Home >News > ProMED翻訳情報(385回) ~チュニジアで発生した飼い犬からの狂犬病曝露による人の死亡事例~

ProMED翻訳情報(385回) ~チュニジアで発生した飼い犬からの狂犬病曝露による人の死亡事例~





Date: Fri 5 Jun 2015     Source: Directinfo, TAP report [in French, trans. Mod.AB, edited]



A young native of the village of Tamra, in the delegation of Sejnane  (Governorate of Bizerte), aged 21, died on Friday [5 Jun 2015] of rabies, said the regional director of health in Bizerte, Dr. Mohammed Mokri.

サジャナン(ビゼルト県の行政区)委任地、タムラ村の21歳の若い住民が狂犬病で金曜日(2015年6月5日)に死亡したとビゼルト県の健康部局の地域部長であるMohammed Mokri博士が述べた。


The man was taken in by the emergency services at the University Hospital Habib Bougatfa in Bizerte on [1 Jun 2015] for pain in the kidneys. Medical examinations showed that the patient was rabid. This was confirmed by a medical report from the Pasteur Institute in Tunis.

その若者はビゼルト県のHabib Bougatfa大学病院の救急治療部に腎臓の疼痛を訴えて(2015年6月1日に)収容された。医学検査により患者が狂犬病に罹っていたことを明らかにした。この事例はチュニスにあるパスツール研究所の医療報告により確認された。


The young man, who was passionate about raising pets, had, according to his family, tried – about 3 months earlier – to heal his dog by himself without success; the dog perished.



The health authorities reminds all citizens of the need to vaccinate their pets, to avoid contact with stray dogs, and to alert the veterinarian or the nearest health facility in case of unvaccinated dog bite.[Byline: Di from TAP]





[Despite the availability of rabies vaccines at the relatively dense network of rabies centers in Tunisia, one continues to deplore human cases detected late and for whom death is unfortunately an almost certain outcome. An increased effort of public awareness of the danger of this disease is needed. Similarly the fight against dog rabies virus vectors needs to be intensified.



The only symptom mentioned is pain in the kidneys; this is not very evocative of human rabies. No nervous signs or behavior disorders have apparently been observed in the patient. It is therefore unclear what induced physicians to suspect rabies in this patient. Now that the case is confirmed, meticulous work from upstream investigation is required to trace all people and pets who have been exposed to biting or licking by the animal that transmitted rabies to the deceased patient.





[It would be interesting to note the age of the pet involved, which appears – according to the above media report – to have been treated by its owner due to some clinical disease, the signs of which are not described.  Was it a domestic owned dog or was it collected elsewhere? In young dogs (say, under the age of 3 months), rabies signs can be rather confusing and difficult to be recognised at times; primary vaccination is usually performed when the pet reaches the age of 3 months. The dog may have suffered the “dumb” form of rabies, not the furious one and the owner may have suspected that the dog died of another cause.



In rabies-endemic countries, the public is warned to refrain from collecting/adopting stray puppies, the background of which unknown. When collected by societies, such animals should be kept under strict veterinary observation for at least 3 months.



It will also be interesting to obtain information on the rabies vaccination coverage of domestic/owned dogs in the Bizerte province. In this respect, Subscribers are referred to the following paper evaluating the efforts of the Tunisian authorities to control rabies.


Touihri, L., Zaouia, I., Elhili, K., Dellagi, K. and Bahloul, C. (2011). Evaluation of Mass Vaccination Campaign Coverage Against Rabies in Dogs in Tunisia. Zoonoses and Public Health, 58: 110-118. doi: 10.1111/j.1863-2378.2009.01306.x

Touihri, L., Zaouia, I., Elhili, K., Dellagi, K. and Bahloul, C. (2011)






In Tunisia, rabies continues to be considered as a serious public health concern. Very costly mass vaccination of dogs against rabies and expensive post-exposure prophylaxis are prerequisites to maintain a low level of human rabies cases.



In Tunisia, the implementation of mass vaccination campaigns at the national level has undoubtedly contributed to the drop of rabies endemicity, but the overall outcome is rather suboptimal. In this investigation, we wanted to estimate the extent of the vaccination coverage in dogs in 3 Governorates (Manouba, Kassrine and Mednine), by collecting data through questionnaires and interviews relevant to 1470 owned dogs.

チュニジアでは国家レベルでの集団ワクチン接種活動の実施は、疑いなく狂犬病流行を減少させるのに寄与しているが、総合的結果はどちらかと言えば次善である。この調査で、我々は1,470頭の飼い犬に関連するアンケート調査と聞き取り調査を利用して収集することで、3つの行政区(Manouba区およびKassrine 区、Mednine区)におけるイヌのワクチン接種率の程度を推定したかった。


When the campaign is correctly applied, as in Manouba, almost all the targeted dog population can be reached by parenteral vaccination and an almost elimination of the disease can be evidenced. However, in Kasserine and especially in Medenine, where the vaccination coverage is lower than 31 percent, a reservoir for the disease can be maintained. To match the official figures of vaccination coverage, we should update the statistics of the size of dog population which seems to be bigger than what is assumed.



In addition, we wanted to assess the level of involvement of the local population with the vaccination campaigns by marking vaccinated dogs with necklaces and establishing later on the vaccination coverage accordingly. — We think that rabies control programmes in Tunisia can be successful if vaccination coverage can reach 70 percent in all parts of the country. The achieved vaccination coverage should be estimated after random visits in many parts of the country and by checking valid vaccination certificates”.



The problem of rabies in stray dogs is another and a major issue deserving discussion; 2 main paths have been subject to discussions and experimentation throughout the years: population control and oral vaccination.]