Ouch! A cross‐sectional study investigating self‐reported human exposure to dog bites in rural and urban households in southern Ontario,Canada

This study investigated self‐reported dog bites in humans in rural and urban households in southern Ontario, Canada. Our objectives were to determine, and compare, the incidence of dog bites in rural and urban households, and to describe the profile of bite victims, biting dogs, and the proportion of biting dogs that respondents self‐reported as being not up to date on rabies vaccination. We conducted a cross‐sectional observational study using an online questionnaire. The 2,006 respondents, each representing one household, included 1,002 rural and 1,004 urban residences. The incidence risk of at least one person in the household being bitten over the previous year in rural households (6.09% per year) was less than in urban households (10.76% per year). In 53.20% of households from which at least one person had been bitten within the past year, only a single person had been bitten. Mostly, victims were 25 to 34 years old (21.67%), male (54.19%), and playing with or interacting with the biting dog at the time of the incident (59.11%). Most biting dogs were 3 to 5 years old (32.02%), males (53.69%), and unleashed (76.85%). Based on self‐reporting by respondents, 83.33% of respondent‐owned biting dogs were vaccinated against rabies at the time of the biting incident. Irrespective of dog ownership, the odds of an individual in a rural household being bitten by a dog were 0.53 (95% CI: 0.38–0.73) the odds for an individual in an urban household. Dog bites constitute a serious, yet preventable, public health concern that requires targeted, community‐specific efforts. Public health organizations could consider findings in developing messaging, particularly as we highlight biting dogs reported by their owners as not up to date on rabies vaccination.     

The experience of dog bites: a survey of veterinary science and veterinary nursing students

AIM: To investigate the circumstances of dogs biting people in New Zealand. METHODS: Veterinary science and veterinary nursing students enrolled at Massey University in 2003 completed a questionnaire detailing their lifetime experience of dog bites and their opinions of dog control legislation. RESULTS: The response rate was 100%. There were 228 completed responses to the survey, and 87 (38%) respondents had been bitten by a dog. Most bites caused minor injury, but 17 (20%) required medical attention. Male respondents were more likely to have been bitten. The highest proportion of respondents (27; 31%) had been bitten while between 6 and 10 years of age, and the hand was the part of the body most often injured. Eighteen (21%) bites involved a stranger's dog, but most bites were by a dog known to the victim. Respondents from rural areas were three times more likely to have been bitten than city dwellers. The victim's home was the place where most (31; 36%) bites occurred. Male dogs were responsible for a larger proportion of bites (38; 44%) than females (24; 28%); respondents were unsure about the sex of the remainder of the dogs (25; 29%) that bit them. Protecting the home, play, accidents, rough handling and pain were identified as the common reasons for dogs to bite. Most (46; 52%) respondents did not believe legislation could have prevented their bite. Only four (5%) bites were reported to authorities. CONCLUSION: Rural dwellers, people with more experience of dogs, children <11 years of age, and male respondents were bitten by dogs most often. Only legislation relating to the fencing of dog owners' properties may have prevented a reasonable proportion (25; 29%) of the bites reported here.     

The experience of dog bites: A survey of veterinary science and veterinary nursing students

AIM: To investigate the circumstances of dogs biting people in New Zealand.

METHODS: Veterinary science and veterinary nursing students enrolled at Massey University in 2003 completed a questionnaire detailing their lifetime experience of dog bites and their opinions of dog control legislation.

RESULTS: The response rate was 100%. There were 228 completed responses to the survey, and 87 (38%) respondents had been bitten by a dog. Most bites caused minor injury, but 17 (20%) required medical attention. Male respondents were more likely to have been bitten. The highest proportion of respondents (27; 31%) had been bitten while between 6 and 10 years of age, and the hand was the part of the body most often injured. Eighteen (21%) bites involved a stranger's dog, but most bites were by a dog known to the victim. Respondents from rural areas were three times more likely to have been bitten than city dwellers. The victim's home was the place where most (31; 36%) bites occurred. Male dogs were responsible for a larger proportion of bites (38; 44%) than females (24; 28%); respondents were unsure about the sex of the remainder of the dogs (25; 29%) that bit them. Protecting the home, play, accidents, rough handling and pain were identified as the common reasons for dogs to bite. Most (46; 52%) respondents did not believe legislation could have prevented their bite. Only four (5%) bites were reported to authorities.

CONCLUSION: Rural dwellers, people with more experience of dogs, children <11 years of age, and male respondents were bitten by dogs most often. Only legislation relating to the fencing of dog owners′ properties may have prevented a reasonable proportion (25; 29%) of the bites reported here.     

Vaccination coverage and epidemiological parameters of the owned-dog population in Thungsong District, Thailand

Canine rabies vaccination is delivered in Thungsong District, Thailand, as an annual campaign between March 1 and 31, and also at other times through private veterinary clinics, para-veterinarians and health-care staff residing in the villages. The current questionnaire-interview survey was conducted between June 23 and July 18, 2002 to determine: rabies-vaccination coverage amongst the owned-dog population; basic dog-population information; and community awareness about rabies. The modified expand programme on immunization cluster-survey method was used to collect information about dog demography and management characteristics. Household knowledge about rabies and sources of rabies information were assessed. Vaccinated dogs were identified from vaccine certificates or owner reports confirmed by vaccinators. Seventy percent (95%CI 62-78) of 364 eligible owned dogs were vaccinated within the 6 months prior to data collection. Of these 255 vaccinated dogs, 44, 21, 13, 17 and 5% were vaccinated through the annual vaccination campaign, veterinary clinics, para-veterinarians, other vaccinators and owners, respectively. Fifty-four percent of households owned dogs. The sex ratio in dogs was 2 males per female; the dog: human ratio was 1: 4.6 with an average of 0.9 dogs per household (1.7 dogs per dog-owning household). Most dogs roamed freely and these were less likely to be vaccinated compared to dogs being kept on premises or on a leash. Almost all households were aware of rabies and the need for dog rabies vaccination as a control method. Seventy-six percent believed that rabies only occurred in summer. There was little awareness about cat rabies amongst households. Vaccination coverage in the total dog population clearly has not yet reached the 80% target level set by Thailand's official rabies-control programme. Improved effectiveness of the owned-dog rabies-vaccination campaigns in each community is needed-perhaps by more community education about dog management or by better management of ownerless dogs.     

Evaluating the contact rate between companion dogs during dog walking and the practices towards potential cases of rabies among dog owners in Japan

This study aimed to examine the habits of dog walking in Japan using an internet survey of insured dog owners. About 96.4% of the respondents (n = 1,151) reported that they would take their dogs for a walk and they most frequently walk their dogs once or twice a day (75.9%) for 30 min to 1 hr (83.1%). The probability of a companion dog having contact with other dogs during dog walking was estimated to be 0.83 (95% confidence interval [CI]: 0.81–0.85), and the associated daily contact rate was estimated using log‐normal distribution with a mean of 2.73 (95% CI: 2.42–3.11) and a standard deviation (SD) of 6.39 (95% CI: 5.18–7.84). Multiple linear regression revealed that the contact rate is mainly influenced by the social behaviour of the owner and to a lesser degree by his/her demographic characteristics including the area of residence, the breed size of dog and the age of the owner. In addition, ten Likert items measured on a 5‐point scale were designed to assess the practices towards potential cases of rabies among dog owners. The respondents (n = 972) achieved a mean score of 2.99 (out of a full score of 4) with a SD of 0.90 in responding to situations related to dog bite incidents and injury from stray cat scratches during dog walking. They achieved a higher score in responding to situations related to sighting a stray or wild animal during dog walking and situations related to non‐specific clinical signs of rabies and bite injuries from stray dogs or wild animals during dog walking with a mean of 3.70 (SD = 0.58) and 3.84 (SD = 0.34), respectively. The level of best practice was also proved to be significantly associated with the demographic characteristics of the dog owner.     

Rabies-vaccination coverage and profiles of the owned-dog population in Santa Cruz de la Sierra, Bolivia

The Bolivian government issued a regulation for rabies control in November 2005, owing to increasing the prevalence of dog and human rabies cases in recent years. An assessment of rabies-vaccination coverage and other factors that might influence the success of the on-going vaccination campaign was needed. The objective of this study was to investigate dog rabies vaccination coverage and risk factors associated with dogs being unvaccinated against rabies, and profiles of the owned-dog population in Santa Cruz de la Sierra, Bolivia, where dog rabies was endemic. Mainly due to logistical reasons, the WHO's expanded programme on immunization cluster-survey method was used. The 390 households were included in the study. Information about dog population and management characteristics was obtained for 542 dogs from 301 households. On average, households had 1.4 dogs and 1.8 dogs per dog-owning household (median = 1). The human-to-dog ratio was 4.6 : 1. During the last 1 year prior to the study, of the 539 dogs aged >or=1 month, 463 (85%; 95% CI 79-91; design effect 3.6) were classified as vaccinated. Amongst the study dogs, dogs aged 1-11 months were the higher risk of dogs not being vaccinated (OR = 8.2; 95% CI 4.3-15.6; P < 0.01). Almost two-thirds of the study dogs were allowed to roam freely throughout the day or in part. Community education efforts should address the importance of dog ownership and movement restriction, and the need to vaccinate young dogs.     

Factors affecting the success of rehoming dogs in the UK during 2005

In the UK, welfare organisations care for several thousand dogs each year. The successful rehoming of these dogs is a difficult process resulting in some of them being returned to rehoming centres. There have been very few studies examining the underlying mechanisms in the UK. Therefore, this study was conducted to determine those factors which affect the success of rehoming dogs.A prospective cohort study was conducted using a sample of 5750 dogs rehomed by Dogs Trust, a UK based dog welfare charity, during 2005. Dogs were followed up for a period of 6 months after adoption to determine if these dogs were still in their placement home. There was a 78% response rate to the follow-up postal questionnaires sent to the new owners, giving information on 4500 owners. Fourteen percent of adoptions failed. The results showed that behavioural problems are an important factor in the success of adoption such that if dogs had shown aggression towards people and the owners had not sought advice, they had 11.1 times the odds (95% CI: 6.6, 18.8) of being returned compared to those dogs without behavioural problems. Attending training classes significantly decreased the chance that the adoption would be unsuccessful (OR 0.3, 95% CI: 0.2, 0.4). It was shown that those owners who found that the effort and work involved in looking after their dog to be more than they had expected, had 9.9 (95% CI: 4.1, 24.6) times the odds of returning their dog than those who found the effort required to be less than they had expected.The results of this study show that there are many factors involved in a successful adoption and it is important that the new owners are informed of what to expect are encouraged to attend training classes and are prepared to work at any behavioural problems that their dog may have.     

遵义市犬钩端螺旋体流行病学调查与分析

为了了解遵义市犬钩端螺旋体病流行情况以及人群对钩端螺旋体病的预防意识,采用犬钩端螺旋体抗体ELISA试剂盒对遵义市320份犬血清样品进行钩端螺旋体血清流行病学调查,并通过网络问卷调查对遵义市646名大学生开展有关钩端螺旋体病的社会调查。血清学试验结果显示,犬钩端螺旋体的总阳性率为5.00%(16/320),犬钩端螺旋体病感染在来源、年龄与性别上差异无显著统计学意义(P>0.05);问卷调查结果中33.13%(214/646)的受访者认为钩端螺旋体病能通过动物传染给人,有45.67%(295/646)的受访者曾经被犬抓伤或者咬伤过,56.35%(364/646)的受访者认为被犬咬伤或抓伤后应立即采用肥皂水或清水彻底冲洗伤口。研究表明遵义市犬钩端螺旋体阳性率较高,并且人群对钩端螺旋体病防范意识不足,存在较大的流行风险。     

Survey of Saskatchewan beef cattle producers regarding management practices and veterinary service usage

Saskatchewan cow-calf producers (n = 2000) were surveyed to determine what factors were associated with their uptake of veterinary services; how and where they access nutritional information and animal health advice; and whether they were comfortable with having non-veterinarians perform veterinary procedures. The survey response rate was 18.1%. Veterinarians were seen as a primary source of nutritional information and animal health advice. Over the past decade producers have shifted their veterinary service usage from individual animal events to herd-level procedures. Producers who pregnancy check were more likely to be large producers (OR = 1.9; 95% CI = 1.2 to 3.1; P = 0.007), to semen test their bulls (OR = 3.4; 95% CI = 2.0 to 5.8: P < 0.001), analyze their forages (OR = 2.3; 95% CI = 1.7 to 4.0; P = 0.006), and to farm in the brown versus the gray or dark brown soil zones (P = 0.004). Most (94.0%) respondents had adequate veterinary services within an hour’s drive of the farm and 90.4% were satisfied with their veterinary service provider. Approximately 25% of respondents would be comfortable with having a non-veterinarian pregnancy check and attend to prolapses.     

Determinants of health seeking behaviour following rabies exposure in Ethiopia

The objective of this study was to identify factors that determine medical treatment seeking behaviour following potential rabies exposure after being bitten by a suspected dog and the likelihood of compliance to receive sufficient doses of post‐exposure prophylaxis after the visit to a health centre visit. A detailed survey based on case investigation was conducted on suspected rabid dog bite cases in three areas of Ethiopia. Two multivariable logistic regression models were created with a set of putative variables to explain treatment seeking and compliance outcomes. Based on the registered bite cases at each health centre and the set of unregistered bite cases derived by contact tracing, 655 bite victim cases were identified to have occurred between September 2013 and August 2014. Of these evaluated bite incidences, 465 cases were considered to have been caused by a potentially rabid dog. About 77% of these suspected rabid dog bite victims visited a health centre, while 57% received sufficient doses of PEP. The overall likelihood of seeking medical services following rabies exposure was higher for people bitten by dogs of unknown ownership, where the bite was severe, being bitten on the leg, spend of more than 100 USD per month and where the victim lived close to the nearest health centre, while the likelihood of receiving sufficient doses of PEP was sensitive to monthly spending and distance to health centre. However, the evaluated factors did only explain a part of the variation among the three districts. The district in which victims lived appeared to have a relevant influence on the likelihood of seeking medical treatment but did not improve the prediction on the likelihood of treatment compliance. Given the insights obtained from this study, improvements in the rural districts with regard to accessibility of post‐exposure prophylaxis delivering health centres in shorter distance could improve health seeking behaviour. In addition, in rural districts, majority of exposed persons who seek medical treatment tend to comply with treatment regimen, indicating that the promotion of medical treatment through awareness creation campaigns could be beneficial.     

Factors Associated with Dog Rabies Vaccination in Bhol,Philippines: Results of a Cross‐Sectional Cluster Survey Conducted Following the Island‐Wide Rabies Elimination Campaign

The Philippines has a long history of rabies control efforts in their dog populations; however, long‐term success of such programmes and the goal of rabies elimination have not yet been realized. The Bohol Rabies Prevention and Elimination Program was developed as an innovative approach to canine rabies control in 2007. The objective of this study was to assess canine rabies vaccination coverage in the owned‐dog population in Bohol and to describe factors associated with rabies vaccination 2 years after implementation of the programme. We utilized a cross‐sectional cluster survey based on the World Health Organization’s Expanded Programme on Immunization coverage survey technique. We sampled 460 households and collected data on 539 dogs residing within these households. Seventy‐seven per cent of surveyed households reported owning at least one dog. The human‐to‐dog ratio was approximately 4 : 1, and the mean number of dogs owned per household was 1.6. Based on this ratio, we calculated an owned‐dog population of almost 300 000. Overall, 71% of dogs were reported as having been vaccinated for rabies at some time in their lives; however, only 64% of dogs were reported as having been recently vaccinated. Dogs in our study were young (median age = 24 months). The odds of vaccination increased with increasing age. Dogs aged 12–23 months had 4.6 times the odds of vaccination compared to dogs aged 3–11 months (95% CI 1.8–12.0; P = 0.002). Confinement of the dog both day and night was also associated with increased odds of vaccination (OR = 2.1; 95% CI 0.9–4.9; P = 0.07), and this result approached statistical significance. While the programme is on track to meet its goal of 80% vaccination coverage, educational efforts should focus on the need to confine dogs and vaccinate young dogs.     

Antibody response to an anti-rabies vaccine in a dog population under field conditions in Bolivia

Rabies remains an important public health issue in Bolivia, South America. Public concern and fears are most focussed on dogs as the source of rabies. The objective of the present study was to assess immunity of an inactivated suckling mouse brain vaccine against canine rabies used for the official vaccination campaigns under field conditions in an endemic area of rabies in Bolivia. A total of 236 vaccinated and 44 unvaccinated dogs in Santa Cruz de la Sierra, selected using stratified random sampling, were investigated in order to obtain owned dog characteristics and antibody titres against rabies in April 2007. The proportion of vaccinated dogs with an antibody titre exceeded the protection threshold value of 0.5 EU/ml was 58% [95% confidence intervals (CI): 52-65], indicating that vaccination is likely to elicit an antibody response (odds ratio 6.3, 95% CI: 1.2-11.5). The range of geometric mean of antibody titre for vaccinated dogs (0.89 EU/ml; 95% CI: 0.75-1.04) was considered to meet the minimal acceptable level indicating an adequate immune response to the vaccine. However, the titre level was not satisfactory in comparison with the results from other field investigations with inactivated tissue culture vaccines. It is recommended for public health authorities to (1) consider modernizing their vaccine manufacturing method because the level of immunity induced by the current vaccine is comparably low, (2) conduct frequent vaccination campaigns to maintain high levels of vaccination coverage, and (3) actively manage the domestic dog population in the study area, which is largely responsible for rabies maintenance.     

Evaluation of risk factors for bite wounds inflicted on caregivers by dogs and cats in a veterinary teaching hospital

OBJECTIVE: To identify factors associated with increased risk of being bitten by a dog or cat in a veterinary teaching hospital. DESIGN: Unmatched case-control study. STUDY POPULATION: 207 animal caregivers. PROCEDURE: Case subjects (n = 75) were any caregiver that reported being bitten by a dog or cat. Control subjects (n = 132) were randomly selected from a list of all caregivers interacting with dogs or cats. Information on the characteristics of the caregivers, characteristics of the dogs and cats, and the nature of the interaction between the dog or cat and the caregiver was obtained by use of self-administered questionnaires. RESULTS: Caregivers were more likely to be bitten by dogs or cats that had warning signs on their cages indicating the potential to bite or that were considered difficult to handle. Caregivers interacting with cats or with older dogs and cats were more likely to be bitten. Only 37 to 55% of dogs and cats that had characteristics traditionally associated with biting or were considered likely to bite were muzzled. CONCLUSIONS AND CLINICAL RELEVANCE: Muzzling dogs and cats should be considered more frequently. Dogs and cats considered to have the propensity to bite frequently do bite, and precautions, such as muzzling, should be taken if the medical condition or conformation of the dog or cat is amenable to this type of restraint.     

A baiting system suitable for the delivery of oral rabies vaccine to dog populations in Zimbabwe

A baiting system suitable for the delivery of oral rabies vaccine to dog populations in developing countries was studied in Zimbabwe. In a field trial, 369 sponge baits containing a placebo liquid, rhodamine B as a biomarker and a pungent attractant were distributed over an area of 60 sq km in a communal land in Manicaland with a dog population of over 500. Twenty-four hours later 21 per cent of the baits were recovered and 79 per cent of these had been significantly bitten or chewed. Twenty-five per cent of the dogs examined showed evidence of superficial staining by rhodamine B indicating that they had chewed baits or ingested their contents. It was concluded that the system would deliver an oral vaccine to dog populations more efficiently than had been the case in comparable studies in wildlife populations, but that the number of baits per unit area should in future studies be increased.     

Rabies status in Zambia for the period 1985-2004

Rabies has been present in Zambia since the early years of the 20th century. It is a significant public health problem in Zambia. Domestic dogs accounted for 69.7% (1348/1935) of the samples received for rabies diagnosis for the period 1985-2004. Of the 1069 positive cases confirmed by the fluorescent antibody test, 747 (69.9%) were from domestic dogs, 139 (13.0%) from cattle and 98 (9.2%) from humans. Wildlife samples accounted for 4.5% (87/1935) of the samples tested with the jackal (Canis adustus) being the predominant species. Cases of rabies were highest in Lusaka Province followed by the Copperbelt, Southern and Central Provinces. The monthly distribution of canine rabies showed an average of 2.93 (95% CI 2.59-3.29) dog positive cases per month. The study confirms that rabies is endemic in Zambia and that the domestic dog is the principal maintenance host. The epidemiology and control measures currently used in Zambia are herein discussed highlighting their limitations and successes. Based on the findings obtained from this study we advocate for strengthening the delivery of public health services and that steps must taken to reduce the incidence of rabies in Zambia.     

Free‐Roaming Dogs in Nepal: Demographics,Health and Public Knowledge,Attitudes and Practices

In Nepal, most dogs are free to roam and may transmit diseases to humans and animals. These dogs often suffer from malnutrition and lack basic health care. Minimal information is available about their demographics and about public attitudes concerning dogs and diseases. We carried out a study in Chitwan District (central Nepal), to collect baseline data on free‐roaming owned dog demographics, assess knowledge, attitudes and practices of dog owners concerning dogs and rabies, evaluate rabies vaccination coverage and anthelmintic treatment of dogs, measure dogs' response to rabies vaccination and assess dog health through body condition scores and parasites. We conducted household interviews with owners of free‐roaming female dogs (n = 60) and administered dogs with rabies vaccination and anthelmintics. Dog owners regularly fed free‐roaming dogs but provided minimal health care; 42% of respondents did not claim ownership of the dog for which they provided care. We collected skin, faecal and blood samples for parasite identification and for measuring rabies virus‐specific antibodies. Ninety‐two per cent of dog owners were aware of the routes of rabies virus transmission, but only 35% described the correct post‐exposure prophylaxis (PEP) following a dog bite. Twenty‐seven per cent of the dogs had measurable rabies virus‐specific antibody titres and 14% had received anthelmintics in the previous year. Following rabies vaccination, 97% of dogs maintained an adequate antibody titre for ≥6 months. Most dogs appeared healthy, although haemoprotozoans, endoparasites and ectoparasites were identified in 12%, 73% and 40% of the dogs, respectively. Poor skin condition and parasite load were associated. Seventy‐four per cent of the females had litters in 1 year (mean litter size = 4.5). Births occurred between September and February; we estimated 60% mortality in puppies. We concluded that vaccination coverage, PEP awareness and anthelmintic treatment should be emphasized in educational programmes focussed on animal welfare, veterinary and public health.     

Avoiding bites and scratches? Understanding the public health implication of human–bat interactions in Ghana

Zoonotic pathogens cause an estimated 70% of emerging and re‐emerging infectious diseases in humans, affecting various aspects of human development on a global scale. The significance of bats as a source of emerging infectious diseases is being progressively appreciated. This study was undertaken post‐Ebola virus disease in West Africa and assessed the public health implications of human–bat interactions by exploring the reasons for contact between humans and bats, as well as reported actions taken upon experiencing bat bites or scratches. The paper highlights the nuances of human–bat interactions, stressing zoonotic disease risk awareness as well as the sources of information. The study used questionnaires to solicit information from 788 respondents in five communities with significant bat populations. We show that bat consumption was one of the main reasons for human–bat interactions. More men across the various communities ate bat meat. Only a small number of respondents (4.4%) reported being bitten by a bat, and 6.1% had been scratched by a bat. More than 21% had come into direct contact with bat blood. An even lower number went to the hospital after been bitten or scratched by bats. There was little knowledge on post‐exposure management. The most common places human–bat interactions occurred were at home and on farms. Seventy‐three per cent of the respondents believed that bats carried diseases, with Ebola virus disease being the most mentioned. Respondents indicated that the way they interacted with bats had not changed, even though they believed bats carried diseases and 46% stated that they had not changed the way they interacted with bats over the last two years. Apart from providing information on avoiding bites and scratches, a more holistic framework is needed to reduce human–bat interactions. The paper recommends a comprehensive and coordinated approach to optimizing an effective response to a potential bat‐borne zoonotic disease spillover.     

Challenges to human rabies elimination highlighted following a rabies outbreak in bovines and a human in Punjab,India

In August 2015, a rabies outbreak occurred in bovines in a Punjab village, India; subsequently, a farmer in the same village died of rabies in October 2015. We surveyed farmers to describe the outbreak, the demographics and rabies prophylaxis administered to householders on case farms, and farmers’ knowledge of rabies prevention and treatment. We used multiple correspondence analysis to guide investigation of associations between demographics, farm status and rabies knowledge, attitudes and practices. The number of affected bovines was unusually high; 15 cattle and buffalo died on 13 smallholder farms (attack rate 4%). Post‐exposure vaccinations were administered to 24 people (median 2 doses). Affected farms had significantly larger households and were more likely to keep their livestock outside (therefore, accessible by stray dogs), suggesting that the impact of the outbreak was disproportionally borne by households of lower socio‐economic status. Primary sources of rabies information were friends and neighbours, not health authorities or media. Women who had not received formal education were less likely to have heard of rabies. Although case farm participants were more likely to have heard about rabies from a veterinarian, their knowledge and practices to prevent rabies did not reflect the level expected considering their contact with a health professional; they were more likely to believe that traditional remedies prevent rabies and less likely to tell their children to avoid playing with stray dogs than participants from other farms. This study highlights knowledge dissemination disparities that, if typical of rural locations, could obstruct attempts to eliminate canine‐mediated human rabies in India. Therefore, understanding the pervasiveness and influence of traditional medical beliefs on treatment‐seeking behaviour, communication structures within villages and the impact of local practices such as carcass disposal on dog populations will be essential to ensure that rabies control strategies are effective in rural India.     

Incidence of canine rabies in N'Djaména, Chad

This work describes for the first time the incidence risk of passively reported canine rabies, and quantifies reported human exposure in N'Djaména (the capital of Chad). To diagnose rabies, we used a direct immunofluorescent-antibody test (IFAT). From January 2001 to March 2002, we were brought 34 rabies cases in dogs and three cases in cats. Canine cases were geographically clustered. The annual incidence risk of canine rabies was 1.4 (95% CI: 1.2, 1.7) per 1000 unvaccinated dogs. Most of the rabid dogs were owned-although free-roaming and not vaccinated against rabies. Most showed increased aggressiveness and attacked people without being provoked. Eighty-one persons were exposed to rabid dogs and four persons to rabid cats (mostly children<15 years old). Most of the exposed persons were neighbours or family members of the animal owner. Most exposures were transdermal bites, but nearly half of all exposed persons did not apply any first wound care or only applied a traditional treatment. In N'Djaména, humans are often exposed to canine rabies but do not use the full-course post-exposure treatment and wound care is insufficient. Most rabid dogs would be accessible to parenteral vaccination. Pilot vaccination campaigns are needed to determine the success of dog mass vaccination in N'Djaména as a way to prevent animal and human rabies.