STUDY OF HUMAN INJURIES FROM ANIMALS AND PREVENTIVE MEASURES TO PROTECT AGAINST RABIES IN THE DOBRICH REGION FOR 2015-2021

Abstract

Rabies is one of the oldest and most dangerous diseases in human history. Rabies is a viral zoonosis still prevalent on the European continent that remains a significant public health threat affecting mammals and humans. In modern conditions, it is spread by injuries (bites and scalds) from animals. The aim of the study was to investigate the registered persons who suffered injuries from wild and domestic animals, their severity and the relative proportion of administered anti-rabies immunization (extreme prophylaxis with vaccine) in the settlements of the municipalities in the Dobrich region for the period 2015 - 2021. We used journals, rapid notifications and epidemiological survey cards from the Regional Health Inspectorate - Dobrich of persons with injuries from domestic and wild animals. The data were obtained from the existing rabies clinics for the application of post-exposure prophylaxis against rabies, reports and analyses of the Regional Health Inspectorate - Dobrich, the Ministry of Health of the Republic of Bulgaria, the National Center for Infectious and Parasitic Diseases - Sofia, the National System for Control and Prevention of Rabies post-exposure prophylaxis. The methods used are partial epidemiological analysis, descriptive, documentary and statistical methods. The results were processed with the mathematical and statistical package SPSS v. 20.
The injuries of 839 persons injured by domestic and wild animals on the territory of Dobrich district were traced. Of these, 230 were immunized with the rabies vaccine Verorab. We analyzed the main epidemiological indicators by settlements, sex, age, occupation, place of infection. The results of the study show that the injuries have an upward trend from 108 cases (2015) to 178 (2019). All 8 municipalities in the district are affected: Dobrich, Dobrichka, Balchik, Kavarna, Shabla, Tervel, Gen. Toshevo, Krushari. The leading municipality is Dobrich - 40.52%, followed by Kavarna - 19.3% and third is Dobrichka Municipality. Injuries caused by dogs have the highest relative share, 66.89% of them - wandering and 23.98% - domestic. With emergency prophylaxis 27,41% of injured persons and 72,58% were non-immunized. The conclusions we drew show a predominance of affecting and respectively immunizing urban residents - twice as many: 73.05% compared to 26.94% in rural regions.
There is good organization, cooperation and coordination in the activities of institutions - regional health inspectorates, treatment network and state veterinary and sanitary control. In one-third of patients, a timely vaccine was administered on the first day after the incident. There is a need to increase health awareness and public responsibility to reduce the stray dog population. Finding an effective model for solving the problem implies a thorough analysis of the results of the methods applied so far and a study of the world's successful experience and practice.