Abstract:
In order to provide relevant therapeutic answers to human patients exposed to risk of rabies infection
who visit the lnstitut Pasteur du Cambodge for post-exposure treatment and to improve control of
rabies in Cambodia, a pilot study was carried out in Phnom Penh Province in November and December
1997 with three objectives: characterization of the population of animals responsible for the exposure
to rabies, observation of the animals concerned, and confirmation of the presence of rabies
virus in the province. Between 18 November 1997 and 19 December 1997, 409 of the 741 patients
treated at the lnstitut Pasteur du Cambodge because of an exposure to a known rabies vector were
included in the study. The animals concerned were: 401 dogs (98 %), six monkeys (1 ,5 %) and two
cats (0,5%). Three-hundred-and-seventy of the animals (90,5%) were owned, 4 (1 %) were unowned
but were available for characterization and observation, and 35 (8,6 %) had an unknown ownership
status and were not available for further study. The exposures occurred on private property in 84% of
the cases, and 80 of the 370 owned animals (22 %) lived in the same home as had the patient. The
374 animals with known ownership status were examined. Five were already dead and two of these
five dogs had presented clinical signs typical of those of rabies. The male:female sex ratio of the dogs
was 2,1: 1. The 369 live animals were placed under observation for 10 d immediately after exposure
of the humans had taken place. At the end of the period none of the animals had developed clinical
signs of rabies, three had died of diseases other than rabies, and one was lost. Tests for the rabies
nucleocapsid antigen were positive in two cases (the two suspected rabid dogs), confirming the presence
of rabies in Phnom Penh Province. Consequently, we recommend measures to improve the
control of rabies in Cambodia.
