Öz
Aim: Due to the risk of rabies contamination and infection, wounds by animals are a significant public health concern. Rabies are still encountered in Turkey. The knowledge of the epidemiology and surveillance of animal bites and rabies prophylaxis is critical in combating this disease. This study aimed to determine the frequency and characteristics of wounds due to animals and rabies prophylaxis at the emergency department of Ege University Faculty of Medicine.
Materials and Methods: In this descriptive and retrospective study, the medical records of patients admitted to the Emergency Department of Ege University Faculty of Medicine between 01.03.2016 and 01.12.2018 with wounds due to animals were reviewed. Of the 427 cases reviewed, four cases (0.9%) due to rats and two patients (0.5%) wounded by bats were not included in the analysis.
Results: Of the 421 applicants, 266 were males (63.2%), and 155 were females (36.8%). Forty-five patients (10.6%) were aged ≤10 (10.6%). Adults aged 18-59 years constituted 78.8% (n=332) of the applications. Most commonly, the wounds were in the lower extremities (220, 53.3%). The attacks were made commonly by dogs (n=312, 74.1%). Immunoglobulins were administered to patients who had injuries extending to the subcutaneous tissues (n=23, 5.5%). The majority of the patients were wounded by stray animals (288, 68.4%). All these patients received the rabies vaccine. On the other hand, the majority of patients wounded by owned animals (n=69, 16.4%) got a rabies vaccine as well (n=59, 85.5%).
Conclusion: Our findings indicate that the most significant risks were due to stray animals. It can be concluded that controls and vaccination of owned animals are insufficient, requiring immunization after the injuries. Additionally, to reduce animal bites and prevent rabies, public education about animal bites will be useful as well.
Anahtar Kelimeler
Animals wounds and injuries bites and stings rabies vaccination.
Kaynakça
- Obonyo M, Akoko JM, Orinde AB et al. Suspected rabies in humans and animals, Laikipia County, Kenya. Emerg Infect Dis 2016; 22 (3): 551-553.
- Fevre E, Kaboyo R, Persson V, Edelsten M, Coleman P, Cleaveland S. The epidemiology of animal bite injuries in Uganda and projections of the burden of rabies. Tropical Med Int Health 2005; 10 (8): 790–8.
- Rosado B, G í -B g S L ó M P J A g S 1 –2004. Vet J 2009; 179 (3): 383–91.
- MacBean CE, Taylor DM, Ashby K. Animal and human bite injuries in Victoria, 1998-2004. Med J Aust 2007; 186 (1): 38.
- Looke D, Dendle C. Bites (mammalian). BMJ Clin Evid 2015; 12: 914.
- Gilchrist J, Gotsch K, Annest JL, Ryan G. Nonfatal dog bite-related injuries treated in hospital emergency departments-United States, 2001. MMWR Morb Mortal Wkly Rep 2003; 52 (Suppl 26): 605-10.
- Gandhi RR, Liebman MA, Stafford BL, Stafford PW. Dog bite injuries in children: a preliminary survey. Am Surg 1999;65(9):863-64.
- Kaye AE, Belz JM, Kirschner RE. Pediatric dog bite injuries: a 5-year review of the experience at the C ’ H l of Philadelphia. Plast Reconstr Surg 2009; 124 (2): 551-58.
- Brook I. Microbiology and management of human and animal bite wound infections. Primary Care C fi Pract 2003; 30(1):25-39.
- Kenya Ministry of Health and Ministry of Agriculture LaF [homepage on the Internet]. Nairobi: Strategic Plan for the Elimination of Human Rabies in Kenya 2014–2030. [updated september 2014]. Available from: www.zdukenya.org
- World Health Organization (WHO) [homepage on the Internet]. Geneva: WHO Expert Consultation on Rabies [updated 2013]. Available from: www.who.int
- Kessels JA, Recuenco S, Navarro-Vela AM et al. Pre-exposure rabies prophylaxis: a systematic review. Bull World Health Organ 2017; 95 (3): 210-219.
- Turkish Ministry of Health. [homepage on the Internet]. Ankara: General Directorate of Primary Health Care. Rabies Prophylaxis Guide. [updated 2019]. Available from: dosyamerkez.saglik.gov.tr
- Sabouri GM, Roshanaei G, Rostampour F, Fallahi A. An epidemiologic study of animal bites in Ilam Province, Iran. Arch Iran Med 2012; 15 (6): 356-60.
- Zeynali M, Fayaz A, Nadim A: Animal bites and rabies situation in Iran. Arch Iran Med 1999; 2 (3): 120-4.
- Singh J, Jain DC, Bhatia R et al: Epidemiological characteristics of rabies in Delhi and surrounding areas, 1998. Indian Pediatr 2001, 38 (12): 1354-60.
- Pandey P, Shlim DR, Cave W, Springer MF. Risk of possible exposure to rabies among tourists and foreign residents in Nepal. J Travel Med 2002, 9 (3): 127-31. 108 Ege Journal of Medicine / Ege Tıp Dergisi
- Freeman AJ, Senn DR, Arendt DM. Seven hundred seventy- eight bite marks: analysis by anatomic location, victim and biter demographics, type of crime, and legal disposition. J Forensic Sci 2005; 50 (6): 1436-43.
- Ali Majidpour, Homayoun Sadeghi-Bazargani, Shahin Habibzadeh. Injuries due to Animal Bites: A Descriptive Study. J Clin Res Gov 2012; 1: 22-24
- Kilic B, Unal B, Semin S, Konakci SK. An important public health problem: rabies suspected bites and post-exposure prophylaxis in a health district in Turkey. Int J Infect Dis 2006; 10 (3): 248-54.
- Quiles-Cosme GM, Perez-Cardona CM, Aponte-Ortiz FI. Descriptive study of animal attacks and bites in the municipality of San Juan, Puerto Rico, 1996–1998. P R Health Sci J 2000; 19 (1): 39-47.
- Eslamifar A, Ramezani A, Razzaghi-Abyaneh M. Animal Bites in Tehran, Iran. Arch Iranian Med 2008; 11 (2): 200-202
- Ngugi JN, Maza AK, Omolo OJ, Obonyo M. Epidemiology and surveillance of human animal-bite injuries and rabies post-exposure prophylaxis, in selected counties in Kenya, 2011-2016 BMC Public Health 2018; 18 (1): 996.
- Pfortmueller CA, Efeoglou A, Furrer H, Exadaktylos AK. Dog bite injuries: primary and secondary emergency department presentations--a retrospective cohort study. Scientific World Journal Pfortmueller CA, Efeoglou A, Furrer H, Exadaktylos AK. Dog bite injuries: primary and secondary emergency department presentations--a retrospective cohort study. Scientific World J doi: 10.1155/2013/393176.
- Sudarshan MK, Mahendra BJ, Narayan DH. A community survey of dog bites, anti-rabies treatment, rabies and dog population management in Bangalore city. J Commun Dis 2001; 33: 245-51.
- Sacks JJ, Sinclair L, Gilchrist J, Golab GC, Lockwood R. Breeds of dogs involved in fatal human attacks in the United States between 1979 and 1998. J Am Vet Med Assoc 2000; 217 (6): 836-40.
Öz
Amaç: Hayvan kaynaklı yaralanmalar, kuduz virüsü bulaşma riski ve sebep olduğu enfeksiyon nedeni ile önemli bir halk sağlığı problemidir. Türkiye'de halen kuduz vakaları saptanmaktadır. Kuduzla mücadelede hayvan ısırıklarının epidemiyolojisi ve sürveyansının bilinmesi ile ısırılma sonrası kuduz profilaksisi uygulanmaları kritik öneme sahiptir. Bu çalışmamızda, Ege Üniversitesi Tıp Fakültesi acil servisine hayvan yaralanmaları ile başvuru sıklığını, yaralanmaların özelliklerini ve kuduz profilaksi uygulamalarını belirlemeyi amaçladık.
Gereç ve Yöntem: Bu tanımlayıcı ve retrospektif çalışmada hayvan yaralanması nedeniyle 01.03.2016-01.12.2018 tarihleri arasında Ege Üniversitesi Acil Servise başvuran olguların dosyaları incelenmiş ve analiz edilmiştir. Belirlenen 427 vakadan fare (n=4; 0,9%) ve yarasa (n=2; 0,5%) ısırıkları analize dahil edilmemiştir.
Bulgular: Başvuran 421 hastanın dosyası incelendiğinde; 266’sının erkek (%63,2), 155’inin kadın (%36,8) olduğu bulunmuştur. On yaş ve altındaki başvuran sayısı 45 kişi (%10,6) olarak saptanmıştır. En sık ısırılan bölge alt ekstremitedir (n=220, %52,2). Daha çok köpek tarafından ısırılma mevcuttur (n=312, %74,1). Erişkinlerde 18-59 yaş arasında yaralanma oranı %78,8 (n=332) olarak bulunmuştur. Hastaların 23’üne (%5,5) immünglobulin yapılmış olup, bu hastaların deri altına uzanan kesileri mevcuttur. Isırılan hastaların çoğu sahipsiz hayvanlar olup (n=288, %68,4) bu hayvanlar tarafından ısırılan hastaların hepsine kuduz aşısı yapılmışken, sahipli hayvanlar tarafından (n=69, %16,4) ısırılanların da büyük çoğunluğuna kuduz aşısı yapılmıştır (n=59, %85,5).
Sonuç: Bu çalışmaya göre hayvansal kökenli yaralanmalar açısından en büyük riski sahipsiz hayvanlar taşımaktadır. Sahipli hayvanların kontrollerinin ve aşılamalarının yetersiz yapıldığı, bu nedenle de sahipli hayvan ısırması sonrası aşılama yapılmak zorunda kalındığı düşünülebilir. Ek olarak, evcil hayvanların aşılarının ve kontrollerinin yapılmasının yanında hayvan ısırıklarının azaltılmasında ve kuduzun önlenmesi için topluma hayvan ısırıklarından korunma konusunda eğitim vermek etkili olacaktır.
Anahtar Kelimeler
Hayvanlar yaralar ve yaralanmalar ısırık ve sokmalar kuduz aşı.
Kaynakça
- Obonyo M, Akoko JM, Orinde AB et al. Suspected rabies in humans and animals, Laikipia County, Kenya. Emerg Infect Dis 2016; 22 (3): 551-553.
- Fevre E, Kaboyo R, Persson V, Edelsten M, Coleman P, Cleaveland S. The epidemiology of animal bite injuries in Uganda and projections of the burden of rabies. Tropical Med Int Health 2005; 10 (8): 790–8.
- Rosado B, G í -B g S L ó M P J A g S 1 –2004. Vet J 2009; 179 (3): 383–91.
- MacBean CE, Taylor DM, Ashby K. Animal and human bite injuries in Victoria, 1998-2004. Med J Aust 2007; 186 (1): 38.
- Looke D, Dendle C. Bites (mammalian). BMJ Clin Evid 2015; 12: 914.
- Gilchrist J, Gotsch K, Annest JL, Ryan G. Nonfatal dog bite-related injuries treated in hospital emergency departments-United States, 2001. MMWR Morb Mortal Wkly Rep 2003; 52 (Suppl 26): 605-10.
- Gandhi RR, Liebman MA, Stafford BL, Stafford PW. Dog bite injuries in children: a preliminary survey. Am Surg 1999;65(9):863-64.
- Kaye AE, Belz JM, Kirschner RE. Pediatric dog bite injuries: a 5-year review of the experience at the C ’ H l of Philadelphia. Plast Reconstr Surg 2009; 124 (2): 551-58.
- Brook I. Microbiology and management of human and animal bite wound infections. Primary Care C fi Pract 2003; 30(1):25-39.
- Kenya Ministry of Health and Ministry of Agriculture LaF [homepage on the Internet]. Nairobi: Strategic Plan for the Elimination of Human Rabies in Kenya 2014–2030. [updated september 2014]. Available from: www.zdukenya.org
- World Health Organization (WHO) [homepage on the Internet]. Geneva: WHO Expert Consultation on Rabies [updated 2013]. Available from: www.who.int
- Kessels JA, Recuenco S, Navarro-Vela AM et al. Pre-exposure rabies prophylaxis: a systematic review. Bull World Health Organ 2017; 95 (3): 210-219.
- Turkish Ministry of Health. [homepage on the Internet]. Ankara: General Directorate of Primary Health Care. Rabies Prophylaxis Guide. [updated 2019]. Available from: dosyamerkez.saglik.gov.tr
- Sabouri GM, Roshanaei G, Rostampour F, Fallahi A. An epidemiologic study of animal bites in Ilam Province, Iran. Arch Iran Med 2012; 15 (6): 356-60.
- Zeynali M, Fayaz A, Nadim A: Animal bites and rabies situation in Iran. Arch Iran Med 1999; 2 (3): 120-4.
- Singh J, Jain DC, Bhatia R et al: Epidemiological characteristics of rabies in Delhi and surrounding areas, 1998. Indian Pediatr 2001, 38 (12): 1354-60.
- Pandey P, Shlim DR, Cave W, Springer MF. Risk of possible exposure to rabies among tourists and foreign residents in Nepal. J Travel Med 2002, 9 (3): 127-31. 108 Ege Journal of Medicine / Ege Tıp Dergisi
- Freeman AJ, Senn DR, Arendt DM. Seven hundred seventy- eight bite marks: analysis by anatomic location, victim and biter demographics, type of crime, and legal disposition. J Forensic Sci 2005; 50 (6): 1436-43.
- Ali Majidpour, Homayoun Sadeghi-Bazargani, Shahin Habibzadeh. Injuries due to Animal Bites: A Descriptive Study. J Clin Res Gov 2012; 1: 22-24
- Kilic B, Unal B, Semin S, Konakci SK. An important public health problem: rabies suspected bites and post-exposure prophylaxis in a health district in Turkey. Int J Infect Dis 2006; 10 (3): 248-54.
- Quiles-Cosme GM, Perez-Cardona CM, Aponte-Ortiz FI. Descriptive study of animal attacks and bites in the municipality of San Juan, Puerto Rico, 1996–1998. P R Health Sci J 2000; 19 (1): 39-47.
- Eslamifar A, Ramezani A, Razzaghi-Abyaneh M. Animal Bites in Tehran, Iran. Arch Iranian Med 2008; 11 (2): 200-202
- Ngugi JN, Maza AK, Omolo OJ, Obonyo M. Epidemiology and surveillance of human animal-bite injuries and rabies post-exposure prophylaxis, in selected counties in Kenya, 2011-2016 BMC Public Health 2018; 18 (1): 996.
- Pfortmueller CA, Efeoglou A, Furrer H, Exadaktylos AK. Dog bite injuries: primary and secondary emergency department presentations--a retrospective cohort study. Scientific World Journal Pfortmueller CA, Efeoglou A, Furrer H, Exadaktylos AK. Dog bite injuries: primary and secondary emergency department presentations--a retrospective cohort study. Scientific World J doi: 10.1155/2013/393176.
- Sudarshan MK, Mahendra BJ, Narayan DH. A community survey of dog bites, anti-rabies treatment, rabies and dog population management in Bangalore city. J Commun Dis 2001; 33: 245-51.
- Sacks JJ, Sinclair L, Gilchrist J, Golab GC, Lockwood R. Breeds of dogs involved in fatal human attacks in the United States between 1979 and 1998. J Am Vet Med Assoc 2000; 217 (6): 836-40.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2020 |
| Gönderilme Tarihi | 12 Haziran 2019 |
| Yayımlandığı Sayı | Yıl 2020 |