[A public health intervention at the time of a case of rabies in Quebec].

BACKGROUND

In the fall of 2000, a nine-year-old child living in Montreal (Québec) died of rabies encephalitis. Cases of human rabies had not been reported in Canada for 15 years. The molecular characterization of viral nucleic acid implicated the Ln/Ps variant associated with the silver-haired bat and the eastern pipistrelle. This article describes and analyzes the intervention carried out by public health.

INTERVENTION AND DISCUSSION

The investigation revealed that contact with the bat must have occurred while the child was sleeping. Following the search for close contacts of the reference case, rabies postexposure prophylaxis (RPEP) was recommended to 59 people (3 household contacts, 12 playmates and 44 health care workers). Discussion with other public health departments in the province was important because of the media coverage of this case, which led to a considerable increase in the number of reported exposures to bats and in RPEP administration.

CONCLUSION

Lessons learned from this event are that rapid and coordinated action with all stakeholders is essential to the success of this type of public health intervention and that the population must be informed of the risk of rabies transmission from bats.