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Canadian Journal of Public Health

, Volume 95, Issue 2, pp 138–141 | Cite as

Intervention de la santé publique lors de la survenue d’un cas de rage humaine au Québec

  • Doris Deshaies
  • Pierre A. Pilon
  • Louise Valiquette
  • John CarsleyEmail author
Article

Résumé

Contexte

À l’automne 2000, un enfant de 9 ans, résidant de Montréal (Québec), est décédé d’une encéphalite rabique. Aucun cas de rage humaine n’avait été signalé depuis quinze ans au Canada. La caractérisation moléculaire de l’acide nucléique viral a permis d’identifier la variante Ln/Ps associée à la chauve-souris argentée et à la pipistrelle de l’Est. Cet article décrit et analyse l’intervention de la santé publique.

Intervention et discussion

L’enquête a révélé que le contact avec la chauve-souris serait survenu pendant le sommeil de l’enfant. La recherche des contacts significatifs avec le cas de référence a conduit à recommander la prophylaxie postexposition contre la rage (PPER) à 59 personnes (3 contacts familiaux, 12 compagnons de jeux et 44 travailleurs de la santé). La concertation avec les autres directions de santé publique de la province a été importante à cause de la couverture médiatique de ce cas qui a fait grimper considérablement les signalements d’exposition aux chauves-souris et l’administration de PPER.

Conclusion

Les leçons tirées de cet événement sont: une action rapide et concertée avec tous les acteurs concernés est essentielle au succès d’une telle intervention de santé publique; la population doit être informée du risque de transmission de la rage par les chauves-souris.

Abstract

Background

In the fall of 2000, a nine-year-old child living in Montreal (Québec) died of rabies encephalitis. Cases of human rabies had not been reported in Canada for 15 years. The molecular characterization of viral nucleic acid implicated the Ln/Ps variant associated with the silver-haired bat and the eastern pipistrelle. This article describes and analyzes the intervention carried out by public health.

Intervention and Discussion

The investigation revealed that contact with the bat must have occurred while the child was sleeping. Following the search for close contacts of the reference case, rabies postexposure prophylaxis (RPEP) was recommended to 59 people (3 household contacts, 12 playmates and 44 health care workers). Discussion with other public health departments in the province was important because of the media coverage of this case, which led to a considerable increase in the number of reported exposures to bats and in RPEP administration.

Conclusion

Lessons learned from this event are that rapid and coordinated action with all stakeholders is essential to the success of this type of public health intervention and that the population must be informed of the risk of rabies transmission from bats.

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Copyright information

© The Canadian Public Health Association 2004

Authors and Affiliations

  • Doris Deshaies
    • 1
  • Pierre A. Pilon
    • 1
  • Louise Valiquette
    • 1
    • 2
  • John Carsley
    • 1
    • 2
    Email author
  1. 1.Unité Maladies infectieusesDirection de santé publique de Montréal-CentreMontréalCanada
  2. 2.Institut national de santé publique du QuébecCanada

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