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Pre-exposure rabies vaccination among US international travelers: findings from the global TravEpiNet consortium.
Vector Borne Zoonotic Dis. 2014 Feb; 14(2):160-7.VB

Abstract

BACKGROUND

People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009-2010.

MATERIAL AND METHODS

We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics. Travel destinations were classified by strength level of rabies vaccination recommendation.

RESULTS

Of 13,235 travelers, 226 (2%) reported previous rabies vaccination, and 406 (3%) received rabies vaccine at the consultation. Common travel purposes for these 406 travelers were leisure (26%), research/education (17%), and nonmedical service work (14%). Excluding the 226 who were previously vaccinated, 8070 (62%) of 13,009 travelers intended to visit one or more countries with a strong recommendation for rabies vaccination; 1675 (21%) of these 8070 intended to travel for 1 month or more. Among these 1675 travelers, 145 (9%) were vaccinated, 498 (30%) declined vaccination, 832 (50%) had itineraries that clinicians determined did not indicate vaccination, and 200 (12%) remained unvaccinated for other reasons. In both bivariate and multivariate analyses, travelers with trip durations >6 months versus 1-3 months (adjusted odds ratio [OR]=4.9 [95% confidence interval [CI] 2.1, 11.4]) and those traveling for "research/education" or to "provide medical care" (adjusted OR=5.1 [95% CI 1.9, 13.7] and 9.5 [95% CI 2.2, 40.8], respectively), compared with leisure travelers, were more likely to receive rabies vaccination.

CONCLUSIONS

Few travelers at GTEN clinics received rabies vaccine, although many planned trips 1 month long or more to a strong-recommendation country. Clinicians often determined that vaccine was not indicated, and travelers often declined vaccine when it was offered. The decision to vaccinate should take into account the strength of the vaccine recommendation at the destination country, duration of stay, availability of postexposure prophylaxis, potential for exposure to animals, and likelihood of recurrent travel to high-risk destinations.

Authors+Show Affiliations

1 Travelers' Health Branch, Division of Global Migration and Quarantine, Centers for Disease Control and Prevention , Atlanta, Georgia .No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

24359420

Citation

Dolan, Samantha B., et al. "Pre-exposure Rabies Vaccination Among US International Travelers: Findings From the Global TravEpiNet Consortium." Vector Borne and Zoonotic Diseases (Larchmont, N.Y.), vol. 14, no. 2, 2014, pp. 160-7.
Dolan SB, Jentes ES, Sotir MJ, et al. Pre-exposure rabies vaccination among US international travelers: findings from the global TravEpiNet consortium. Vector Borne Zoonotic Dis. 2014;14(2):160-7.
Dolan, S. B., Jentes, E. S., Sotir, M. J., Han, P., Blanton, J. D., Rao, S. R., LaRocque, R. C., Ryan, E. T., Abraham, G. M., Alvarez, S., Ansdell, V., Yates, J. A., Atkins, E. H., Cahill, J., Birich, H. K., Vitek, D., Connor, B. A., Dismukes, R., Kozarsky, P., ... Vinetz, J. (2014). Pre-exposure rabies vaccination among US international travelers: findings from the global TravEpiNet consortium. Vector Borne and Zoonotic Diseases (Larchmont, N.Y.), 14(2), 160-7. https://doi.org/10.1089/vbz.2013.1381
Dolan SB, et al. Pre-exposure Rabies Vaccination Among US International Travelers: Findings From the Global TravEpiNet Consortium. Vector Borne Zoonotic Dis. 2014;14(2):160-7. PubMed PMID: 24359420.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pre-exposure rabies vaccination among US international travelers: findings from the global TravEpiNet consortium. AU - Dolan,Samantha B, AU - Jentes,Emily S, AU - Sotir,Mark J, AU - Han,Pauline, AU - Blanton,Jesse D, AU - Rao,Sowmya R, AU - LaRocque,Regina C, AU - Ryan,Edward T, AU - ,, AU - Abraham,George M, AU - Alvarez,Salvador, AU - Ansdell,Vernon, AU - Yates,Johnnie A, AU - Atkins,Elisha H, AU - Cahill,John, AU - Birich,Holly K, AU - Vitek,Dagmar, AU - Connor,Bradley A, AU - Dismukes,Roberta, AU - Kozarsky,Phyllis, AU - Dosunmu,Rone, AU - Goad,Jeffrey A, AU - Hagmann,Stefan, AU - Hale,DeVon, AU - Hynes,Noreen A, AU - Jacquerioz,Frederique, AU - McLellan,Susan, AU - Knouse,Mark, AU - Lee,Jennifer, AU - LaRocque,Regina C, AU - Ryan,Edward T, AU - Oladele,Alawode, AU - Demeke,Hanna, AU - Pasinski,Roger, AU - Wheeler,Amy E, AU - Rao,Sowmya R, AU - Rosen,Jessica, AU - Schwartz,Brian S, AU - Stauffer,William, AU - Walker,Patricia, AU - Vinetz,Joseph, Y1 - 2013/12/20/ PY - 2013/12/24/entrez PY - 2013/12/24/pubmed PY - 2014/10/30/medline SP - 160 EP - 7 JF - Vector borne and zoonotic diseases (Larchmont, N.Y.) JO - Vector Borne Zoonotic Dis VL - 14 IS - 2 N2 - BACKGROUND: People who travel to areas with high rabies endemicity and have animal contact are at increased risk for rabies exposure. We examined characteristics of international travelers queried regarding rabies vaccination during pretravel consultations at Global TravEpiNet (GTEN) practices during 2009-2010. MATERIAL AND METHODS: We performed bivariate and multivariable analyses of data collected from 18 GTEN clinics. Travel destinations were classified by strength level of rabies vaccination recommendation. RESULTS: Of 13,235 travelers, 226 (2%) reported previous rabies vaccination, and 406 (3%) received rabies vaccine at the consultation. Common travel purposes for these 406 travelers were leisure (26%), research/education (17%), and nonmedical service work (14%). Excluding the 226 who were previously vaccinated, 8070 (62%) of 13,009 travelers intended to visit one or more countries with a strong recommendation for rabies vaccination; 1675 (21%) of these 8070 intended to travel for 1 month or more. Among these 1675 travelers, 145 (9%) were vaccinated, 498 (30%) declined vaccination, 832 (50%) had itineraries that clinicians determined did not indicate vaccination, and 200 (12%) remained unvaccinated for other reasons. In both bivariate and multivariate analyses, travelers with trip durations >6 months versus 1-3 months (adjusted odds ratio [OR]=4.9 [95% confidence interval [CI] 2.1, 11.4]) and those traveling for "research/education" or to "provide medical care" (adjusted OR=5.1 [95% CI 1.9, 13.7] and 9.5 [95% CI 2.2, 40.8], respectively), compared with leisure travelers, were more likely to receive rabies vaccination. CONCLUSIONS: Few travelers at GTEN clinics received rabies vaccine, although many planned trips 1 month long or more to a strong-recommendation country. Clinicians often determined that vaccine was not indicated, and travelers often declined vaccine when it was offered. The decision to vaccinate should take into account the strength of the vaccine recommendation at the destination country, duration of stay, availability of postexposure prophylaxis, potential for exposure to animals, and likelihood of recurrent travel to high-risk destinations. SN - 1557-7759 UR - https://www.unboundmedicine.com/medline/citation/24359420/Pre_exposure_rabies_vaccination_among_US_international_travelers:_findings_from_the_global_TravEpiNet_consortium_ L2 - https://www.liebertpub.com/doi/10.1089/vbz.2013.1381?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -