LAUSR

Corresponding author: Folorunso Oludayo Fasina, Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 0110 South Africa. E-mail: [email protected] This issue of Asian Pacific Journal of Tropical Medicine has published a case report[1]. This report detailed an atypical fatal case of fox-mediated human rabies. It once again reemphasized the importance of zoonotic disease transmission by animals (including wildlife), and a need to look introspectively in order to consider innovative solutions aimed at reducing the burden of zoonoses. Rabies continues to significantly impact human lives, particularly in the Asian and Africa regions where fatal dogmediated rabies in humans accounts for 96% of total rabiesassociated global death annually (> 59 000)[2]. In the current case, a fox (Vulpes vulpes) had attacked a man in a farm area in Qom, Iran, inflicting injuries in the head and palms. The patient only sought wound dressing without the necessary follow-up postexposure prophylaxis. Ultimately, death supervene despite all effort at late recovery[1]. This brings to focus the importance of targeted but intense community awareness campaign on rabies and other zoonoses, especially with regards to preventive and mitigation measures that can reduce zoonotic burdens in atrisk communities. Such activities have been tested with positive outcomes in Moshi, Tanzania and elsewhere[3, 4]. Although Qom is a metropolis, south of Tehran, and it is the seventh largest city in Iran with a human population of over 1.2 million, the Qom Province has four other cities. Perhaps these cities may not be predisposed to cases of wildlife associated rabies except in rare cases of stray wildlife. However, all other human habitations in the province are classified as villages. It is a fact that villages are suitable interfaces for human-wildlife-domestic animal interactions. The wild cats, hyenas, wolves, jackals, desert foxes and foxes (all potentials reservoirs for Rabies lyssavirus), are among the rich fauna of Iran, inclusive of, in the low plain of Qom[5], and these animals may likely be involved in territorialrelated human-animal and wildlife-domestic animal conflicts. Although, sources of aggression may include provocation, entering the animal protected territories, possessiveness, response to a painful injury, fear, maternal instinct, pursuant of prey, or rabies-associated aggression[3], in the current case, the cause of the fox attack was not stated. Based on reports, dog-mediated rabies had predominated in Qom and other parts of Iran, but this should not exclude the possibility of other forms of rabies transmission. The current atypical case of fox bite associated rabies puts into perspective, that other forms of rabies transmission, not dogmediated rabies, is likely to happen. This present case should elicitate more investigation on potential causes of human deaths, especially when symptoms suggestive of rabies exist, even in the absence of histories of dog bites. Perhaps, cases of atypical human rabies have been underreported in previous circumstances. Asian Pacific Journal of Tropical Medicine 2019; 12(11): 483-484