According to statistics compiled by the Taiwan Centers for Disease Control (Taiwan CDC), between 4pm on July 27 and 4pm on July 28, 2013, a total of 49 new animal bite cases applying for rabies vaccine were received. Of the applications, 30 have been approved, including 1 application from Taipei, 1 application from northern Taiwan, 14 applications from central Taiwan, 6 applications from southern Taiwan, 5 applications from Kaohsiung and Pingtung, and 3 applications from eastern Taiwan. Between 4pm on July 21 and 4pm on July 28, 2013, an accumulative total of 145 animal bite cases applying for rabies vaccine were received. Of the applications, 66 have been approved, including 2 applications from Taipei, 5 applications from northern Taiwan, 21 applications from central Taiwan, 10 applications from southern Taiwan, 6 applications from Kaohsiung and Pingtung, 16 applications from eastern Taiwan, and 6 applications from out of the country. 14 applications were approved for the use of human rabies immune globulin (HRIG) and 5 of them have received the prophylaxis.

Taiwan CDC reminds the public to take heed of the following three preventive actions against rabies:

1. Avoid animal bite: Avoid contact with wild animals and do not pick up sickened animals or animal carcasses and report sightings of sickened animals or animal carcasses to local animal epidemic prevention agencies or the Council of Agriculture (COA) through calling the hotline: 0800-761-590.

2. When bitten or scratched by animals, please remember to take the following 4 steps: 1.Remember: Try to remain calm and remember the characteristics of the biting animal; 2. Wash: Immediately wash the wound with soap and an ample amount of clean water for 15 minutes and then disinfect the wound with iodine or 70% alcohol; 3. Seek: Seek prompt medical attention for proper evaluation and treatment to reduce the risk of infection; and 4. Observe: Try to detain the biting animal for a 10-day observation if possible. However, do not risk capturing the animal if it gets violent.

3. Seek medical attention when bitten or scratched by animals: Please seek medical assistance at one of the 28 hospitals with a stockpile or rabies vaccine, which can be found in every city and county in the nation. The health authority continues to increase the number of healthcare facilities offering rabies vaccination. High-risk population needs five does of post-exposure vaccine when bitten or scratched by rabid animals. Rabies pre-exposure vaccination can provide up to 100% protection. HRIG is only administered to patients who received severe bites.

In response to the ongoing rabies situation in Taiwan, the Vice Premier of the Executive Yuan, Mao Chi-kuo convenes a daily meeting to supervise the rabies prevention inter-ministerial working group and closely monitors the operation of the working group. In addition, 120 doses (2c.c.) of HRIG arrived in Taiwan in the evening of July 28, 2013. The distribution of the immunoglobulin to the Taiwan CDC Regional Centers is scheduled to begin in the afternoon of July 29. Taiwan CDC will continue to purchase more rabies vaccine and increase the number of hospitals with a stockpile of rabies vaccine. Further, Taiwan CDC will also organize trainings and education courses in rabies prevention and control for healthcare professionals and relevant courses will be made available online.

Taiwan CDC reminds clinicians who encounter wild animal bite cases to remember to record the location where the bite occurred, the animal species that made the bite, and whether the animal has been retained for observation. If a patient is qualified for post-exposure vaccination, please contact a Taiwan CDC Regional Center to facilitate the application for rabies vaccines. For more information on rabies prevention, please visit the Taiwan CDC’s website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922, or 0800-024582 if calling from a cell phone. For more information on outbreaks of animal diseases, please call the COA’s hotline, 0800-761-590.