Home >News > ProMED翻訳情報(232回) ~インドにおける狂犬病による人の死亡事例~

ProMED翻訳情報(232回) ~インドにおける狂犬病による人の死亡事例~


Date: Tue 24 Dec 2013
Source: The Times of India [edited]

A 27-year-old man succumbed to rabies at the civic-run Naidu Infectious Diseases Hospital [Maharashtra state] [on 13 Dec 2013],taking the toll of deaths due to the infection to 15 in the city so
far this year. Civic officials said the man had been bitten by a dog near his right ankle 5 months ago [July 2013] and that he had taken anti-rabies vaccines on scheduled days. However, doctors he was taking treatment from did not administer rabies immunoglobulin that can [inactivate] the virus. “The victim was not from Pune city. As per our
medical records, he was a resident of Bhosari [Maharashtra state] and was admitted to Naidu Hospital when his health condition
deteriorated,” said S T Pardeshi, medical officer of health (MoH),Pune Municipal Corporation (PMC).

27歳の男性が、2013年12月13日にMaharashtra州の市立 Naidu感染症病院において狂犬病で死亡した。本年度これまでに、その市では15人が狂犬病で亡くなっている。感染症に死の代償を得た。その男性は5か月前(2013年7月)に右足首近くをイヌに噛まれ、予定された日に抗狂犬病ワクチン接種を受けていたと市職員は述べた。しかし、彼が治療を受けていた医師はウイルスを失活させることができる狂犬病免疫グロブリンを投与しなかった。「患者はPune市出身でない。我々の診療記録によると、彼はBhosari [Maharashtra 州]の住人であり、彼の健康状態が悪化してNaidu病院を受診した。」とPune 自治法人(PMC)の医務技官(MoH)であるS T Pardeshiは述べた。

The deceased has been identified as a resident of Alandi road in Bhosari. He was walking on the roadside when a stray dog bit him 5 months ago. According to the World Health Organization [prediction],the incubation period for the infection is typically 1-3 months, but may vary from one week to one year. “It was a category III dog bite wound. As per the medical history given to our health staff by the victim’s relatives, the victim received anti-rabies vaccination on the scheduled days at some hospital in Pimpri Chinchwad. However, he was not administered rabies immunoglobulin, readymade antibody and is extremely effective in inactivating the virus in category III dog bite injury,” said Anjali Sabne, deputy medical officer of health, PMC. The victims are usually injected with a fast-acting readymade antibody, rabies immunoglobulin (RI), near the wound, to inactivate the rabies virus. The readymade antibodies are given to the patient for immediate protection because the vaccine generally takes 14 days to [induce] antibodies. As per WHO guidelines, rabies immunoglobulin (RIG) should be given for all category III exposures, irrespective of the interval between exposure and beginning of treatment.

亡くなった人はBhosariのAlandi roadの住人と確認された。5か月前に彼が道路沿いを歩いていた時に放浪犬に咬まれた。WHO(の予測)によると、この感染症の潜伏期間は典型的には1から3か月であるが、1週間から1年の間で変動する場合もある。PMCの副医務技官であるAnjali Sabneは以下のように述べた。「それはカテゴリーⅢのイヌの咬傷であった。患者の親戚によって我々の医療職員にもたらされた医療歴によると、患者はPimpri Chinchwadのある病院において、予定日に抗狂犬病ワクチンを受けていた。しかし、彼は出来合いの抗体であり、カテゴリーⅢイヌ咬傷事例におけるウイルス失活に非常に有効である狂犬病免疫グロブリンを接種されなかった。」一般的に患者は、狂犬病ウイルスの失活の為に、即効性の出来合いの抗体である狂犬病免疫グロブリン(RI)を、受傷部位の近くに接種される。ワクチンは一般に抗体(の誘導)に14日を要するため、出来合いの抗体により患者に即効性の防御を与える。WHOガイドラインによると、狂犬病免疫グロブリン(RIG)は、曝露と治療開始の間隔とは無関係にすべてのカテゴリーⅢ曝露者に投与されるべきである。

The victim developed mild fever and breathlessness a few days before he was admitted to PMC-run Naidu Infectious Diseases Hospital on [12 Dec 2013]. “He had developed symptoms of rabies, like hydrophobia
(fear of water), and was extremely breathless at the time of admission. He succumbed to rabies infection at 12:30 pm on [13 Dec 2013],” Sabne said. The hospital he initially sought treatment from could not be identified. He was brought to Naidu hospital by his relatives.

患者は数日前に微熱と息切れを発症し、PMC-run Naidu感染症病院を2013年12月12日に受診した。「彼は恐水症(水を恐れる)の様な狂犬病症状を表しており、入院時には極度の呼吸不全であった。彼は2013年12月13日午後12時30分に狂犬病で亡くなった。」とSabneは述べた。彼が最初に治療を求めた病院は、確定できなかった。彼は彼の親戚によってNaidu病院に運ばれた。

An 11-year-old girl from Bibvewadi [Pune, Maharashtra state] died of rabies infection on [4 Dec 2013]. Her parents had alleged that she was administered anti-rabies vaccines but not inoculated with rabies immunoglobulin in and around the wound, which is a prerequisite if the bite wound is serious. However, doctors had refuted the charge.

Bibvewadi [Pune, Maharashtra 州]出身の11歳の少女が2013年12月4日に狂犬病感染で亡くなった。彼女の両親は、彼女は抗狂犬病ワクチンを接種されたが、咬傷が重篤であった場合には必須である、傷口とその周囲への狂犬病免疫グロブリンは接種されなかったと主張した。しかし、医師は料金に異議を唱えた。

An average of 1000 dog-bite cases are being reported in the city [Pune] every month, with as many as 12 319 cases recorded from January to November, this year [2013]. A total of 14 people have died of rabies in Pune city in this period, 3 of whom were local residents.Densely populated areas of Gadikhana, Mandai, Shukrawar Peth, Bajirao Road in the heart of the city, Yerawada, Hadapsar, Kothrud and
Sahakarnagar have reported the highest number of dog-bite cases this year. According to the Association for Prevention and Control of Rabies in India, greater awareness about rabies and timely treatment,
combined with efforts at controlling the stray-dog population, pet-dog licensing and annual anti-rabies vaccination of animals, are necessary to control the infection.

人口密集地のGadikhana、Mandai、Shukrawar Peth、市の核心であるBajirao Road、Yerawada、Hadapsar、Kothrud およびSahakarnagarで、この年最も多くのイヌ咬傷事例が報告された。インド狂犬病予防制御協会によれば、放浪犬集団の制御への努力、ペットイヌの認可と動物への毎年の抗狂犬病予防接種と共に狂犬病とタイムリーな治療へのより多くの認識が狂犬病の制御に必要である。

Communicated by:

[This account describes the unfortunate outcome of anti-rabies treatment that varied from the strict protocol advised by the WHO and other medical authorities. While this was clearly a rare event,visitors to India should avoid situations where they may be in contact with free-ranging urban dogs, and if bitten should be aware of the essential treatment response. – Mod.CP