Investigation and management of rabies outbreak control in a case of rabid puppy in a school, Donmaung District, Bangkok, August-October 2018

Abstract

Background: On 24 August 2018, the Rabies Control Group, Health Department, Bangkok Metropolitan Administration notified to the Public Health Center 60 of a suspected rabid dog which was brought from a school in Don Mueang District. The veterinary team caught and quarantined the suspected dog in the Prawet Dog Control Center. Later, the dog died on 29 August 2018. Autopsy findings showed that the dog was confirmed to have rabies infection. The staff from the Public Health Center 60 coordinated with the school and conducted an investigation on 31 August 2018 to determine the extent of the outbreak and recommend control measures.
Methods: A descriptive epidemiological study was performed using the questionnaires to interview people exposed to the rabid dog, those who developed suspected rabies symptoms, and those touched or were bitten by a sick dog during June 2018. Rabies-exposed person was defined as a person who was exposed to animal or patient confirmed or suspected of rabies infection. Rabies exposure was defined as bite, scratch, saliva splashed into wound or scratched skin, licked at the mouth, nose or eyes, or eating raw food prepared from rabid animals.
Results: Categories of contact with a suspected rabid animal included 2,899 persons for category I, 183 persons for category II and 55 persons for category III.
Conclusions and discussions: Depending on severity of contact with the suspected rabid animal, category II and III exposures were assessed as carrying a risk of developing rabies and required post-exposure prophylaxis measures with vaccination and/or administration of rabies immunoglobulin. Most exposures occurred through licking when saliva and secretions exposed to the lining of the eyes, mouth, nose or bleeding wound. Lack of awareness and knowledge of rabies, and lack of vaccination in dogs were remarked in this event. Therefore, public health departments should have measures to provide health education in schools and community, and raise awareness about the importance of rabies prevention, including continuous and consistent surveillance.