engleski

Hospitalised patients following animal bites in period 1995-2003

According to the medical records of the Zagreb Institute of Public Health, the National Reference Centre for Rabies, ine the period 1995-2003 there were 123 patients reported hospitalised in different Zagreb hospitals, following animal bites. This number represents 1, 255 of the 9812 examined patients in the antirabies ambulance in the given period. The range of hospitalised patients was between 1 and 80 years ; 24 were male, 28 female, and 71 were children. The localisation of wounds was as follows: head and neck 36, multiple injuries 36 ; lower limbs 27 ; fist and fingers 14 ; upper limbs 10. There were no reported bites on the trunk, except in combination with multiple injuries. According to our ABCD categories (I, II, III in international classification), the distribution of animals afflicting wounds were: catetory A - 1 dog ; category B - 1 cat ; category C - 17 dogs, 9 rats, 4 cats ; category D - 80 dogs ; 9 cats, 1 pig, 1 donkey. Out of 123 animals afflicting wounds 15 were killed, 108 remained healthy ; while 5 corpses of killed were taken to the Croatian Vetarinary Institute for laboratory confirmation of rabies. Of these, four were negative and only one was positive. In 80 out of 123 cases, the animals were put under veterinary surveillance. Sixty-five patients were immunized against rabies, and fifty-eight were not. Out of sixty-five patients, who started the antirabies immunisation, in 22 cases the treatment was discontinued. Fourty three patients completed the antirabies immunization. The main reason for discontinuing the antirabies treatment was the veterinarians' report thet the animal under surveillance remained healthy after a 10-day observation period. In 15 cases the animals were killed, so that the veterinary examination could not be done. Most of the children received a combined active-passive immunization, while in adults it was applied in children bites the owner of the animal (e.g. dog, mostly!) was not known at the time of reporting. The patients were hospitalised in the following Zagreb clinics (N in brackets): -Clinic for Children Diseases "Zagreb" (50), -Clinic for Infectious Diseases "Dr Fran Mihaljević" (27), -Clinical Hospital Centre "Zagreb" (17), -Clinical Hospital "Dubrava" (12), -Clinic for Traumatology "Zagreb" (6), -Clinical Hospital "Systers of Mercy" (6), -Clinical Hospital "Merkur" (3), -Clinical Hospital Centre "Šalata" - Clinic for ORL (1), General Hospital "Sveti Duh" (1). Conclusions: 1. The most of the hospitalised patients were children (57, 72%). 2. The localisation of the wounds was as follows: head and neck, multiple injuries, lower limbs, fist and fingers and upper limbs. 3. There were no reported bites on the trunk, except in combination with multiple injuries. 4. The dogs were the most represented category of the total animal species afflicting wounds (79, 67%). 5. The measure that was most commonly used was putting animals under veterinary surveillance. 6. The veterinary receit of putting animal under surveillance, was the main reason for discontinuing the antirabies treatment.

animal; bite; hospitalisation

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