title: Risk of potentially rabid animal exposure among foreign travelers in Southeast Asia.
abstract: BACKGROUND
  Each year millions of travelers visit Southeast Asia where rabies is still prevalent. This study aimed to assess the risk of rabies exposure, i.e., by being bitten or licked by an animal, among travelers in Southeast Asia. The secondary objective was to assess their attitudes and practices related to rabies.
  
  
  RESULTS
  Foreign travelers departing to the destination outside Southeast Asia were invited to fill out the study questionnaire in the departure hall of Bangkok International Airport. They were asked about their demographic profile, travel characteristics, pre-travel health preparations, their possible exposure and their practices related to rabies during this trip. From June 2010 to February 2011, 7,681 completed questionnaires were collected. Sixty-two percent of the travelers were male, and the median age was 32 years. 34.0% of the participants were from Western/Central Europe, while 32.1% were from East Asia. Up to 59.3% had sought health information before this trip. Travel clinics were the source of information for 23.6% of travelers. Overall, only 11.6% of the participants had completed their rabies pre-exposure prophylaxis, and 15.3% had received only 1-2 shots, while 73.1% had not been vaccinated at all. In this study, the risk of being bitten was 1.11 per 100 travelers per month and the risk of being licked was 3.12 per 100 travelers per month. Among those who were bitten, only 37.1% went to the hospital to get post exposure treatment. Travelers with East Asian nationalities and longer duration of stay were significantly related to higher risk of animal exposure. Reason for travel was not related to the risk of animal exposure.
  
  
  CONCLUSIONS
  Travelers were at risk of being exposed to potentially rabid animals while traveling in Southeast Asia. Many were inadequately informed and unprepared for this life-threatening risk. Rabies prevention advice should be included in every pre-travel visit.
authors.affiliation: Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. tewpe@mahidol.ac.th
authors.forename: Watcharapong
authors.initials: W
authors.lastname: Piyaphanee
authors.forename: Chatporn
authors.initials: C
authors.lastname: Kittitrakul
authors.forename: Saranath
authors.initials: S
authors.lastname: Lawpoolsri
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
authors.forename: Wataru
authors.initials: W
authors.lastname: Kashino
authors.forename: Waraluk
authors.initials: W
authors.lastname: Tangkanakul
authors.forename: Prangthip
authors.initials: P
authors.lastname: Charoenpong
authors.forename: Thitiya
authors.initials: T
authors.lastname: Ponam
authors.forename: Suda
authors.initials: S
authors.lastname: Sibunruang
authors.forename: Weerapong
authors.initials: W
authors.lastname: Phumratanaprapin
authors.forename: Terapong
authors.initials: T
authors.lastname: Tantawichien
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001210:Asia, Southeastern / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011818:Rabies / Q000453:epidemiology*; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014195:Travel; D055815:Young Adult