Rabies postexposure prophylaxis in returned injured travelers from France, Australia, and New Zealand: a retrospective study.
BACKGROUND
There is little published information available describing rabies pre- and postexposure prophylaxis (PEP) in tourists returning to their home country and seeking care for animal-associated injuries, especially those associated with a rabies risk.


METHODS
We analyzed 261 travelers seeking care on returning to their home country following an animal-related injury acquired abroad. Information on individual cases of rabies (PEP) including preexposure status, type of contact with a potentially rabid animal, type of animal, and the nature of rabies PEP was collected by retrospectively analyzing records from May 1997 to May 2005.


RESULTS
The majority of injuries were acquired in South-east Asia and North Africa. Only 6.8% of injured patients were previously vaccinated against rabies, while 75.4% of the cohort experienced a severe injurious contact with animals (World Health Organization category III). Of travelers who sustained a high-risk injury, only 24% received both vaccination and rabies immune globulin,(RIG) while 76% received vaccination only. Of the travelers who did not receive RIG, 43% had received a first dose of vaccine more than 7 days after return and before presenting to a clinic in their home country.


CONCLUSIONS
This study highlights important deficiencies in rabies PEP for travelers who acquire high-risk, animal-associated injuries in rabies-endemic countries, with the majority not receiving adequate PEP or experiencing a substantial delay before receiving rabies vaccination.
Gautret
Philippe
P
Service des Maladies Infectieuses et Tropicales, Hôpital Nord, Marseille, France. philippe.gautret@club-internet.fr
Shaw
Marc
M
Gazin
Pierre
P
Soula
Georges
G
Delmont
Jean
J
Parola
Philippe
P
Soavi
Marie José
MJ
Brouqui
Philippe
P
Matchett
D Elizabeth
DE
Torresi
Joseph
J
D001315:Australia; D005602:France; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use; D009520:New Zealand; D011818:Rabies / Q000517:prevention & control*; D011819:Rabies Vaccines / Q000627:therapeutic use; D012189:Retrospective Studies; D014195:Travel
D007136:Immunoglobulins; D011819:Rabies Vaccines