| Abstrakt: |
Simple Summary: In Mongolia, where nomadic pastoralism is still commonly practiced, a majority of reported human rabies exposure is attributed to dogs, with this case study highlighting an atypical exposure via horse bite occurring in an urban setting. The infected horse had been attacked by stray dogs prior to biting a 6 year old, which likely was the source of the rabies infection. This report highlights a successful response by the National Center for Zoonotic Diseases in conducting a thorough rabies investigation following a suspected exposure event and PEP initiation. Also discussed are common challenges in managing rabies in Mongolia, including limited access to vaccinations for domestic animals and wildlife due to financial constraints. Prompt and indiscriminate PEP initiation in rabies-endemic regions will need to be readily available across Mongolia, not just within proximity to Ulaanbaatar. Furthermore, integrated rabies management in Mongolia will need to be paired with community outreach and require coordination between veterinarians, health professionals, and policymakers to ensure proper access to care following exposure events from atypical sources such as livestock and horses. Rabies is a highly fatal zoonotic disease that causes an estimated 60,000 human deaths each year, many of which occur in Africa and Asia where the disease is likely underreported. Uncontrolled transmission of rabies presents a major threat to public health in countries such as Mongolia, where 26% of the population lives a pastoralist lifestyle characterized by increased interaction with livestock animals. Here, we report a case of rabies exposure in a six-year-old male after being bitten by a horse in both the head region and the leg. At the suspicion of rabies, post-exposure prophylaxis (PEP) was initiated, with the patient receiving four doses of PEP vaccine as well as a single treatment of rabies immunoglobulin. The horse was later confirmed to be rabies-positive through rapid antigen testing and RT-PCR. Human rabies exposure from horses is unusual within Mongolia, given that historically over 70% of human rabies cases within the country are attributed to dogs, wolves, or foxes. This case further emphasizes the need for more routine vaccination of domestic animals within Mongolia. Additionally, animal bites, even from animals not frequently associated with rabies, should be treated as possible rabies exposure events. [ABSTRACT FROM AUTHOR] |
