Epidemiology of human rabies post-exposure prophylaxis in Bangkok, 1984-1986.

A study was conducted to determine the current situation of human rabies post-exposure prophylaxis (PEP) in Bangkok for the period 1984-1986. A review of all Bangkok residents receiving PEP at the Queen Saovabha Memorial Institute revealed an increasing incidence rate of PEP from 10.1 cases per 10,000 persons in 1984 to 12.6 cases per 10,000 persons in 1986. The highest incidence rate was observed in young males aged 5-14 years. About 68% of individuals receiving PEP had exposures to bites, especially by dogs, and nearly 30% of PEP cases were due to non-bite exposures. Dogs were responsible for 90% of PEP cases, of which 59% were exposed to stray dogs. Exposure to domestic dogs and cats constituted about 36% of PEP. Approximately 55% of persons received PEP for exposures to animal sources not proven rabid. To reduce the number of PEP, the programme should be directed towards the swift reduction of susceptible animals, which can be achieved by effective elimination of stray dogs and immunization of domestic dogs and cats. Massive health education to the public emphasizing the importance of prevention and control of rabies should be undertaken. The programme for control of rabies can be effective if there is an increased awareness and cooperation among professional people, health personnel, and other people in the community.