Tags

Type your tag names separated by a space and hit enter

Rabies vaccination for international travelers.
Vaccine. 2012 Jan 05; 30(2):126-33.V

Abstract

Rabies prevention in travelers is a controversial issue. According to experts, the decision to vaccinate results from an individual risk assessment based on the duration of stay, the likelihood of engagement in at-risk activities, the age of the traveler, the rabies endemicity and access to appropriate medical care in the country of destination. However, no detailed information is available regarding the last two determinants in many regions. Twenty-two cases of rabies were reported in tourists, expatriates and migrant travelers over the last decade, including three cases following short-term travel of no more than two weeks. Studies on rabies post-exposure prophylaxis (PEP) in travelers show that overall, 0.4% (range 0.01-2.3%) of travelers have experienced an at-risk bite per month of stay in a rabies-endemic country, while 31% of expatriates and 12% of tourists were vaccinated against rabies before traveling. The main reason cited by travelers for not being vaccinated is the cost of the vaccine. The majority of patients who sustained a high risk injury was not vaccinated against rabies before traveling and were not properly treated abroad. From available studies, the following risk factors for injuries sustained from potentially rabid animals may be identified: traveling to South-East Asia, India or North Africa, young age, and traveling for tourism. The duration of travel does not appear to be a risk factor. It should be noted that "at-risk activities" have not been addressed in these studies. Detailed rabies distribution maps and information on the availability of rabies biologics are urgently needed in order to identify those travelers who need pre-travel vaccination. Meanwhile, cost-minimization of rabies pre-exposure vaccination may be achieved in several ways, notably by using the intra-dermal method of vaccination.

Authors+Show Affiliations

Institut Hospitalo-Universitaire en Maladies Infectieuses et Tropicales, Hôpital Nord, AP-HM, Marseille, France. philippe.gautret@club-internet.frNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

22085557

Citation

Gautret, Philippe, and Philippe Parola. "Rabies Vaccination for International Travelers." Vaccine, vol. 30, no. 2, 2012, pp. 126-33.
Gautret P, Parola P. Rabies vaccination for international travelers. Vaccine. 2012;30(2):126-33.
Gautret, P., & Parola, P. (2012). Rabies vaccination for international travelers. Vaccine, 30(2), 126-33. https://doi.org/10.1016/j.vaccine.2011.11.007
Gautret P, Parola P. Rabies Vaccination for International Travelers. Vaccine. 2012 Jan 5;30(2):126-33. PubMed PMID: 22085557.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rabies vaccination for international travelers. AU - Gautret,Philippe, AU - Parola,Philippe, Y1 - 2011/11/12/ PY - 2011/08/19/received PY - 2011/10/21/revised PY - 2011/11/01/accepted PY - 2011/11/17/entrez PY - 2011/11/17/pubmed PY - 2012/3/22/medline SP - 126 EP - 33 JF - Vaccine JO - Vaccine VL - 30 IS - 2 N2 - Rabies prevention in travelers is a controversial issue. According to experts, the decision to vaccinate results from an individual risk assessment based on the duration of stay, the likelihood of engagement in at-risk activities, the age of the traveler, the rabies endemicity and access to appropriate medical care in the country of destination. However, no detailed information is available regarding the last two determinants in many regions. Twenty-two cases of rabies were reported in tourists, expatriates and migrant travelers over the last decade, including three cases following short-term travel of no more than two weeks. Studies on rabies post-exposure prophylaxis (PEP) in travelers show that overall, 0.4% (range 0.01-2.3%) of travelers have experienced an at-risk bite per month of stay in a rabies-endemic country, while 31% of expatriates and 12% of tourists were vaccinated against rabies before traveling. The main reason cited by travelers for not being vaccinated is the cost of the vaccine. The majority of patients who sustained a high risk injury was not vaccinated against rabies before traveling and were not properly treated abroad. From available studies, the following risk factors for injuries sustained from potentially rabid animals may be identified: traveling to South-East Asia, India or North Africa, young age, and traveling for tourism. The duration of travel does not appear to be a risk factor. It should be noted that "at-risk activities" have not been addressed in these studies. Detailed rabies distribution maps and information on the availability of rabies biologics are urgently needed in order to identify those travelers who need pre-travel vaccination. Meanwhile, cost-minimization of rabies pre-exposure vaccination may be achieved in several ways, notably by using the intra-dermal method of vaccination. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/22085557/Rabies_vaccination_for_international_travelers_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(11)01761-0 DB - PRIME DP - Unbound Medicine ER -