Morsures canines et expositions à la rage au Nunavik : épidémiologie, gestion et différences liées à l'âge
In Nunavik, arctic fox rabies is still endemic and dog bites represent a considerable source for human exposure, nevertheless, we are lacking scientific evidence to guide management and prevention strategies in this particular socio-cultural context.   In the present study, we analyze cases of declared animal bites that were reported to the Nunavik Regional Health Board (NRHB) from 2008 to 2017, taking into account the specific and global context, as well as the differences between children and adults in order to retrieve accurate, contextual and reliable information to guide future control and prevention strategies. Over the ten year period, 320 cases of animal related injuries were reported with an important increase during the study period. Over 90% of these cases involved dogs. The annual incidence was higher than previously reported in other regions in Canada and the United States (US). The spatial distribution, for potential human exposures to rabies as well as animal rabies cases, was different between the villages of Hudson Bay and Ungava Bay.  Two main victim profiles have emerged through the analysis, namely children under 15 years old (y/o) who were most likely to be exposed in the head and neck, mostly during play and young male adults through activities such as mushing and hunting; these differences should be considered and targeted in prevention strategies as risk factors. During the study period, 15 rabid animals were identified. Although positivity rate was higher among wildlife, most confirmed human exposures occurred with a dog (60%). These results sustain the importance of dog bites as a public health issue in Inuit communities of Nunavik and highlight the need for preventive approaches that are adapted to the context.
Nunavik Inuit bite dog exposure rabies Public Health management prevention