Epidemiology of urban dog-related injuries requiring rabies post-exposure prophylaxis in Marseille, France

摘要: Dog bites are a serious public health concern. Besides injuries and the adverse psychological impacts, dog can be complicated by infections including rabies, which has highest case-fatality rate of all infectious diseases. 1 The last case human rabies acquired in mainland France was reported 1924 fox 1998. However, rabid dogs repeatedly imported into travelers, with majority originating from Morocco after having been transported through Spain car. 2–6 decision to prescribe vaccine and/or immunoglobulin patients injured depends on origin animal. Over-prescription post-exposure prophylaxis (PEP) questioned France. 7 In Marseille, efforts minimize over-prescription vaccination for PEP conducted, delaying initiation treatment involving an apparently healthy that kept under observation. 8 significant numbers vaccinations still given due high proportion cannot this context, interventions aimed at reducing number critical. reduction dog-related educational shown some success children, 9,10 although contradicted. 11 As first step towards possible implementation such strategy we conducted preliminary survey describe epidemiology requiring city. 2. Materials methods From 2007 2010, epidemiological data associated were prospectively collected attending Marseille center (RTC) using standardized forms. At RTC, Background: Methods: Dog-associated occurring city investigated 245 individuals among presenting over 4-year period. Results: Male more likely report compared female (66.5% vs. 33.5%; odds ratio 2.25, 95% confidence interval 1.72–2.93). mean age 32 years (range 1–85 years). Children young adults 30 than four times others. Most cases occurred outdoors (73.0%) – areas (38.0%) involved animals unknown owners 56.3% cases. Only 28.2% available (63.7%) received complete prophylaxis. distribution not homogeneous incidence significantly higher areas. Eleven percent declared bitten whose owner street beggar, clustered evidenced these one area Conclusions: Programs offering low-cost veterinary care pets belonging group beggars should considered. Such programs may implemented other large cities Europe where frequently seen. s