Rabies circulates intensely in Cambodia, mainly affecting rural populations. We conducted a
prospective study to estimate the baseline incidence of potentially infective dog bites in rural
villages of Siem Reap province, Cambodia. The study was conducted in a convenience sample of
844 families totaling 1,779 persons in four villages. The study collected data in a total of 802.3
person-years.
Trained village health workers (VHW) exhaustively documented consecutive dog bites at the end
of each month. Between May 15th and November 15th, 2011, a total of 40 attacks (43 bites; 1.07
bites per attack) were notified by 39 persons (50% female; one suffered two distinct incidents) to
VHW. The all-age attack rate for bites over this 6-month period was 2.3% (CI95%: 1.7% - 3.1%),
with a global incidence rate estimated at 4.84 bites/100 person-years (CI95%: 3.5 – 6.6). The mean
age in bite victims was 20.8  18.9 years (median 12.5; interquartile range 6-36; range 1 - 63). The
dog was identified in 39 (97.5%) of cases, being the household dog in 9 (22.5%) of cases. Bites
were classified as severe (WHO Category III - broken skin with bleeding) in 33 (82.5%) of cases
with a severe dog bites incidence estimated at 4/100 person-years (CI95%: 2.8 – 5.6). The bites
involved the hand or face in 1 (2.5%) case each (both Category III). In 20 incidents (50%), only
rice was applied to the wounds. There were no suspected or confirmed human rabies deaths during
the study period but one dog died after biting (2 others were lost to follow-up and 14 were put
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down by their owner). Our study documented an extremely high incidence of dog bites in of rural
Cambodian adults and children. Adapted control policies for canine vaccination are urgently
needed.