Animal-associated exposure to rabies virus among travelers, 1997-2012
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
Emerging Infectious Diseases 2015, 21 (4): 569-77
Among travelers, rabies cases are rare, but animal bites are relatively common. To determine which travelers are at highest risk for rabies, we studied 2,697 travelers receiving care for animal-related exposures and requiring rabies postexposure prophylaxis at GeoSentinel clinics during 1997-2012. No specific demographic characteristics differentiated these travelers from other travelers seeking medical care, making it challenging to identify travelers who might benefit from reinforced pretravel rabies prevention counseling. Median travel duration was short for these travelers: 15 days for those seeking care after completion of travel and 20 days for those seeking care during travel. This finding contradicts the view that preexposure rabies vaccine recommendations should be partly based on longer travel durations. Over half of exposures occurred in Thailand, Indonesia, Nepal, China, and India. International travelers to rabies-endemic regions, particularly Asia, should be informed about potential rabies exposure and benefits of pretravel vaccination, regardless of demographics or length of stay.
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