• Journal of Preventive Medicine and Public Health
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• v.50 no.3
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• pp.210-216
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• 2017

Objectives: One way to prevent deaths due to rabies is the timely utilization of post-exposure prophylaxis (PEP). Therefore, in addition to an understanding of the epidemiological distribution of animal bites, it is necessary to explore the factors leading to delays in PEP initiation. Methods: This cross-sectional study was conducted in Iran in 2011, and included 7097 cases of animal bites recorded at the Rabies Treatment Center of the Shiraz University of Medical Sciences using the census method. Logistic regression was used to identify factors associated with delays in PEP. Results: Among the patients studied, 5387 (75.9%) were males. The prevalence of animal bites in Fars province was 154.4 per 100 000 people. Dogs were the most frequent source of exposure (67.1%), and the most common bitten part of the body was the hands (45.5%). A delay in the initiation of PEP was found among 6.8% of the studied subjects. This delay was more likely in housewives (odds ratio [OR], 4.66; 95% confidence interval [CI], 2.12 to 10.23) and less likely in people with deep wounds (OR, 0.65; 95% CI, 0.43 to 0.97). Conclusions: Although all animal bite victims received complete PEP, in some cases, there were delays. Further, the type of animal involved, the depth of the bite, and the patient's occupation were the major factors associated with a delay in the initiation of PEP for rabies prevention.

• Microbiology and Biotechnology Letters
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• v.46 no.3
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• pp.269-276
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• 2018

Rabies virus (RABV)-specific antibodies in animals and humans are measured using standard methods such as fluorescent antibody virus neutralization (FAVN) tests and rapid fluorescent focus inhibition tests, which are based on cell culture systems. An alternative assay that is safe and easy to perform is required for rapid sero-surveillance following mass vaccination of animals. Two purified monoclonal antibodies (4G36 and B2H17) against RABV were selected as capture and detection antibodies, respectively. A genetically modified RABV, the ERAGS strain, was propagated and concentrated by polyethylene glycol precipitation. Optimal conditions for the RABV antigen, antibodies, and serum dilution for a blocking enzymelinked immune sorbent assay (B-ELISA) were established. We evaluated the sensitivity, specificity, and accuracy of the B-ELISA using serum samples from 138 dogs, 71 raccoon dogs, and 25 cats. The B-ELISA showed a diagnostic sensitivity of 95.8-96.3%, specificity of 91.3-100%, and accuracy of 96.0-97.2% compared to the FAVN test. These results suggest that the B-ELISA is useful for sero-surveillance of RABV in dogs, raccoon dogs, and cats.

• Journal of Preventive Medicine and Public Health
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• v.52 no.3
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• pp.170-178
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• 2019

Objectives: To determine the epidemiological features of patients and animals after bites/scratches from rabies-suspected animals in Zenica-Doboj Canton, Bosnia and Herzegovina. Methods: Data from all patients (and the causative animals) admitted to the Antirabies Service of the Institute for Health and Food Safety Zenica in the 2009-2017 period were analyzed, including age, sex, anatomical site of the bite/scratch, animal type (stray/owned/wildlife), veterinary observations of the animal, and whether antirabies post-exposure prophylaxis (PEP) was indicated and/or administered. Results: In total, 1716 patients were admitted. Bites/scratches were most frequently recorded during April and May (n=181, 10.5% and n=163, 9.5%, respectively). The persons admitted were mostly from the Zenica municipality (n=1278, 74.5%; incidence: 11.55/1000), which is 66.6% urbanized. Males were more frequently represented (n=1089, 63.6%). The patients were mostly 50-64 and 25-49 years of age (n=425, 24.7% and n=390, 22.7%, respectively). Dog bites were the most common cause (n=1634, 95.1%, of which n=1258, 77.0% were caused by stray dogs). PEP was indicated for 997 (58.1%) patients. Only 340 (19.9%) animals underwent veterinary observations (3.1% of stray and 76.1% of owned animals). The largest number of injuries were presented at lower extremities, 1044 (60.8%) cases. Conclusions: Zenica-Doboj Canton is a rabies-free region. Due to the high rate of stray animals not undergoing veterinary observations, the non-existence of a unique dog registry, and the consequent lack of information about stray animals in terms of number, vaccination, neutering, and euthanasia, there is an urgent need for improving the prevention and control of rabies within the One Health framework.

• Korean Medical Education Review
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• v.18 no.2
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• pp.58-64
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• 2016

The birth of the scientific revolution, brought forth by Vesalius and Copernicus in 1543, marked the beginning of a new age. However, the changes such as treatment effectiveness, survival rate, prevalence of specific diseases, etc. had not yet become clear during the 16th century. In the early 17th century, Boerhaave emphasized bedside teaching and practice. His attitude influenced numerous students and educators, so many medical students visited hospital wards where he worked. From the late 18th to 19th centuries, Jenner's smallpox vaccination, Pasteur's anthrax and rabies vaccinations, and Koch's four postulates used to detect pathogens were developed using the scientific research method, which initiated big changes for medicine. Flexner, credited for reporting the new medical education system, adopted scientific medicine. He believed medical students must study basic medical science since it could be the foundation of clinical medicine and lead to a revolution in the field. He proposed a new medical curriculum composed of two-years of basic medicine and two-years of clinical medicine, which has been used more than 100 years. During the late 20th century, bedside teaching rounds decreased gradually as scientific medicine has become popular. Many medical educators in many articles have proposed bedside education as an effective method for medical learning. Despite the advent of the age of artificial intelligence and the changing of medical environments in the near future, bedside education will be more useful and important for medical students, educators, and patients as it is a traditional method and essential for patients who desire a more personal approach.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.540-563
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• 1998

This Study has been carried out to make a recommendation for the next amendment of the Infectious Disease Prevention Act with a specific focus on the kind of notifyable disease. Korean, Japanese, German, U.S, English and French acts on infectious diseases prevention were reviewed, compared with and analized in regards of numbers and kinds of notifyable infectious diseases and their tendency of amendments. An criteria was designed to assess the level of validity of diseases to be designated in the act. Four items, the fatality (greater than 10% or not), the possibility to make a big epidemic, the availability of efficient vaccination and the usefulness of isolation, are used in the assessment. This index is applied to the diseases in Korean and other countries' Infectious Disease Prevention Acts. Results are as follows: 1. The Korean Infectious Disease Preventon Act has a unique way of classifying the notifyable infectious disease, that is, the first, the second and the third class. But the author cannot find the basis of classification. No other countries reviewed have the similar classification. 2. The ten diseases, cholera, plague, yellow fever, diphtheria, typhoid fever, poliomyelitis, rabies, tetanus, malaria, and meningococcal meningitis are designated as the notifyable diseases not only in Korea but also in Japan, Germany, United States, England and france. 3. Thirty seven diseases including small pox, Lassa fever, anthrax, influenza, German measles, Legionellosis, infection with E. coli O157:H7, Q-fever, brucellosis, Lyme disease are designated as legal disease at least one of the above mentioned countries. 4. The Korea has been coped with the change of the infectious disease occurrence for last fifty years in amendment of the Infectious Disease Prevention Act. 5. Japan has a special infectious surveillance system composed of 3,880 clinics throughout the whole country. 6. Germany has classified infectious diseases in five categories which are based on seriousness of disease. Any confirmed death, cases and suspected cases in class I should be reported within 24 hours. But only confirmed death and cases in class II, but not suspected cases, are reportable in Germarny. 7. Plague, bacillary dysentery, pertussis, mumps, Japanese encephaltis and Korean hemorrhagic fevers are diseases with high credits validity index among Korean legal disease. 8. German measles, anthrax, E. coli O157 : H7 infection, Lassa fever, Q-fever, brucellosis are high in validity index among those which are not designated in Korea but designated in other countries. In conclusion, the Korean Infectious Disease Prevention Act has well been coped with the changes of infectious disease occurrence for last fifty years, but the classification basis and the validity of diseases to be designated as legal diseases is worth reevaluating.