{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:24:55Z","timestamp":1785860695408,"version":"3.56.0"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chinese National Science and Technology Major Project","award":["2018ZX10101002-003-002"],"award-info":[{"award-number":["2018ZX10101002-003-002"]}]},{"name":"Emergency Response Mechanism Operation Program","award":["102393220020010000017"],"award-info":[{"award-number":["102393220020010000017"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec009\">\n<jats:title>Background<\/jats:title>\n<jats:p>Rabies continues to pose a significant public health challenge in China. Here we reported the risk factors associated with the failure to initiate post-exposure prophylaxis (PEP) vaccination in China for period 2016\u20132020. It is essential for identifying strategies to decrease the incidence of these preventable fatalities.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec010\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We analyzed data from 1,733 case investigations in China between 2016 and 2020. Chi-squared tests and logistic regression analyses were utilized to identify factors associated with the failure to initiate PEP vaccination.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec011\">\n<jats:title>Results<\/jats:title>\n<jats:p>A majority of the incidents (n\u2009=\u20091,295; 84.3%) involved animal bites, with dog wounds constituting 94.0% of these cases (n\u2009=\u20091,437). Domestic animals from the victims\u2019 own residences accounted for 48.5% (n\u2009=\u2009690) of human rabies cases, followed by free-roaming animals at 34.4% (n\u2009=\u2009489). Among the domesticated animals, 95.7% (n\u2009=\u2009779) had not been vaccinated against rabies. Category III wounds were present in 66.1% (n\u2009=\u2009952) of all cases. In the multivariable model, factors occupation, exposure category, and source of attacking animal were significantly associated with failure to initiate PEP vaccination. However, only 4.3% (n\u2009=\u200941) received rabies immunoglobulin (RIG), and a mere 1.2% (n\u2009=\u200911) underwent complete PEP vaccination in addition to RIG administration. The median incubation period for rabies was recorded at 72 days, with an interquartile range (IQR) of 35.0\u2013173.0 days.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec012\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The majority of individuals affected by rabies did not pursue PEP vaccination, especially those with category II wounds or those bitten by domestic animals from their own households. To decrease mortality from rabies, it is imperative to launch prevention campaigns directed at these groups. Furthermore, enhancing the regular vaccination of domestic dogs is crucial for long-term control of the disease.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013089","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T17:50:45Z","timestamp":1749059445000},"page":"e0013089","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Characteristics, Post-exposure prophylaxis usage, and clinical features of Chinese human rabies cases, 2016\u20132020"],"prefix":"10.1371","volume":"19","author":[{"given":"Qian","family":"Ren","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Mu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man-Tong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Nan","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi-Jian","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Jie","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si-Han","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun-Yuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Wu","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0453-7609","authenticated-orcid":true,"given":"Qiu-Lan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Ping","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"issue":"4","key":"pntd.0013089.ref001","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1001\/jama.2022.22254","article-title":"Rabies","volume":"329","author":"J Jin","year":"2023","journal-title":"JAMA"},{"issue":"39","key":"pntd.0013089.ref002","doi-asserted-by":"crossref","first-page":"825","DOI":"10.46234\/ccdcw2021.204","article-title":"Progress in the Development of Animal Rabies Vaccines in China","volume":"3","author":"C Yin","year":"2021","journal-title":"China CDC Wkly"},{"issue":"5","key":"pntd.0013089.ref003","doi-asserted-by":"crossref","first-page":"121","DOI":"10.15585\/mmwr.mm6905a1","article-title":"Human Rabies - Utah, 2018","volume":"69","author":"D Peterson","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"4","key":"pntd.0013089.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0003709","article-title":"Estimating the global burden of endemic canine rabies","volume":"9","author":"K Hampson","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"pntd.0013089.ref005","doi-asserted-by":"crossref","first-page":"17188","DOI":"10.1038\/s41598-018-35158-0","article-title":"Exposure history, post-exposure prophylaxis use, and clinical characteristics of human rabies cases in China, 2006-2012","volume":"8","author":"C Guo","year":"2018","journal-title":"Sci Rep"},{"issue":"39","key":"pntd.0013089.ref006","doi-asserted-by":"crossref","first-page":"813","DOI":"10.46234\/ccdcw2021.200","article-title":"Accelerate the Progress Towards Elimination of Dog-Mediated Rabies in China","volume":"3","author":"Q Chen","year":"2021","journal-title":"China CDC Wkly"},{"issue":"39","key":"pntd.0013089.ref007","doi-asserted-by":"crossref","first-page":"831","DOI":"10.46234\/ccdcw2021.205","article-title":"Progress and Prospects of Dog-Mediated Rabies Elimination in China","volume":"3","author":"W Yin","year":"2021","journal-title":"China CDC Wkly"},{"issue":"3","key":"pntd.0013089.ref008","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0003589","article-title":"Uptake of rabies control measures by dog owners in Flores Island, Indonesia","volume":"9","author":"E Wera","year":"2015","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013089.ref009","volume-title":"WHO Expert Consultation on Rabies. 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