Cross-border and multi-sector investigation of a suspected rabies case - Savannakhet Province, Lao PDR, May 2011


Background: Rabies is a viral zoonotic disease. It causes acute encephalitis in humans with almost 100% case fatality if no post-exposure prophylaxis (PEP) is provided. While recommended, vaccination of dogs against rabies is not widely practiced in Laos. PEP vaccine is offered by some provincial hospitals but there is no immunoglobulin available. The Epidemiology Unit, Mukdahanh Province, Thailand, was informed about the death of an 8-year old boy suspected of having rabies. The child was treated in Thailand but came from Savannakhet Province, Laos. A cross-border investigation was initiated to examine the patient's history, detect close contacts and prevent further rabies deaths. Methods: Lao Health and Veterinary Offices at provincial and district levels undertook the investigation. Close relatives were interviewed to detect previous animal exposure. Active case finding and contact tracing were performed in order to administer PEP to those potentially exposed to rabies virus. Results: One pet dog bit two b