title: Case report: Evidence of rise in rabies cases in southern Malawi--better preventative measures are urgently required.
abstract: We describe five children who died of clinical rabies in a three month period (September to November 2011) in the Queen Elizabeth Central Hospital. From previous experience and hospital records, this number of cases is higher than expected. We are concerned that difficulty in accessing post-exposure prophylaxis (PEP) rabies vaccine may be partly responsible for this rise. We advocate: (a) prompt course of active immunisation for all patients with significant exposure to proven or suspected rabid animals. (b) the use of an intradermal immunisation regime that requires a smaller quantity of the vaccine than the intramuscular regime and gives a better antibody response. (c) improved dog rabies control measures.
authors: Department of Paediatrics, Queen Elizabeth Central Hospital, Blantyre, Malawi.
authors: S J
authors: SJ
authors: Depani
authors: N
authors: N
authors: Kennedy
authors: M
authors: M
authors: Mallewa
authors: E M
authors: EM
authors: Molyneux
mesh_terms: D000293:Adolescent; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004285:Dogs; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D015994:Incidence; D008295:Malawi / Q000453:epidemiology; D008297:Male; D056990:Post-Exposure Prophylaxis / Q000600:supply & distribution; D011818:Rabies / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000008:administration & dosage
chemical_list: D011819:Rabies Vaccines
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