Human Rabies Postexposure Prophylaxis: Experience of a National Pediatric Centre

Date of submission: 10-06-2017 | Date of acceptance: 14-09-2018 | Published: 29-01-2019

Abstract

Introduction: Rabies is a fatal acute infectious disease with a variable incubation period. Portugal is a rabies’ free country, certified since 1960, with a recommended vaccination plan after risk contacts. The study aim was to analyse the potential cases of exposure to rabies, in children under 18 years old, evaluate compliance, adverse effects of vaccination and clinical outcomes.

Methods: A retrospective, descriptive study with the review of clinical records from a Rabies Vaccination Centre, between 2013 and 2016; clinical outcomes were obtained by a telephone survey. The definitions of exposure were based in the World Health Organization (WHO) guidelines. Results: ten cases of post-exposure prophylaxis were identified in an age range of 2 to 15 years old, eight within the last two years, and all were imported from endemic countries: Angola, Indonesia, Brazil and China. Nine cases were minor contacts. Transmission occurred through dogs (n = 6), monkeys (n = 3) and bat (n = 1). A five-dose regimen vaccination was proposed in nine and a four-dose in one case; 70% completed the schedule (minimum number of doses = 4). The mean interval between exposure and immunization was 3 days (median = 1). One cutaneous reaction was documented but no serious reactions occurred.

Discussion: In a period of 42 months, we had an average of 2.9 cases per year of children with potential rabies exposure in endemic countries. Early prophylaxis was administered to this cohort with no significant adverse effects.