Rabies Immunization of Travelers in a Canine Rabies Endemic Area

Sibunruang, Suda; Tepsumethanon, Saowaluck; Raksakhet, Natthasri; Tantawichien, Terapong

doi:10.1111/jtm.12023

Cited by 14 publications

(12 citation statements)

References 17 publications

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“…Among these cases, 5 cases, including the data of rabies vaccination-related studies, were published in the Korean Journal of Pediatric Infectious Diseases in 2013 [8]. This percentage is consistent with the results of a study in the UK but higher than that reported in Thailand and Nepal [9, 10, 11]. Only one study from New Zealand reports a higher child-to-adult ratio of 1:5, suggesting that children are at high risk group [12].…”

Section: Discussionsupporting

confidence: 80%

“…Previous studies also report remarkably high percentages of dog bites, in addition to monkey and cat bites [9, 10, 11, 12, 13]. In the present study, of the 26 cases of monkey exposure, 23 were concentrated in Thailand (13 cases) and Indonesia (10 cases), reflecting the regional distribution of monkey populations.…”

Section: Discussionsupporting

confidence: 67%

“…Bite injuries mostly occurred in Southeast Asia, especially Thailand. The main animal causing bite injuries was dogs, and the most common injury site was the lower extremities (Table 4) [9, 10, 11, 12, 13]. …”

Section: Discussionmentioning

confidence: 99%

“…Besides visiting China and Japan, Koreans visiting Southeast Asia is one of the reasons for the results, but other studies report that bite injuries occurred most commonly in Southeast Asia [9, 10, 11, 12, 13]. …”

Section: Discussionmentioning

confidence: 99%

“…The other 64 patients were vaccinated with RIG in our clinic within 1 week after the first vaccination. As shown in studies from clinics in the UK and Thailand, such low local RIG vaccination rates are expected because of the complex issues of relatively low availability of RIG compared with rabies vaccine, a lack of patient understanding about rabies PEP, and cost [9, 10]. …”

Section: Discussionmentioning

confidence: 99%

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Rabies Post-Exposure Prophylaxis of Overseas Travelers in the International Travel Clinic of the National Medical Center from 2006 to 2012, Korea

et al. 2014

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BackgroundRabies is an acute fatal viral disease generally transmitted from infected animals to humans through bites. It is distributed worldwide. The number of Korean people traveling to rabies-endemic countries and being bitten by infected animals has been increasing recently. Therefore, we investigated international travelers who received rabies post-exposure prophylaxis (PEP) at the National Medical Center (NMC) and compared the data with those of other clinics.Materials and MethodsThis study was a retrospective review of 106 patients who visited the International Travel Clinic of the NMC and received rabies PEP between July 2006 and December 2012. During that period, we used the Essen intramuscular regimen protocol. Complete rabies PEP was defined as 5 doses of rabies vaccination with or without rabies immunoglobulin (RIG) administration according to the World Health Organization guidelines.ResultsA total 106 cases documented within the period of 6 years were selected, including 10 children younger than 15 years and 96 older than 15 years. The mean age of the patients who received PEP was 33.4 years. Of the patients, 53 were male and another 53 were female. Most of the exposures occurred in Southeast Asia, predominantly from dog bites (71, 66.9%). The lower extremities were the most frequent site of exposure (37, 34.9%). All the patients began receiving rabies vaccination for prophylaxis after exposure, and 51 received rabies vaccination with RIG. Meanwhile, 74 cases (69.8%) initiated rabies vaccination overseas, but only 10 of them received RIG while overseas; the remaining 32 (30.2%) initiated rabies vaccination after returning to Korea. Within 7 days, all the children and 74 adults received their first rabies vaccination. Six adults initiated first rabies vaccination after 1 week. Eleven of the 106 patients stopped PEP before 5 doses, among whom 4 (1 child and 3 adults) discontinued vaccination after confirming that the biting animal remained healthy throughout 10 days of observation. None of the patients had been previously vaccinated against rabies.ConclusionsMost of the overseas travelers who visited our clinic after being bitten by suspected rabid animals received appropriate rabies PEP. However, the interval between exposure and first rabies vaccination was often delayed. Tourists who plan to travel in rabies enzootic regions need to be aware that prompt initiation of PEP is important to reduce the risk for developing human rabies.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Rabies Post-Exposure Prophylaxis of Overseas Travelers in the International Travel Clinic of the National Medical Center from 2006 to 2012, Korea

et al. 2014

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Rabies in Travelers

Gautret

Parola

2014

Curr Infect Dis Rep

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Most cases of rabies in travelers are associated with dog bites and occur in adults who are commonly migrants. 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, but nonhuman primates are the leading animals responsible for injuries in travelers returning from Southeast Asia. Travel to Southeast Asia, India and North Africa, young age, and traveling for tourism are risk factors for potential exposure. More than 70 % of travelers are not immunized prior to departing and do not receive adequate care when injured. The intradermal vaccination route has been proven economical, safe and immunogenic in travelers. The immunity provided by the three-dose series is long-lasting and should be considered an investment for future travel. Abbreviated schedules may be used for last-minute travelers.

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International Travelers’ Sociodemographic, Health, and Travel Characteristics: An Italian Study

Troiano

Mercone²,

Bagnoli³

et al. 2017

Annals of Global Health

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Rabies Immunization of Travelers in a Canine Rabies Endemic Area

Abstract: Rabies prophylaxis is an important decision for each traveler. It should be made before visiting endemic areas.

Cited by 14 publications

References 17 publications

Rabies Post-Exposure Prophylaxis of Overseas Travelers in the International Travel Clinic of the National Medical Center from 2006 to 2012, Korea

Rabies Post-Exposure Prophylaxis of Overseas Travelers in the International Travel Clinic of the National Medical Center from 2006 to 2012, Korea

Rabies in Travelers

International Travelers’ Sociodemographic, Health, and Travel Characteristics: An Italian Study

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