Should travellers in rabies endemic areas receive pre-exposure rabies immunization?

A questionnaire survey was conducted in 1,882 foreign travellers, 74% of which were Europeans, after being in Thailand for an average of 17 days, about the history of potential rabies exposure during their visits. Dog bite and dog lick were experienced in 1.3% and 8.9% of the travellers respectively. The exposed individuals tended to stay in Thailand longer and the incidents occurred mainly in cities rather than in the rural areas. Thirty-one (1.6%) of all travellers had a history of rabies vaccination, 9 as a result of dog bite or dog lick in Thailand whereas the remaining 22 had already received the vaccine prior to coming to Thailand. Such high prevalences of potential rabies exposure and rabies vaccination may justify the inclusion of rabies vaccine into the multiple vaccination program for travellers to rabies endemic countries. This was favoured by over half of the travellers interviewed.