Philippe Gautret1, Philippe Parola. 1. Institut Hospitalo-Universitaire des Maladies Infectieuses et Tropicales, Hôpital Nord, Université d'Aix-Marseille, Marseille, France. philippe.gautret@club-internet.fr
Abstract
PURPOSE OF REVIEW: This review sought to describe the recent findings on the epidemiology of rabies exposure and rabies cases in travelers and to discuss possible cost-saving measures that could be used to increase pretravel vaccination coverage in travelers. RECENT FINDINGS: On the basis of global data, most cases of rabies in travelers are associated with dog bites, occur in adults who are commonly migrants, and are not necessarily associated with long-term travel. The incidence of injuries to travelers caused by potentially rabid animals is approximately 0.4% per month of stay. Dogs account for 51% of cases, and the remaining animals, notably monkeys, carry a lower risk of rabies transmission. Travel to Southeast Asia, India, and north Africa, young age, and traveling for tourism are risk factors for potential exposure; the duration of travel is not a risk factor. More than 70% of travelers are not immunized prior to departing and do not receive adequate care when injured. SUMMARY: The intradermal vaccination route has been proven economical, safe, and immunogenic in the population of rabies-endemic areas, and this route of administration has been recently used in travelers from developed countries. The immunity provided by the three-dose series is long-lasting and should be considered an investment for future travel. Abbreviated schedules have been tested for last-minute travelers.
PURPOSE OF REVIEW: This review sought to describe the recent findings on the epidemiology of rabies exposure and rabies cases in travelers and to discuss possible cost-saving measures that could be used to increase pretravel vaccination coverage in travelers. RECENT FINDINGS: On the basis of global data, most cases of rabies in travelers are associated with dog bites, occur in adults who are commonly migrants, and are not necessarily associated with long-term travel. The incidence of injuries to travelers caused by potentially rabid animals is approximately 0.4% per month of stay. Dogs account for 51% of cases, and the remaining animals, notably monkeys, carry a lower risk of rabies transmission. Travel to Southeast Asia, India, and north Africa, young age, and traveling for tourism are risk factors for potential exposure; the duration of travel is not a risk factor. More than 70% of travelers are not immunized prior to departing and do not receive adequate care when injured. SUMMARY: The intradermal vaccination route has been proven economical, safe, and immunogenic in the population of rabies-endemic areas, and this route of administration has been recently used in travelers from developed countries. The immunity provided by the three-dose series is long-lasting and should be considered an investment for future travel. Abbreviated schedules have been tested for last-minute travelers.
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