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Rabies postexposure consultations in New Zealand from 1998 to 2012.
J Travel Med. 2015 Jan-Feb; 22(1):31-8.JT

Abstract

BACKGROUND

Rabies is an invariably fatal zoonotic viral disease. New Zealanders going abroad are largely unaware of the risk of contracting the disease. Prevention is the key to controlling the spread of this disease.

METHODS

Data from 363 individuals presenting to New Zealand travel health clinics between 1998 and 2012 for post-travel consultations on potential rabies exposure were collated retrospectively. The data focused on traveler demographics, the country and nature of exposure, the purpose of travel, and pre-travel rabies awareness.

RESULTS

The female-to-male ratio of subject travelers presenting was almost equal (1.1 : 1 ratio, respectively); the subjects were typically between 16 and 30 years (44.6%), tourists (64.5%), traveling less than 1 month (55.3%), and likely to have been exposed to animal contact in either Thailand (31.1%), China (13.2%), or Indonesia (12.3%). The animals to which they were exposed were usually dogs (59.5%) or monkeys (28.7%). Most potential exposures were penetrating (69.9%). Injury caused by the animal was more common in the lower limbs (50%) than in the upper limbs (43.4%); 89.4% of exposures were of World Health Organization (WHO) category III. Travelers were more likely to have received pre-travel rabies advice if they had been seen by a travel medicine specialist (96.1%) compared to a general practitioner (GP) (53.3%). Sixteen percent of travelers received rabies preexposure prophylaxis. Of the subjects who were managed following exposure, 79.7% did not receive immunoglobulin when indicated, and 21.5% did not receive any vaccine. Of the travelers that did receive a vaccine, 62.5% did so on the day of exposure. Of the travelers assessed, 16.7% had traveled without insurance.

CONCLUSIONS

New Zealanders require better guidance in understanding the need for travel-related rabies vaccination, as they are not managed abroad according to WHO guidelines. Few travelers had had pre-travel immunization, and only 20.3% of them had received WHO-advised postexposure management. Thus, 79.7% of the cohort theoretically remained at risk for contracting rabies because of inappropriate management following possible exposure to the disease.

Authors+Show Affiliations

Worldwise Travellers Health Centres of New Zealand, Auckland, New Zealand; School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia.No affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

25315202

Citation

Shaw, Marc T M., et al. "Rabies Postexposure Consultations in New Zealand From 1998 to 2012." Journal of Travel Medicine, vol. 22, no. 1, 2015, pp. 31-8.
Shaw MT, Visser J, Edwards C. Rabies postexposure consultations in New Zealand from 1998 to 2012. J Travel Med. 2015;22(1):31-8.
Shaw, M. T., Visser, J., & Edwards, C. (2015). Rabies postexposure consultations in New Zealand from 1998 to 2012. Journal of Travel Medicine, 22(1), 31-8. https://doi.org/10.1111/jtm.12167
Shaw MT, Visser J, Edwards C. Rabies Postexposure Consultations in New Zealand From 1998 to 2012. J Travel Med. 2015 Jan-Feb;22(1):31-8. PubMed PMID: 25315202.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rabies postexposure consultations in New Zealand from 1998 to 2012. AU - Shaw,Marc T M, AU - Visser,Jenny, AU - Edwards,Ciaran, Y1 - 2014/10/15/ PY - 2014/02/11/received PY - 2014/06/21/revised PY - 2014/07/15/accepted PY - 2014/10/16/entrez PY - 2014/10/16/pubmed PY - 2015/9/15/medline SP - 31 EP - 8 JF - Journal of travel medicine JO - J Travel Med VL - 22 IS - 1 N2 - BACKGROUND: Rabies is an invariably fatal zoonotic viral disease. New Zealanders going abroad are largely unaware of the risk of contracting the disease. Prevention is the key to controlling the spread of this disease. METHODS: Data from 363 individuals presenting to New Zealand travel health clinics between 1998 and 2012 for post-travel consultations on potential rabies exposure were collated retrospectively. The data focused on traveler demographics, the country and nature of exposure, the purpose of travel, and pre-travel rabies awareness. RESULTS: The female-to-male ratio of subject travelers presenting was almost equal (1.1 : 1 ratio, respectively); the subjects were typically between 16 and 30 years (44.6%), tourists (64.5%), traveling less than 1 month (55.3%), and likely to have been exposed to animal contact in either Thailand (31.1%), China (13.2%), or Indonesia (12.3%). The animals to which they were exposed were usually dogs (59.5%) or monkeys (28.7%). Most potential exposures were penetrating (69.9%). Injury caused by the animal was more common in the lower limbs (50%) than in the upper limbs (43.4%); 89.4% of exposures were of World Health Organization (WHO) category III. Travelers were more likely to have received pre-travel rabies advice if they had been seen by a travel medicine specialist (96.1%) compared to a general practitioner (GP) (53.3%). Sixteen percent of travelers received rabies preexposure prophylaxis. Of the subjects who were managed following exposure, 79.7% did not receive immunoglobulin when indicated, and 21.5% did not receive any vaccine. Of the travelers that did receive a vaccine, 62.5% did so on the day of exposure. Of the travelers assessed, 16.7% had traveled without insurance. CONCLUSIONS: New Zealanders require better guidance in understanding the need for travel-related rabies vaccination, as they are not managed abroad according to WHO guidelines. Few travelers had had pre-travel immunization, and only 20.3% of them had received WHO-advised postexposure management. Thus, 79.7% of the cohort theoretically remained at risk for contracting rabies because of inappropriate management following possible exposure to the disease. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/25315202/Rabies_postexposure_consultations_in_New_Zealand_from_1998_to_2012_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/jtm.12167 DB - PRIME DP - Unbound Medicine ER -