Philippe Gautret1, Marta Diaz-Menendez2, Abraham Goorhuis3, Ryan M Wallace4, Veerle Msimang5, Jesse Blanton4, Laurent Dacheux6, Perrine Parize6, Lucille Blumberg5, Hervé Bourhy6, Martin P Grobusch3. 1. Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France. Electronic address: philippe.gautret@ap-hm.fr. 2. National Referral Unit for Imported Tropical Diseases. Department of Internal Medicine. Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, Spain. 3. Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam University Medical Centers, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam, the Netherlands. 4. United States Centers for Disease Control and Prevention, National Center for Emerging Zoonotic Infectious Diseases, Atlanta, GA, USA. 5. National Institute for Communicable Diseases of the National Health Laboratory Service and University of Pretoria, South Africa. 6. Institut Pasteur, National Reference Center for Rabies, WHO Collaborating Center for Reference and Research on Rabies, Lyssavirus Epidemiology and Neuropathology Unit, Paris, France.
Abstract
BACKGROUND: Sixty cases of rabies in international travellers from 1990 to 2012 were previously reviewed. We present here an update of rabies cases in international travellers from 2013 to 2019. METHODS: We systematically reviewed the existing literature and collected 23 cases of rabies in individuals who crossed an international border between the time of infection and diagnosis, or who were infected following expatriation or migration. RESULTS: Most cases were in male adult travellers and diagnosed in Europe and the Middle East, with most exposures in Asia or in Africa. Migrants originating from rabies-endemic low-and-middle income countries and their descendants accounted for two thirds of cases. Other cases were in tourists, business travellers and expatriates. Median travel duration (excluding migration trip) was 60 days (range 7-240 days). Most cases were due to dog bites and most common clinical presentation was furious rabies. In most patients (74%), no rabies post-exposure prophylaxis (RPEP) was administered before rabies symptoms appeared. Other patients received incomplete RPEP series. CONCLUSION: Rabies should be suspected in any patient with encephalitis or paralysis who travelled to, or migrated from a rabies-endemic country. Comprehensive information about a rabies risk should be given to travellers to rabies endemic countries, notably migrants visiting friends and relatives.
BACKGROUND: Sixty cases of rabies in international travellers from 1990 to 2012 were previously reviewed. We present here an update of rabies cases in international travellers from 2013 to 2019. METHODS: We systematically reviewed the existing literature and collected 23 cases of rabies in individuals who crossed an international border between the time of infection and diagnosis, or who were infected following expatriation or migration. RESULTS: Most cases were in male adult travellers and diagnosed in Europe and the Middle East, with most exposures in Asia or in Africa. Migrants originating from rabies-endemic low-and-middle income countries and their descendants accounted for two thirds of cases. Other cases were in tourists, business travellers and expatriates. Median travel duration (excluding migration trip) was 60 days (range 7-240 days). Most cases were due to dog bites and most common clinical presentation was furious rabies. In most patients (74%), no rabies post-exposure prophylaxis (RPEP) was administered before rabies symptoms appeared. Other patients received incomplete RPEP series. CONCLUSION: Rabies should be suspected in any patient with encephalitis or paralysis who travelled to, or migrated from a rabies-endemic country. Comprehensive information about a rabies risk should be given to travellers to rabies endemic countries, notably migrants visiting friends and relatives.
Authors: Martin P Grobusch; Leisa Weld; Abraham Goorhuis; Davidson H Hamer; Mirjam Schunk; Sabine Jordan; Frank P Mockenhaupt; François Chappuis; Hilmir Asgeirsson; Eric Caumes; Mogens Jensenius; Perry J J van Genderen; Francesco Castelli; Rogelio López-Velez; Vanessa Field; Emmanuel Bottieau; Israel Molina; Christophe Rapp; Marta Díaz Ménendez; Effrossyni Gkrania-Klotsas; Carsten S Larsen; Denis Malvy; David Lalloo; Federico Gobbi; Simin A Florescu; Philippe Gautret; Patricia Schlagenhauf Journal: Lancet Reg Health Eur Date: 2020-11-12
Authors: Wenshu He; Can Baysal; Maria Lobato Gómez; Xin Huang; Derry Alvarez; Changfu Zhu; Victoria Armario-Najera; Aamaya Blanco Perera; Pedro Cerda Bennaser; Andrea Saba-Mayoral; Guillermo Sobrino-Mengual; Ashwin Vargheese; Rita Abranches; Isabel Alexandra Abreu; Shanmugaraj Balamurugan; Ralph Bock; Johannes F Buyel; Nicolau B da Cunha; Henry Daniell; Roland Faller; André Folgado; Iyappan Gowtham; Suvi T Häkkinen; Shashi Kumar; Ramalingam Sathish Kumar; Cristiano Lacorte; George P Lomonossoff; Ines M Luís; Julian K-C Ma; Karen A McDonald; Andre Murad; Somen Nandi; Barry O'Keef; Subramanian Parthiban; Mathew J Paul; Daniel Ponndorf; Elibio Rech; Julio C M Rodrigues; Stephanie Ruf; Stefan Schillberg; Jennifer Schwestka; Priya S Shah; Rahul Singh; Eva Stoger; Richard M Twyman; Inchakalody P Varghese; Giovanni R Vianna; Gina Webster; Ruud H P Wilbers; Paul Christou; Kirsi-Marja Oksman-Caldentey; Teresa Capell Journal: Plant Biotechnol J Date: 2021-07-19 Impact factor: 13.263