Postgraduate Program in Technology, Environment and Society, Federal University of the Jequitinhonha e Mucuri Valleys, Teófilo Otoni, MG, Brazil.
Special Indigenous Health District of Minas Gerais and Espírito Santo, Ministry of Health, Governador Valadares, MG, Brazil.
Infect Dis Poverty. 2023 Aug 24;12(1):78. doi: 10.1186/s40249-023-01130-y.
Human rabies outbreak transmitted by bats continues to be a relevant public health problem not only in the Amazon region. The disease has affected one of the areas with the greatest poverty in southeastern Brazil, a region inhabited by the Maxakali indigenous people.
We describe four cases of rabies among indigenous children that occurred in the indigenous village of Pradinho, municipality of Bertópolis, Minas Gerais, Brazil. Cases were notified between April and May 2022, all of whom died on average eight days after the first symptoms. All cases were observed in rural residents under 12 years of age. The probable form of exposure was through bat bites. The predominant symptoms were prostration, fever, dyspnea, sialorrhea, tachycardia, and altered level of consciousness. Half of the cases underwent late and/or incomplete post-exposure rabies prophylaxis, however, the other half underwent pre-exposure rabies prophylaxis, with only one case completing the scheme and another undergoing the adapted Milwaukee Protocol (Recife Protocol). All cases ended in death.
This was the first rabies outbreak among indigenous people in Brazil. Among the manifested clinical forms in the series, there was a disease atypical presentation in at least one case. We suggest active surveillance and an intercultural educational campaign to prevent new cases.
由蝙蝠传播的人类狂犬病爆发不仅在亚马逊地区仍然是一个相关的公共卫生问题。该疾病已经影响到巴西东南部一个贫困程度最高的地区，该地区居住着马克萨斯卡利土著人民。
我们描述了巴西米纳斯吉拉斯州贝尔托波利斯市普拉迪尼奥土著村的四起土著儿童狂犬病病例。病例于 2022 年 4 月至 5 月期间报告，所有患者平均在出现第一症状后八天死亡。所有病例均观察到农村居民在 12 岁以下。可能的暴露形式是被蝙蝠咬伤。主要症状有乏力、发热、呼吸困难、流涎、心动过速和意识水平改变。一半的病例接受了晚期和/或不完全的暴露后狂犬病预防，然而，另一半病例接受了暴露前狂犬病预防，只有一例完成了方案，另一例接受了改良的密尔沃基方案（累西腓方案）。所有病例均死亡。
这是巴西首例土著人狂犬病爆发。在该系列中表现出的临床形式中，至少有一例表现出不典型的疾病。我们建议进行主动监测和跨文化教育活动，以防止新的病例发生。
