title: Animal-associated injuries and related diseases among returned travellers: a review of the GeoSentinel Surveillance Network.
abstract: BACKGROUND
  Increased travel to exotic destinations around the world is escalating the risk of exposure to animal-associated injuries with a risk of acquiring rabies.
  
  
  METHODS
  We have examined data reported to GeoSentinel Surveillance Network to highlight characteristics of animal-associated injuries in travellers.
  
  
  RESULTS
  A total of 320 cases were reported from 1998 to 2005. Travellers were predominantly tourists from developed countries with median travel duration of 23 days. A pre-travel encounter was recorded in 45.0% of the cases. A significantly greater proportion of patients with animal-related injuries were female compared to other travel associated diagnosis (54.7% versus 47.4%) and were most likely patients aged <15 years (6.2% versus 2.6%). The proportionate morbidity for sustaining an animal bite was higher among travellers visiting Southeast Asia (3.9%) and the rest of Asia (2.2%) compared to Australia-New Zealand (1.9%), Africa (1.0%), Latin America (0.8%), North America (0.9%) and Europe (1.2%). Seventy-five percent of cases occurred in countries endemic for rabies. Dogs were involved in 51.3% of cases, monkeys in 21.2%, cats in 8.2%, bats in 0.7% and humans in 0.7%. The higher likelihood for animal-related injuries among female travellers was dependant on the animal species involved, with monkeys accounting for the majority of injuries. In contrast, males were more likely to be injured by dogs. Only 66.1% of all patients reported with animal-related injury received rabies post-exposure prophylaxis.
  
  
  CONCLUSIONS
  This data shows that animal-associated injuries are not uncommon among returned travellers presenting to GeoSentinel sites. The highest proportion of injuries was recorded in travellers to Asia, mostly in regions, which are endemic for rabies, and this had led to a requirement for PEP.
authors.affiliation: Service des Maladies Infectieuses et Tropicales, AP-HM, Hôpital Nord, 13015 Marseille, Cedex 05, France. philippe.gautret@club-internet.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
authors.forename: Eli
authors.initials: E
authors.lastname: Schwartz
authors.forename: Marc
authors.initials: M
authors.lastname: Shaw
authors.forename: Georges
authors.initials: G
authors.lastname: Soula
authors.forename: Pierre
authors.initials: P
authors.lastname: Gazin
authors.forename: Jean
authors.initials: J
authors.lastname: Delmont
authors.forename: Philippe
authors.initials: P
authors.lastname: Parola
authors.forename: Marie José
authors.initials: MJ
authors.lastname: Soavi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Matchett
authors.forename: Graham
authors.initials: G
authors.lastname: Brown
authors.forename: Joseph
authors.initials: J
authors.lastname: Torresi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001733:Bites and Stings / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011818:Rabies / Q000517:prevention & control*; D014195:Travel