OBJECTIVES: To examine the circumstances of animal exposure in a case series of Australian travellers who required rabies postexposure prophylaxis, and to assess the appropriateness of current guidelines for rabies pre-exposure vaccination. DESIGN, PARTICIPANTS AND SETTING: Prospective case series of 65 returned travellers who presented to four Australian travel medicine clinics between 1 April 2009 and 31 July 2010 for rabies post-exposure prophylaxis. MAIN OUTCOME MEASURES: Demographic characteristics associated with risk of injury; countries where injuries occurred; circumstances of the injuries; and travellers' experiences of obtaining postexposure prophylaxis overseas. RESULTS: Animal bites and scratches occurred most commonly among travellers aged 20-29 years. Most injuries occurred in Bali, Indonesia (30 [46%]) and Thailand (21 [32%]), and the most common animals responsible for the injuries to the 65 travellers were monkeys (29 travellers [45%]) and dogs (27 [42%]). Thirty-nine of the travellers (60%) initiated contact with the animal. Forty travellers (62%) were able to commence rabies vaccination overseas, but only nine (14%) were able to obtain rabies immunoglobulin overseas. CONCLUSIONS: Most travellers had difficulty obtaining rabies postexposure prophylaxis overseas, resulting in significant delays in appropriate treatment. We recommend that current National Health and Medical Research Council guidelines for at-risk persons be broadened, and that the risk of rabies and the option of pre-exposure vaccination be discussed with all travellers to rabies-endemic areas.
OBJECTIVES: To examine the circumstances of animal exposure in a case series of Australian travellers who required rabies postexposure prophylaxis, and to assess the appropriateness of current guidelines for rabies pre-exposure vaccination. DESIGN, PARTICIPANTS AND SETTING: Prospective case series of 65 returned travellers who presented to four Australian travel medicine clinics between 1 April 2009 and 31 July 2010 for rabies post-exposure prophylaxis. MAIN OUTCOME MEASURES: Demographic characteristics associated with risk of injury; countries where injuries occurred; circumstances of the injuries; and travellers' experiences of obtaining postexposure prophylaxis overseas. RESULTS: Animal bites and scratches occurred most commonly among travellers aged 20-29 years. Most injuries occurred in Bali, Indonesia (30 [46%]) and Thailand (21 [32%]), and the most common animals responsible for the injuries to the 65 travellers were monkeys (29 travellers [45%]) and dogs (27 [42%]). Thirty-nine of the travellers (60%) initiated contact with the animal. Forty travellers (62%) were able to commence rabies vaccination overseas, but only nine (14%) were able to obtain rabies immunoglobulin overseas. CONCLUSIONS: Most travellers had difficulty obtaining rabies postexposure prophylaxis overseas, resulting in significant delays in appropriate treatment. We recommend that current National Health and Medical Research Council guidelines for at-risk persons be broadened, and that the risk of rabies and the option of pre-exposure vaccination be discussed with all travellers to rabies-endemic areas.
Authors: Michael P Muehlenbein; Kristina M Angelo; Patricia Schlagenhauf; Lin Chen; Martin P Grobusch; Philippe Gautret; Alexandre Duvignaud; François Chappuis; Kevin C Kain; Emmanuel Bottieau; Loïc Epelboin; Marc Shaw; Noreen Hynes; Davidson H Hamer Journal: J Travel Med Date: 2020-11-09 Impact factor: 8.490
Authors: G N K Mahardika; N Dibia; N S Budayanti; N M Susilawathi; K Subrata; A E Darwinata; F S Wignall; J A Richt; W A Valdivia-Granda; A A R Sudewi Journal: Epidemiol Infect Date: 2013-08-19 Impact factor: 2.451
Authors: Philippe Gautret; Kira Harvey; Prativa Pandey; Poh Lian Lim; Karin Leder; Watcharapong Piyaphanee; Marc Shaw; Susan C McDonald; Eli Schwartz; Douglas H Esposito; Philippe Parola Journal: Emerg Infect Dis Date: 2015-04 Impact factor: 6.883
Authors: Philippe Gautret; Kristina M Angelo; Hilmir Asgeirsson; David G Lalloo; Marc Shaw; Eli Schwartz; Michael Libman; Kevin C Kain; Watcharapong Piyaphanee; Holly Murphy; Karin Leder; Jean Vincelette; Mogens Jensenius; Jesse Waggoner; Daniel Leung; Sarah Borwein; Lucille Blumberg; Patricia Schlagenhauf; Elizabeth D Barnett; Davidson H Hamer Journal: PLoS Negl Trop Dis Date: 2018-11-13
Authors: Philippe Gautret; Jesse Blanton; Laurent Dacheux; Florence Ribadeau-Dumas; Philippe Brouqui; Philippe Parola; Douglas H Esposito; Hervé Bourhy Journal: PLoS Negl Trop Dis Date: 2014-05-15