducted in PubMed, SciELO, Scopus, and Researchgate. A total of 163 references were consulted, and 51 sources containing the most relevant information were selected to fulfill the objective of the work. Conclusions: It is currently possible to better understand the mechanisms of transmission and spread of the virus in the organism; there is new knowledge about the receptors involved, as well as their function in viral replication. However, the goal of eradicating rabies in the short term is complex. The invasion of wild territories makes rabies a possible re-emerging pathogen; vaccination of transmitting species is the ideal means to achieve disease control.

Retrospective analysis of dog bites in Southern Italy / Análise retrospectiva de mordidas de cães no sul da Itália

Dog bite is one of the major public health problems involving people worldwide. Although, several studies have investigated this phenomenon in different countries, little information about the incidence of dog bite episodes in Italy is available. We analysed data about dog biting events between 2010 and 2019 provided by the CRIUV, the Regional Reference Centre for Veterinary Urban Hygiene in the largest city of Southern Italy, namely. Naples. We observed severe and profound inconsistencies in the data collection that reveal structural and significant weaknesses of the current data collection system. Given the multifactorial nature of dog bite, we highlight the need to improve the gathering of all the information related to the factors affecting the occurrence of biting episodes for an accurate assessment of the biting phenomenon.

A mordida de cães é um dos maiores problemas de saúde pública que envolve pessoas em todo o mundo. Embora vários estudos tenham investigado esse fenômeno em diferentes países, poucas informações sobre a incidência de episódios de mordidas por cães na Itália estão disponíveis. Analisamos dados sobre eventos de mordidas de cães entre 2010 e 2019 fornecidos pelo CRIUV, Centro de Referência Regional para Higiene Veterinária Urbana na maior cidade do sul da Itália, Nápoles. Observamos inconsistências graves e profundas na coleta de dados que revelam fragilidades estruturais e significativas do sistema de coleta de dados atual. Dada a natureza multifatorial da mordida canina, destaca-se a necessidade de melhorar a coleta de todas as informações relacionadas aos fatores que afetam a ocorrência de episódios de mordida para uma avaliação precisa deste fenômeno.

Comprehensive Dental Management of a Medically Compromised Individual under Anticoagulant Therapy – A Victim of Rabid Dog Bite

In India, about 15 million people are bitten by animals, mostly dogs, every year and need post-exposure prophylaxis. Most animal bites in India (91.5%) are by dogs, of which about 60% are strays and 40% pets. The incidence of animal bites is 17.4/1000 population. Oral anticoagulants are usually prescribed for patients recovering from cardiovascular diseases, ischemic incidents such as myocardial infarction and angina pectoris followed by cerebrovascular accidents. Patients are usually placed under antiplatelet or oral anticoagulants increase the hemorrhage risk after oral surgical procedures. Here, we report a case of a patient on anticoagulants who, while seeking dental treatment, was bitten by a rabid street dog and shed light on the decisions faced by a dental professional while treating such patients.

A cross sectional study of lipid profile in stroke patients

Background: Atherosclerosis affects multiple vascular beds, accounting for nearly all of coronary heart disease and some proportion of ischemic strokes. Serum lipid levels have an effect on the short-term mortality due to strokes. But in some studies, there was no dyslipidemia in patients who presented with acute stroke. It is important to evaluate the serum lipid levels in both the types of strokes to guide lipid lowering therapy which can reduce incidence of stroke and related mortality. This study is undertaken to evaluate the role of serum lipids in patients of stroke in our centre.Methods: It is a cross sectional study, conducted on 176 patients of stroke, who were assessed by NIHSS stroke scale clinically. Serum lipid profile was measured in all patients. Data was entered in Microsoft Excel and analysed by descriptive statistics. Chi Square test was used for association of qualitative variables. A p value<0.05 was considered statistically significant.Results: In this study conducted on 176 patients, LDL values were deranged more in CVA-bleed group compared to CVA-infarct group. BMI was the best anthropometric measure that correlated with LDL. LDL was also the most common parameter that was deranged in nonsmokers (61.8%) whereas in smokers, total cholesterol (66.3%) was most commonly deranged. Triglyceride and VLDL values were deranged more commonly in diabetic group than in non-diabetic group. A total of 123 out of 145patinets with CVA- infarct, had deranged lipid profile and among patients with CVA- bleed 24 out of 32 had deranged lipid profile.Conclusions: Results of this study shows significant derangement in lipid profile especially in LDL cholesterol levels in both infarct and bleed group, therefore starting statin therapy would prove to be beneficial in preventing recurrence of stroke.

Myths and unhealthy wound practices regarding animal bite among subjects attending anti rabies clinic in a South Delhi municipal corporation polyclinic in Mehrauli, Delhi

Background: Rabies is one of the highly fatal diseases, with nearly fifty nine thousand deaths annually globally and almost one third of these are in India. Higher rates of dog bites are common in our country, due to large stray dog population. Despite a preventable disease, unhealthy wound practices are still prevailing in the community due to lot of myths related to the disease. The objectives of the study were to assess the magnitude of unhealthy wound practices and to assess the knowledge regarding health seeking behaviour following animal bite.Methods: The present study was a cross sectional study conducted at SDMC Polyclinic, Mehrauli, Delhi from January to December 2015. A total of 160 cases of animal bite that attended OPD and consented were analysed for knowledge, practices and health seeking behaviour towards animal bite.Results: Out of total 160 respondents almost all were bitten by dogs of which 2/3rd was stray dogs and most common site of bite was lower limb. 55% of the subjects did not wash or clean the wounds after bite. 27% of subjects applied chilli powder or its paste with oil and 2.5% used oil and turmeric paste and 1.9% oil on the wound. Only 41.9% of the subjects believed that vaccination is the treatment of the choice following animal bite.Conclusions: Intensive health education through mass media and mid media can be used to create awareness about the disease transmission and preventive measures like wound management and post-exposure prophylaxis. Also, pet vaccination should be made mandatory for all those who keep pets.

Morphometric analysis of bite mark patterns caused by domestic dogs ( Canis lupus familiaris ) using dental wax registers / Análisis de patrones de huellas de mordedura producidos por perros domésticos ( Canis lupus familiaris ) utilizando registros en cera dental

Dog bites are a known public health problem involving physical, mental and emotional traumas. From a forensic point of view, it has been stated that their morphological characters, and the intercanine and interincisive measurements, could allow a taxonomic and specific identification of the implicated animal. The aim of this study was to differentiate and identify the biological profile of a potential aggressor dog by analysing eight morphometric bite patterns belonging to three different dog breeds. The data obtained were analyzed following three categories: a) breeds; b) sexes among breeds; and c) sex within breed. Significant differences were detected among the variables (p≤ 0.05), but only the maximum maxillary intercanines width (MaxCW) allowed a breed differentiation. The other variables allowed a differentiation between two breeds or one breed over the others. The principal components analysis (PCA) allowed visualizing the degree of dispersion and relationship among the scores. It showed three well-defined and separated breed groups, and different degrees of dispersion within and among breeds. The most important variable for such a differentiation was MaxCW. When considering sex among breeds for males, it showed a statistically significant difference, but only the diastema located between the third left mandibular, incisive and the left mandibular canine (C-I-ManL) allowed breed differentiation. For females, only MaxCW allowed a differentiation among breeds. The multivariate analysis permitted with a 95 % confidence interval, a breed and sex differentiation. Besides, the PCA models allowed classifying, identifying, separating and graphically showing the relationship among the variables. This made it possible to differentiate between breeds and sexes. Due to the large range of dog breeds around the world, this multivariate analysis could also help determining the dog's weight and size, narrowing down towards an approximate number of offending dogs, focussing on a certain kind of dog breed, and pinpointing any suspect dog.

Las mordeduras de perros son un conocido problema de salud pública que involucra traumas físicos, mentales y emocionales. En la faz forense, se ha establecido que características morfológicas, así como las medidas intercanina e interincisiva, permitirían una identificación taxonómica y especifica del animal involucrado. El objetivo fue diferenciar e identificar el perfil biológico de un potencial perro agresor analizando ocho patrones morfológicos de mordeduras pertenecientes a tres diferentes razas caninas. Los datos fueron analizados considerando tres categorías: a) razas; b) sexo entre razas; y c) sexo en cada raza. Se observaron diferencias entre las variables (p≤0,05), pero sólo la distancia máxima entre caninos maxilares (MaxCW), permitió una diferenciación entre razas. Las otras variables permitieron una diferenciación entre dos razas o de una raza sobre las otras. El análisis de componentes principales (PCA) permitió visualizar el grado de dispersión y la relación entre las puntuaciones (dentro y entre razas). Se observaron tres grupos (razas) bien definidos y separados con diferentes grados de dispersión dentro y entre razas. La variable más importante para tal diferenciación fue la MaxCW. Al considerar sexo (machos) entre razas, se encontró diferencia estadísticamente significativa, pero sólo la medida del diastema localizado entre el tercer incisivo y canino izquierdo mandibulares (C-I-ManL) permitió la diferenciación entre razas. Para hembras, sólo la MaxCW permitió una diferenciación entre razas. El análisis multivariante permitió, con un intervalo de confianza del 95 %, diferenciar raza y sexo. El modelo PCA permitió además clasificar, identificar, separar y mostrar gráficamente la relación entre las variables. Esto posibilitó diferenciar entre razas y sexos. Debido a la gran variedad de razas de perros en el mundo, este análisis multivariado permitiría estimar peso y tamaño del animal, indicando un número aproximado de perros atacantes, centrándose en ciertos tipos de raza, y localizar a cualquier cánido sospechoso.

Profile of dog bite cases reporting to ARV OPD of a tertiary care hospital

Background: Animal bites pose a major public health problem in children and adults worldwide. Rabies is a viral zoonosis caused by bite of a rabid dog that occurs in >100 countries and territories. India accounts for 60% of all the world burden of rabies related deaths. The objective of the present study is to analyse the profile of dog bite victims reporting to ARV OPD of a tertiary care hospital.Methods: This was a cross-sectional study conducted in the ARV OPD of a tertiary care hospital. A total of 228 victims of dog bite were interviewed. They were selected using systematic random sampling technique. Analysis of data obtained was done using SPSS.Results: Majority of the participants belonged to the age group 20-30 years. The proportion of male was higher than female. Most of the victims had suffered category II type of dog bite (66.2%). A statistically significant association was seen between age group and nature of dog bite, sex of victim and type of dog, type of dog and category of dog bite and the category of bite and history of dog biting other individuals.Conclusions: The burden of dog bite seems to be borne by the economically productive age group. All individuals need to be educated on how to behave around animals so that they can avoid animal bite.

Community awareness and risk of rabies associated with exposure to animals in India

Background: Rabies is a fatal but preventable disease. Around the world, awareness studies about rabies have been widely used to understand the disease and in its preventive measures. Objectives: The present study was conducted to assess the awareness of rabies as a disease, its transmission, and prevention among the general population and also to assess the perceived health risks associated with exposure to animals. Methods: A cross-sectional study was undertaken across seven representative states in India between July and November 2017. Multistage sampling methodology was followed to select 1012 households as the primary sampling unit, and one adult responsible respondent from each household was interviewed as study participants. Results: Six hundred and eleven (60.4%) participants had heard of rabies. Only 0.2% had extensive knowledge of rabies. Majority (440, 72.0%) of the participants considered rabies as a fatal disease; 77.3% opined that risk of rabies from dogs was high compared to 41.6% who believed that there was little or no risk of rabies from cats. Only 37 (3.7%) participants were aware about preexposure prophylaxis. Conclusion: The awareness on rabies and its prevention in the study population was not satisfactory.

Osteomielitis secundaria a Pasteurella canis / Osteomyelitis due to Pasteurella canis

Resumen Se comunica el caso de una paciente que sufrió mordedura de perro. Solicitó atención médica inmediatamente en donde realizaron asepsia y antisepsia de la herida para posteriormente tratar la lesión. A las 12 horas la paciente comenzó a mostrar cambios de la coloración, aumento de temperatura, volumen y dolor de severa intensidad, por lo que acudió a nuestro hospital para valoración. Se tomaron cultivos y se realizó resonancia magnética, que mostró datos compatibles con infección de tejidos blandos y osteomielitis. En los cultivos se aisló Pasteurella canis. Se dio tratamiento con antibióticos orales con lo que se logró un desenlace favorable. El género Pasteurella lo constituyen cocobacilos gramnegativos, inmóviles, anaerobios facultativos. La cepa más aislada es P. canis posterior a mordeduras de perro y P. multocida y P. septicum en mordeduras de gato. La manifestación más frecuente es celulitis en el sitio de mordedura o arañazo. El diagnóstico se establece mediante métodos microbiológicos. El tratamiento de elección es la penicilina.

Abstract This paper reports a case of osteomyelitis due to Pasteurella canis after a dog bite. The patient requested medical care immediately after the bite, there were performed asepsis and antisepsis of the wound to later close the injury. After 12 hours, the patient's wound started changing colour with increase in temperature, volume and severe pain, so patient went to our hospital for evaluation. Cultures were taken, and magnetic resonance imaging showed images related to soft tissue infection and osteomyelitis. In cultures, Pasteurella canis was isolated. Treatment was given with oral antibiotics, achieving a favourable outcome. The genus Pasteurella are gram-negative, immobile, anaerobic facultative coccobacilli. The most isolated strain is P. canis after dog bites, and P. multocida and P. septicum in cat bites. The most frequent manifestation is cellulitis at the site of a bite or scratch. The diagnosis is made by microbiological methods. The treatment of choice is penicillin.

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

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.

Pediatric nasal reconstruction with frontal flap: a case report

Authors presented the case of a 4-year-old male patient who suffered a dog bite on his face with partial amputation of the nasal tip, managed at another institution conservatively, so that one year after the injury he came for the nasal deformity. A frontal flap was performed for reconstruction achieving excellent results, coverage was achieved with similar characteristics of the skin as color and texture. The patient had a follow-up of 5 years with an appropriate course. Authors presented the case due to few reports in the literature of its use in children, where it can be observed that it is an excellent reconstructive tool.

A cross sectional study to assess the knowledge and response to dog bite among the urban and rural population of Hubballi taluk

Background: Rabies is a fatal zoonotic disease of the central nervous system, most commonly caused by the bite of rabid dogs. Globally canine rabies causes 59,000 human deaths, over 3.7 million DALYs and 8.6 billion USD economic losses annually. These losses are due to a lack of knowledge about wound management and post-exposure prophylaxis. The objective of the study was to assess the knowledge and practices following dog bite and its management among the urban and rural population.Methods: A cross-sectional study was conducted in the field practice area of KIMS, Hubli. 120 households of the urban and rural locality were interviewed with a semi-structured pretested questionnaire.Results: Overall 89.16% of the study population was aware that the disease can be prevented by vaccination. 35% of the rural and 28% of the urban population believed that the disease can spread from person to person. The knowledge about the site and the number of doses of vaccine was poor among both the population. The harmful practices for treatment of bite were still prevalent among both rural (25%) and urban (8.3%) population.Conclusions: The knowledge about the dog bite management and Rabies prevention is insufficient among both populations. There are myths and misconceptions about the disease and wound management. Practices like application of harmful substances like lime, turmeric, mud are the problems hindering rabies prevention and control. Proper steps need to be taken up to control the canine rabies.

Caracterización clínico-epidemiológica de mordeduras en personas mayores en la provincia de los Andes, región de Valparaíso, Chile / Clinical-epidemiological characterization of bites in the elderly in the Andes province, Valparaíso region, Chile

Introducción: las mordeduras constituyen un relevante problema de salud, con amplio espectro clínico, pudiendo causar la muerte. Existe escasa información del tema en personas mayores (PM). Método: análisis de base de datos realizada a partir de formularios de notificación de mordeduras de centros de salud y de Protocolos de Denuncia de Animal Mordedor en la provincia de Los Andes, Chile. Objetivo: caracterizar epidemiológicamente las mordeduras en personas mayores ocurridas en la provincia de Los Andes, V región,(2005-2007). Resultados: de los 2358 casos de mordeduras notificados, 234 casos ocurrieron en PM (9,92 por ciento del total de casos), con un promedio de edad de 70,09 ± 7,896 años (rango = 60-95 años). La tasa de mordeduras para PM fue de 657,1 por 100000 hbtes (2005), 745,8 por 100000 hbtes (2006) y 627,6 por 100000 hbtes (2007). De éstos, la mayoría se produjo en el sexo femenino (56,8 por ciento) (p 0,016). El animal mordedor más frecuente fue el perro (75,6 por ciento) en ambos sexos. La complicación más frecuente fue la herida (74,4 por ciento), seguida por enfermedad por arañazo de gato (2,1 por ciento) y fractura (1,3 por ciento). Hubo 1 caso de artritis y 1 de celulitis por mordedura de araña. Conclusiones: las mordeduras en personas mayores son causa de morbilidad importante. Es relevante mejorar los sistemas de registro y vigilancia, y las medidas de educación en la tenencia responsable de animales para lograr una disminución de casos. Se requieren más estudios para determinar otras complicaciones y consecuencias de mordeduras en PM no visualizadas en este estudio.(AU)

Introduction: bites are a relevant health problem, with a varied clinical spectrum, which can cause death. There is limited information about bites in old people (OP). Methods: database analysis made with bites notification forms by health centers and Animal Bites Reporting Protocols in the province of Los Andes, Chile. Objective: typify bites epidemiologically in old people in the province of Los Andes, V region (2005 to 2007). Objective: typify bites epidemiologically in elderly people in the province of Los Andes, V region (2005 to 2007). Results: 234 out of 2358 cases of reported bites occurred in OP (9.92 percent of all cases), with an average age of 70.09 ± 7.896 years (range = 60-95 years). The bite rate for OP was 657.1 per 100000 inhabitants (2005), 745.8 per 100000 inhabitants (2006) and 627.6 per 100000 inhabitants (2007). Of these, most of them occurred in females (56.8 percent) (p 0.016). The most frequent biting animal was the dog in both genders (75.6 percent). The most frequent complication was injury (74.4 percent), followed by cat scratch disease (2.1 percent) and fracture (1.3 percent). There was 1 case of arthritis and 1 case of cellulitis due to spider bite. The most frequent complication was the wound (74.4 percent), followed by cat's scratch disease (2.1 percent) and fracture (1.3 ). There was 1 case of arthritis and 1 case of cellulitis due to spider bite. Conclusions: bites in old people are a cause of relevant morbidity. It is relevant to improve the registration and surveillance systems, and the education measures in responsible animal tenure to achieve a reduction of of cases. More studies are required to determine other complications and consequences of bites in OP not visualized in this study.(AU)

Treatment of oral and maxillofacial dog bites in children / 口腔疾病防治

Objective @#To summarize experience treating dog bites in the oral and maxillofacial regions of children and provide a reference for clinical practice.@*Methods @#Nineteen children with dog bite wounds in the maxillofacial region were treated from July 2011 to June 2018 with primary debridement and suturing. A rabies vaccine, tetanus vaccine and human immunoglobulin as a passive immune agent were given via intramuscular injection. Anti-inflammatory therapy with amoxicillin and clavulanate potassium or other antibiotics. Follow-up observation and a retrospective analysis of the treatment effect were carried out.@*Results@#After treatment, among the 19 pediatric patients, 18 cases showed primary healing and 1 case showed secondary healing. The follow-up period ranged from six months to seven and a half years. No cases of rabies occurred.@*Conclusion @#For the treatment of patients with maxillofacial dog bite wounds, the first stage debridement and suture can reduce the scar after operation and is beneficial to the recovery of face.

Disease burden of animal injury in China, 1990-2016 / 中华流行病学杂志

Objective To analyze the disease burden of animal injury in China between 1990 and 2016.Methods Data obtained from the Global Burden of Disease 2016 were used to analyze the age and gender specific disease burden of animal injury in China,using the incidence and disability adjusted of life years (DALYs) rate.Relative and annual changes were evaluated.Results In 2016,the age-standardized incidence and DALYs rate of animal injury in China showed as 245.05 per 100 000 people and 12.73 per 100 000.The age-standardized incidence of non-venomous animal injury was significantly higher than that of venomous animal injury,but the differences in age-standardized incidence and DALYs rate between venomous animal injury and non-venomous animal injury were not significant.Between 1990 and 2016,there was a significantly decreasing trend in the age-standardized incidence and DALYs rate of animal injury,and obvious decline could be seen in the incidence of non-venomous animal injury,compared with venomous animal injury.The incidence and DALYs rate of animal injury declined in both males and females and in different age groups.The obvious decline of incidence and DALYs rate could be found in children aged 5-14 years and aged ＜ 5 years.Conclusions Between 1990 and 2016,there was a significant alleviation of the disease burden of animal injury in China.Young children were most prone to animal injury,resulting in serious disability and death,indicating more attention should be paid to this population at high risk and in animal injury prevention and control programs.

Disease burden of animal injury in China, 1990-2016 / 中华流行病学杂志

Objective To analyze the disease burden of animal injury in China between 1990 and 2016.Methods Data obtained from the Global Burden of Disease 2016 were used to analyze the age and gender specific disease burden of animal injury in China,using the incidence and disability adjusted of life years (DALYs) rate.Relative and annual changes were evaluated.Results In 2016,the age-standardized incidence and DALYs rate of animal injury in China showed as 245.05 per 100 000 people and 12.73 per 100 000.The age-standardized incidence of non-venomous animal injury was significantly higher than that of venomous animal injury,but the differences in age-standardized incidence and DALYs rate between venomous animal injury and non-venomous animal injury were not significant.Between 1990 and 2016,there was a significantly decreasing trend in the age-standardized incidence and DALYs rate of animal injury,and obvious decline could be seen in the incidence of non-venomous animal injury,compared with venomous animal injury.The incidence and DALYs rate of animal injury declined in both males and females and in different age groups.The obvious decline of incidence and DALYs rate could be found in children aged 5-14 years and aged ＜ 5 years.Conclusions Between 1990 and 2016,there was a significant alleviation of the disease burden of animal injury in China.Young children were most prone to animal injury,resulting in serious disability and death,indicating more attention should be paid to this population at high risk and in animal injury prevention and control programs.

Epidemiology of animal bite reported at animal bite clinic during 2015-16 at a tertiary care centre of Himachal Pradesh.

Background: One health approach for rabies prevention in humans can be done only by targeting the animal source of the virus. Animal bite is the most common mode of transmission of virus to human being. Objective: to describe the epidemiology of animal bite among those attending the animal bite clinic of a tertiary care center of district Kangra, Himachal Pradesh. Methods: This hospital based descriptive study was carried out from March 2015 through February 2016 at Animal Bite Clinic of Department of Community Medicine, Dr. Rajendra Prasad Govt. Medical College, Tanda, Kangra, Himachal Pradesh. A preformed and pre tested closed ended questionnaire was used. World Health Organization’s category of animal bite was used to categorize the patients. Results: Males outnumbered females and around 30% were below 20 years of age followed by third decade. Majority of victims were students (31%) and in 61.1% the wound was localized in the lower extremities. Dogs bite was reported in 86% cases. Stray animal bite resulted in 94.2% of category III bites. More than half of the victims were aware of local remedy to be done after bite and practiced it within 30 minutes of bite. Conclusions: Agent, host and environmental factor of animal bite studied in this study indicate that vaccination of animal, abolishing environment favorable for stray animals and awareness of early management of animal bite cases can lead to goal of elimination of rabies.

Rising pattern, Seasonal predisposition and Trend analysis of Animal bite Cases Attending the Anti-rabies Clinic of a Tertiary Care Hospital

Background: India is responding to achieve the target of zero human death from dog-mediated rabies by 2030. Objectives: To study the rising pattern, seasonal predisposition and trend analysis of animal bite cases attending the anti-rabies clinic of a tertiary care hospital. Methodology: This retrospective cross-sectional study was conducted in the anti-rabies clinic of Department of Community Medicine, Government Medical College, Srinagar, Jammu & Kashmir. Data were collected from the animal bite register maintained at the said clinic. Data were entered into Microsoft Excel spreadsheet and analysed with the application of mean, proportion and trend analysis. Results: Total number of animal bite cases were 49508 in last 14 years (2004-2017). The rising case pattern has been observed since the year 2009.The maximum number of cases being 7324 in the year 2016 followed by 6548 in the year 2017 respectively. The seasonal predisposition of animal bite cases was seen in the month of March and June. On-trend analysis, forecasting for 2018, 2019 and 2020 showed 7570, 8108 and 8645 cases respectively. Conclusion: We conclude that the animal bite cases are on an increase in the future years and applicable management measures with intersectoral coordination ought to be started vigorously in endemic areas.

Reconstrucción labial por mordedura canina en una anciana / Labial reconstruction due to a dog bite in an elderly woman

Se presenta el caso clínico de una anciana de 80 años de edad con antecedentes de demencia senil, quien acudió acompañada de sus hijos a la consulta de Emergencia del Hospital Provincial Docente Clinicoquirúrgico Saturnino Lora Torres por presentar mordedura de un perro en la región labial. A la paciente se le realizó lavado de la herida, desbridamiento y profilaxis, seguidos de la confección de colgajos locales combinados y sutura inmediata. Los resultados cosméticos y funcionales fueron catalogados como favorables.

The case report of an 80 years elderly woman with history of Alzheimer´s is presented, who went along with her children to the Emergency Service of Saturnino Lora Torres Teaching Clinical Surgical Provincial Hospital due to a dog bite in the labial region. The wound cleaning, debridement and prophylaxis was carried out to the patient, followed by making combined local flaps and immediate suture. The cosmetic and functional results were classified as favorable.

APPLICATION OF DOUBLE PEDICLED FLAP AND TECHNIQUE OF GEOMETRIC BROKEN LINE FOR PRIMARY REPAIR OF SERIOUS DOG BITE WOUNDS / 中国修复重建外科杂志

METHODS: Between October 2006 and December 2014, 9 patients with serious dog bite wound were treated. There were 3 males and 6 females with an average age of 34.5 years (range, 8-68 years), and with a mean disease duration of 4 hours (range, 30 minutes to 24 hours). The defect ranged from 1.7 cm×0.5 cm to 15.0 cm×8.0 cm, with the mean depth of 0.5 cm (range, 0.3-0.8 cm). Deep tissue exposure was observed. After routine debridement, a vacuum sealing drainage (VSD) was equipped to suck and irrigate for 1 day, then wound was repaired. The superomedial edge of defect was trimmed, then a GBL shape mainly with square and rectangular was designed. According to defect size, a double pedicled flap was designed at the lateroinferior edge of defect, which size ranged from 1.7 cm×1.5 cm to 18.0 cm×15.0 cm. The donor site was sutured directly. VSD was used for 3 days after operation.