Çiğdem ATAMAN HATİPOĞLU, Sami KINIKLI, Ali Pekcan DEMİRÖZ, Meliha Çağla SÖNMEZER, Necla Eren TÜLEK, Esra KAYA KILIÇ, Cemal BULUT

KUDUZ ŞÜPHELİ TEMAS ÖYKÜSÜ İLE BAŞVURAN PEDİATRİK YAŞ GRUBU HASTALARIN DEĞERLENDİRİLMESİ

AMAÇ:Bu çalışmada kuduz şüpheli temas öyküsü ile hastanemiz Kuduz Aşı Merkezi'ne yapılan 18 yaş altındaki başvurular irdelendi ve klinik yaklaşımlara ışık tutması amaçlandı.GEREÇ VE YÖNTEM: Bu çalışmaya hastanemiz Kuduz Aşı Merkezi'ne kuduz şüpheli temas nedeniyle başvuran 18 yaş altındaki hastalar kabul edildi. Bir form hazırlanarak yaş, cinsiyet, temasa neden olan hayvan, hayvanın sahipli olma durumu, temas tipi, temas olan vücut bölgesi ve uygulanan aşı programı kayıt altına alındı.BULGULAR: Haziran 2013 ve Temmuz 2014 tarihleri arasında toplam 3024 hasta retrospektif olarak değerlendirildi. Hastaların 475'i erkek (%63), 281'i (%37) kadındı. Yaş ortalaması 9,55 (±4,749) olarak saptandı. 10-18 yaş grubunda şüpheli temas daha fazla (%38,1) saptandı. Üst ekstremiteler hayvan temasına en çok maruz kalan (%53,4) bölge iken bunu alt ekstremiteler (%29,4) ve gluteal alan (%5,6) izlemektedir. Şüpheli temasa neden olan hayvanlar sıklık sırasına göre 567 (%75) köpek, 186 (%24,6) kedi, 2 (%0,3) kemirgen, 1 (%0,1) tavşandı. Hayvanların 545' inin kaçtığı (takip edilemiyor) (%72,1), 168' inin (%22,2) sahipli ve aşısız, 43' ünün (%5,7) sahipli ve aşılı olduğu belirlendi. Lezyon yerlerine göre seçilen aşı programına baktığımızda, baş bölgesinden ısırılan tüm hastalara (%100) kuduz immunglobulin + 5 doz aşı uygulandığı saptandı. 2-1-1 aşı şemasının diğer tüm bölgelerde oluşan temaslarda en çok tercih edilen şema olduğu belirlendi.SONUÇ: Aşı ile önlenebilen bir hastalık olmasına rağmen kuduz halen ülkemiz için ciddi bir halk sağlığı problemi olarak önemini korumaktadır. Hızlı, etkin yara bakımı ve temas sonrası aşılama hastalıktan korunmada etkili yöntemlerdir

EVALUATION OF PEDIATRIC AGE GROUP ADMITTED WITH SUSPECTED RABIES CONTACT HISTORY

OBJECTIVE: In the present study, we aimed to evaluate patients who were younger than 18 years, and who were admitted to the rabies vaccination center with suspected contact, and to highlight the clinical approaches.MATERIAL AND METHODS: Patients who were under the age of 18, and who were admitted to the Ankara Training and Research Hospital Infectious Diseases and Clinical Microbiology Department Rabies Vaccination Center for suspected contact with rabies were included in the study A form containing age, gender, animal that led to contact, ownership status of the animal, type of contact, body area of contact, type of vaccination program, and location of the patient was prepared.RESULTS: 3024 patients between June 2013 and July 2014 were retrospectively evaluated. Seven hundred fifty-six of them (26.1%) were younger than 18 years old. Four hundred seventy-five patients were male (63%), and 281 patients were female (37%). The mean age was 9.55±4.749. We detected more rabies suspicious contacts (38.1 %) in the 10-18 age group. While upper extremities most exposed to animal contact (53.4 %), the lower extremities (29.4 %) and the gluteal area (5.6%) are followed. The frequency distribution of animals that caused suspected contact was as follows: 567 dogs (75%), 186 cats (24.6%), two rodents (0.3%), and one rabbit (0.1%). Five hundred forty-five animals escaped (follow-up not possible) (72.1%), 168 animals (22.2%) had owners, but they were not vaccinated; 43 animals (5.7%) had owners, and they were vaccinated. When we evaluated vaccination programs according to lesion area, all patients who were bitten in the head region (100%) received rabies immunoglobulin + 5 doses of vaccination. 2-1-1 vaccination schedule was determined as the most preferred scheme in all other regions.CONCLUSION: Rabies is a disease that can be prevented by vaccination; still, it remains a severe public health problem in Turkey. Fast and effective wound care, and vaccination after exposure are effective methods to provide protection from this disease

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