Rabies as a traveler's risk, especially in high-endemicity areas.
Rabies is a viral zoonosis, an animal disease transmissible to humans, caused by rhabdoviruses of the genus Lyssavirus. It is almost invariably fatal in humans. Rabies is widely distributed throughout the world and present in all continents. More than 99.,9 % of human deaths from rabies reported worldwide result from the bite of a rabid dog. Prompt and thorough cleansing of the wound, together with administration of immunoglobulin in cases of severe exposure, and immunization with modern vaccines starting immediately after exposure, virtually guarantee complete protection. When assessing the risk of contracting the disease for a traveller visiting a rabies- affected area, to contract the disease one should consider the probability of: rabies exposure that which is directly related to the incidence of rabies in the area and the probability of contact with an infected rabies- susceptible animals, be it either wild or and domestic animals, especially dogs and cats; being provided with the best possible treatment, which depends upon the availability of modern safe and efficacious rabies vaccines and rabies immunoglobulin, and the rabies awareness of the health care providers in charge of rabies prophylaxis in the area where the exposure occurs. This article,paper using a number of examples and recent data on dog bite incidence and vaccine availability in various parts of the world, provides guidance on how to assess the risk and proposes means to avoid or mitigate this risk.
Meslin
François-Xavier
FX
Department of Communicable Diseases, World Health Organization, Switzerland.
D000818:Animals; D004285:Dogs; D019353:Endemic Diseases / Q000517:prevention & control* / Q000706:statistics & numerical data*; D014943:Global Health; D006801:Humans; D007115:Immunization Schedule; D015994:Incidence; D007271:Injections, Intradermal; D007273:Injections, Intramuscular; D010353:Patient Education as Topic / Q000379:methods; D017410:Practice Guidelines as Topic; D011818:Rabies / Q000453:epidemiology* / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000627:therapeutic use; D018570:Risk Assessment / Q000379:methods; D014195:Travel
D011819:Rabies Vaccines