Post exposure human-prophylaxis for rabies in developing countries

Abstract

Three types of geographical categories of rabies exist: (a) areas free of rabies, mostly islands: England, Australia, Japan and parts of the Caribbeans and Hawaii which require four to six months quarantine before any imported animal enters the country; (b) areas with controlled canine rabies but disease spread by wild animals, e.g. western Europe (red foxes transmit to dogs, cats, deer); Canada (foxes and skunks); Caribbean Islands of Cuba, Puerto Rico, Hispaniola, Grenada and South Africa where mongoose rabies is found. In some areas of (a) and (b) aerosol transmission in laboratories, corneal transplant transmission and transmission by insectivorous bats have also been reported. (c) areas where canine and feline rabies continue, e.g. in developing countries of Africa, India, Asia, Latin America [1). In countries under (c), data on incidence of rabies - post exposure prophylaxis (PEP) unlike in developed countries [2] are often difficult to obtain, but the recent work of Bogel and Motschwiller [3J using 1979 analysed data showed varying rates of 0.1-28.8 per million cases of rabies and varying rates of PEP from South Africa to India