We aimed to monitor the adverse effects (AE) and efficacy of post exposure prophylaxis (PEP) in health care workers (HCWs) exposed to a rabies patient. In this study 109 HCWs and eight household contacts were PEP candidates. Contact persons without infection control precautions were in Group I (high risk-82 cases). HCWs indirectly exposed to environmental surfaces were classified in Group II (low risk-35 cases). PEP schedule was rabies vaccine (RBV) + equine rabies immunoglobulin (eRIG) in Group I and only RBV in Group II. Local and systemic AE were observed in all cases. Efficacy of post exposure prophylaxis (PEP) was determined by rabies development in a six month follow-up. 585 doses of RBV have been used in 117 cases and eRIG has been used in 82 cases. 32 Nurses (39%); 22 emergency medicine technicians (26.8%); 12 doctors (14%); six laboratory technicians (0.07%); six radiology technicians (0.07%); four cleaners (0.05%) were in Group I (82 cases), respectively. One doctor, laboratory technician, nurse and radiology technician (0.02%); two emergency medicine technicians (0.04%) and nine cleaners (25.7%) were in Group II (35 cases), respectively. Routes of transmission were blood in five (0.06%); saliva in 14 (17%); sweat in 50 (61%); CSF/serum in five (0.06%); sexual intercourse in one (0.01%); personal equipment in seven (0.09%) in Group I, respectively. Indirect contact was the only route in Group II. The most common local and systemic AE were seen in Group I; pain at injection side (19 cases) and fever (13 cases). Both of them showed statistically significant difference (P<0.05). Allergic rash has been seen at only one case. PEP failed in one case where the possible exposure way was sexual intercourse. PEP is the safest way to prevent rabies. Infection control precautions were still not enough applied. eRIGs are also safe and have rare AE.

中文翻译：

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致命狂犬病病例和医护人员大规模暴露后预防的经验。


我们的目的是监测接触狂犬病患者的医护人员 (HCW) 的不良反应 (AE) 和暴露后预防 (PEP) 的效果。在这项研究中，109 名医护人员和 8 名家庭联系人是 PEP 候选人。没有采取感染控制预防措施的接触者属于第一组（高风险 - 82 例）。间接暴露于环境表面的医护人员被分为第二组（低风险 - 35 例）。 PEP 方案第一组为狂犬病疫苗 (RBV) + 马狂犬病免疫球蛋白 (eRIG)，第二组仅使用 RBV。所有病例均观察到局部和全身 AE。暴露后预防 (PEP) 的效果是根据六个月随访中狂犬病的发展情况来确定的。 117 例患者使用了 585 剂 RBV，82 例患者使用了 eRIG。 32 名护士 (39%)； 22名急诊医学技术人员（26.8%）； 12名医生（14%）；六名实验室技术员（0.07%）；六名放射技术员（0.07%）；第一组（82 例）分别有 4 名清洁工（0.05%）。一名医生、化验员、护士和放射技师（0.02%）；第二组（35 例）分别有 2 名急救医学技术人员（0.04%）和 9 名清洁工（25.7%）。传播途径为血液传播，五人（0.06%）； 14 人（17%）有唾液； 50 人（61%）出汗；脑脊液/血清占五分（0.06%）；性交之一（0.01%）；第一组中的个人装备分别占 7 件（0.09%）。间接接触是第二组中唯一的途径。最常见的局部和全身 AE 见于 I 组；注射侧疼痛（19例）、发热（13例）。两者差异有统计学意义（P<0.05）。仅一例出现过敏性皮疹。在一例可能的暴露方式是性交的案例中，PEP 失败了。 PEP 是预防狂犬病最安全的方法。 感染控制预防措施仍然没有得到充分应用。 eRIG 也很安全，并且发生罕见的 AE。