An 8-year-old child with Encephalitis Rabies due to delayed case finding, proper Post Exposure Prophylaxis for Rabies infection a case report
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Abstract
Background and Purpose: Until April 2023, it has been documented about 31.113 case of animal rabies-borne bite, which 23.211 cases are given Post Exposure Prophylaxis Anti Rabies Vaccine and 11 death cases in Indonesia and 95% of them are caused by dog bite. This case report was conducted to describe a rare case of an 8 years old child presenting with late complication of encephalitis in Borong General Hospital due to the delayed case finding, management and proper prophylaxis for Rabies infection.
Case: One day prior to admission, an 8-year-old girl with irritability, aggressive behavior, and severe speech abnormalities reported to the emergency room. These symptoms quickly escalated to confusion and disturbed mental status. One month before to presentation, the patient's parents stated that his right arm had been bitten by a stray dog. Because there were no obvious bite marks and the family was not aware of the dog bite, PEP was not requested. In the previous five days, her parents described experiences of hydrophobia, photophobia, and aerophobia. The patient's health deteriorated two hours after admission, and palpating the carotid artery revealed that there was no pulse. Despite performing cardiopulmonary resuscitation, ROSC was not reached.
Conclusion: Animal rabies control and surveillance are essential, particularly in locations where the disease is endemic. PEP is extremely effective and ought to be given as soon as possible following an exposure to reduce the high fatality rate.
Keywords: aware, PEP, mortality, irritability
Article Details
References
Chitra S. Mani, MD, Dennis L. Murray, et al. Rabies. Pediatrics in Review. Vol.27 No.4 April 2006, 129-136.
A.C. Jackson. Rabies: a medical perspective. Rev. Sci. Tech. Off. Int. Epiz. 2018, 37 (2), 569-580.
Kementerian Kesehatan Republik Indonesia. Buku Saku Petunjuk Teknis Penatalaksanaan Kasus Gigitan Hewan Penular Rabies Di Indonesia, 2016, p. 4
A.C. Banyard, N. Tordo. Rabies pathogenesis and immunology. Rev. Sci. Tech. Off. Int. Epiz., 2018, 37 (2), 323-330.
Angel N. Desai. Dog Bites. Jama Patient Page, Volume 323, Number 24 p. 2535.
Kementerian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia Tahun 2021. 230-232.
Ahmad Ibrahim Al-Mustapha, Folashade O. Bamidele, et al. Perception of canine rabies among pupils under 15 years in Kwara State North Central Nigeria, Plos Neglected Tropical Diseases, 2022, P. 1-13.
Mathilde Sopi Tetchi, M'Begnan Coulibaly, et al. Risk factors for rabies in Cote d'Ivoire, Acta Tropica, 2020, 212 (2020) 105711.
Lwitiko Sikana, Tiziana Lembo, et al. Dog ownership practices and responsibilities for children’s health in terms of rabies control and prevention in rural communities in Tanzania, Plos Neglected Tropical Diseases, 2021, 1-16.
Pakpoom Janewongwirot, Watsamon Jantarabenjakul, et al. A randomized open-label trial of 2-dose or 3-dose pre-exposure rabies prophylaxis among Thai children. Vaccine 37 (2019) 5307–5313.
Nadine N’dilimabaka, Danielle Koumba Mavoungou, et al. Molecular analyses of human rabies virus associated with encephalitis in two children in Gabon. IJID Regions. 2 (2022) 180–183.
Dawn Blackburn. Human Rabies. Morbidity and Mortality Weekly Report. 2021, Vol. 71 / No. 49, p. 1547-1549.
Fatma Khalsi, Ahmed Ayari, et al. Rabies encephalitis in children: a resurgence of a fatal anthropozoonosis. African Health Sciences Vol 18 Issue 3, September, 2018.
Abhishek Royal, Denny John. A Cost-Effectiveness Analysis of Pre-Exposure Prophylaxis to Avert Rabies Deaths in School-Aged Children in India. Vaccines 2023, 11, 88.
Dirk Jochmans, Johan Neyts. The path towards effective antivirals against rabies. Vaccine 37 (2019) 4660–4662.
Ewaldus Wera, Charlotte Warembourg, et al. Immune Response After Rabies Vaccination in Owned Free-Roaming Domestic Dogs in Flores Island, Indonesia. Frontiers in Veterinary Science, June 2022 | Volume 9 | Article 868380
Paulus Mario Christopher. Knowledge, attitudes and practices regarding rabies among community members: a cross-sectional study in Songan Village, Bali, Indonesia. Int Marit Health 2021; 72, 1: 26–35.
Ewaldus Wera, Charlotte Warembourg, et al. Loss of binding antibodies against rabies in a vaccinated dog population in Flores Island, Indonesia. PLOS Neglected Tropical Diseases, September 7, 2021, 1-15.
Patrick Soentjens, Nicole Berens-Riha, et al. Vaccinating children in high-endemic rabies regions: what are we waiting for?, BMJ Global Health 2021;6:e004074.
Kementerian Kesehatan Republik Indonesia. https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20230602/3343156/hingga-april-2023-ada-11-kasus-kematian-karena-rabies-segera-ke-faskes-jika-digigit-anjing/ . 2023. accesed: 19 July 2023.