Rabies in Travelers

Gautret, Philippe; Parola, Philippe

doi:10.1007/s11908-014-0394-0

Cited by 21 publications

(13 citation statements)

References 44 publications

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“…Research confirmed rabies cases among travellers reveals that the population of travellers visiting friends and relatives is at heightened risk. 15,16 This confirms previously described problems with acceptance of preventive measures in this group, despite attendance at a travel clinic. 17 Tourists, another at-risk group, were also more likely to receive intradermal vaccination in our study.…”

Section: Opensupporting

confidence: 89%

“…13 Recognized risk factors for animal-associated rabies exposure in travellers include travel to Southeast Asia, India and North Africa, young age and travelling for tourism. 15 Many cases of rabies exposure have occurred early on in the travel period in the setting of short travel duration. 1,15 However, Dolan and colleagues reported that travellers seeking pretravel vaccination were more likely to be travelling for longer periods.…”

Section: Discussionmentioning

confidence: 99%

“…15 Many cases of rabies exposure have occurred early on in the travel period in the setting of short travel duration. 1,15 However, Dolan and colleagues reported that travellers seeking pretravel vaccination were more likely to be travelling for longer periods. 14 In our study, younger people were less likely to receive pre-exposure prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

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Intradermal pre-exposure rabies vaccination in a Canadian travel clinic: 6-year retrospective observational study

Kong

Vincelette

Laplante

et al. 2018

cmajo

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The introduction of intradermal vaccination for pre-exposure rabies prophylaxis was associated with an increase in vaccination uptake. Reduced cost may be responsible for the increased coverage among younger travellers and those travelling for tourism. The high seroconversion rate after intradermal vaccination supports the effectiveness of this route of administration for pre-exposure rabies prophylaxis in immunocompetent people.

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Section: Opensupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intradermal pre-exposure rabies vaccination in a Canadian travel clinic: 6-year retrospective observational study

Kong

Vincelette

Laplante

et al. 2018

cmajo

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“…Reducing the time frame and number of doses required for PrEP would make it simpler and more cost-effective to implement in travelers as the classic 3-dose PrEP may be difficult to complete with the short average interval to departure (<21 days) of many travelers [ 18 , 19 ]. High vaccine cost is another reason for very low PrEP coverage in travelers [ 20 ]. The new WHO recommendations will hopefully allow increasing rabies pre-travel vaccination coverage in travelers to destinations where RIG administration is unlikely to be provided despite being indicated.…”

Section: Discussionmentioning

confidence: 99%

Rabies post-exposure prophylaxis started during or after travel: A GeoSentinel analysis

et al. 2018

Self Cite

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BackgroundRecent studies demonstrate that rabies post-exposure prophylaxis (RPEP) in international travelers is suboptimal, with only 5–20% of travelers receiving rabies immune globulin (RIG) in the country of exposure when indicated. We hypothesized that travelers may not be receiving RIG appropriately, and practices may vary between countries. We aim to describe the characteristics of travelers who received RIG and/or RPEP during travel.Methodology/Principal findingsWe conducted a multi-center review of international travelers exposed to potentially rabid animals, collecting information on RPEP administration. Travelers who started RPEP before (Group A) and at (Group B) presentation to a GeoSentinel clinic during September 2014–July 2017 were included. We included 920 travelers who started RPEP. About two-thirds of Group A travelers with an indication for rabies immunoglobulin (RIG) did not receive it. Travelers exposed in Indonesia were less likely to receive RIG in the country of exposure (relative risk: 0.30; 95% confidence interval: 0.12–0.73; P = 0.01). Travelers exposed in Thailand [Relative risk (RR) 1.38, 95% Confidence Interval (95% CI): 1.0–1.8; P = 0.02], Sri Lanka (RR 3.99, 95% CI: 3.99–11.9; P = 0.013), and the Philippines (RR 19.95, 95% CI: 2.5–157.2; P = 0.01), were more likely to receive RIG in the country of exposure.Conclusions/SignificanceThis analysis highlights gaps in early delivery of RIG to travelers and identifies specific countries where travelers may be more or less likely to receive RIG. More detailed country-level information helps inform risk education of international travelers regarding appropriate rabies prevention.

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“…Although global experience with vaccines against rabies show that PrEP is immunogenic and well tolerated, an estimated 70% of travellers to rabies-endemic countries do not receive PrEP vaccine pre-travel. 10…”

Section: Introductionmentioning

confidence: 99%

Perceptions of rabies risk: a survey of travellers and travel clinics from Canada, Germany, Sweden and the UK

Marano

Moodley

Melander

et al. 2018

Journal of Travel Medicine

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BackgroundExtensive global experience shows that rabies pre-exposure prophylaxis (PrEP) through vaccination is effective and well tolerated, yet many travellers opt not to be vaccinated when travelling to rabies-endemic countries. Previous research has identified several factors influencing the choices travellers make to reduce the risk of rabies, including cost, time constraint and perspective on the importance of vaccination. The objectives of this study were to assess travellers’ awareness of rabies and advice-seeking attitudes and to evaluate travel clinics practices regarding rabies pre-travel advice.MethodsWe surveyed individuals aged 18–65 years residing in the UK, Germany, Canada and Sweden who had travelled to rabies-endemic countries between 2013 and 2016 and defined this as the rabies visit-risk sample. The first 850 respondents from the visit-risk sample who had undertaken pre-defined at-risk activities (e.g. contact with animals during the trip) completed an additional 15-min online questionnaire and were included in the activity-risk subsample. We also interviewed travel clinic personnel using a 25-min online or phone questionnaire.ResultsThe visit-risk sample included 4678 individuals. Many sought pre-travel health information online (33%) or talked to a family doctor (24%). Within the activity-risk subsample, 83% of travellers were aware of at least a few basic facts about rabies, and 84% could identify at least one correct rabies prevention measure; 49% were aware of a rabies vaccine, however, only 8% reported receiving PrEP vaccination within the past 3 years. Among 180 travel clinic respondents, 21% reported recommending PrEP against rabies to all travellers to rabies-endemic countries. Travel clinics estimated that 81% of travellers complete their travel vaccination schedules and reported sending reminders by e-mails (38%), text (38%), phone calls (37%) or by using vaccination cards (37%).ConclusionsThese findings suggest that although travellers had frequently heard of rabies, awareness of the risks of this serious infectious disease was relatively low.

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Rabies in Travelers

Cited by 21 publications

References 44 publications

Intradermal pre-exposure rabies vaccination in a Canadian travel clinic: 6-year retrospective observational study

Intradermal pre-exposure rabies vaccination in a Canadian travel clinic: 6-year retrospective observational study

Rabies post-exposure prophylaxis started during or after travel: A GeoSentinel analysis

Perceptions of rabies risk: a survey of travellers and travel clinics from Canada, Germany, Sweden and the UK

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