Rabies postexposure prophylaxis in international travellers: Results from a Spanish travellers referral unit.
Adolescent
Adult
Animals
Dogs
Female
Humans
Immunoglobulins
/ administration & dosage
Internationality
Male
Middle Aged
Post-Exposure Prophylaxis
/ statistics & numerical data
Primates
Rabies
/ prevention & control
Rabies Vaccines
/ administration & dosage
Rabies virus
/ immunology
Spain
Travel-Related Illness
Young Adult
Medicina del viajero
Postexposure prophylaxis
Preexposure prophylaxis
Profilaxis postexposición
Profilaxis pre-exposición
Rabia
Rabies
Rabies vaccine
Travel medicine
Vacuna contra la rabia
Journal
Medicina clinica
ISSN: 1578-8989
Titre abrégé: Med Clin (Barc)
Pays: Spain
ID NLM: 0376377
Informations de publication
Date de publication:
24 01 2020
24 01 2020
Historique:
received:
22
07
2018
revised:
11
12
2018
accepted:
13
12
2018
pubmed:
24
2
2019
medline:
15
12
2020
entrez:
24
2
2019
Statut:
ppublish
Résumé
Rabies represents a major public health issue for travellers because pretravel preexposure (PrEP) rabies vaccination is not routinely indicated. For those unvaccinated, adequate postexposure prophylaxis (PEP), including rabies immunoglobulin (RIG) if needed, is the only effective method to prevent this fatal disease. Descriptive retrospective study at a National Referral Unit for Tropical and Travel Medicine in Madrid, Spain, among travellers treated with PEP for rabies (January 2012-December 2017). Demographic, clinical and management data were reviewed. 168 patients were treated for possible rabies exposure (53% females, median age 35 years; IQR: 31-42). Southeast Asia accounted for more than half of the cases (N=86, 57.3%; CI 95% 49-65%). Dogs were the primary animal involved (n=67, 44.9%; CI 37-53%). After the bite, in half of the cases (n=88, 52.4%; CI 44-60%) PEP rabies vaccine was started abroad, and the vaccine plus RIG in about 10% (n=22, 13.1%; CI: 8-19%). Most of patients classified as category III did not received RIG at all (n=88, 69.3% CI: 60-77%). Although indicated, most travellers did not receive RIG abroad, nor appropriate first doses of PEP. Clinicians should be aware of the importance of appropriate PrEP in selected individuals.
Sections du résumé
BACKGROUND
Rabies represents a major public health issue for travellers because pretravel preexposure (PrEP) rabies vaccination is not routinely indicated. For those unvaccinated, adequate postexposure prophylaxis (PEP), including rabies immunoglobulin (RIG) if needed, is the only effective method to prevent this fatal disease.
METHODS
Descriptive retrospective study at a National Referral Unit for Tropical and Travel Medicine in Madrid, Spain, among travellers treated with PEP for rabies (January 2012-December 2017). Demographic, clinical and management data were reviewed.
RESULTS
168 patients were treated for possible rabies exposure (53% females, median age 35 years; IQR: 31-42). Southeast Asia accounted for more than half of the cases (N=86, 57.3%; CI 95% 49-65%). Dogs were the primary animal involved (n=67, 44.9%; CI 37-53%). After the bite, in half of the cases (n=88, 52.4%; CI 44-60%) PEP rabies vaccine was started abroad, and the vaccine plus RIG in about 10% (n=22, 13.1%; CI: 8-19%). Most of patients classified as category III did not received RIG at all (n=88, 69.3% CI: 60-77%).
CONCLUSIONS
Although indicated, most travellers did not receive RIG abroad, nor appropriate first doses of PEP. Clinicians should be aware of the importance of appropriate PrEP in selected individuals.
Identifiants
pubmed: 30795908
pii: S0025-7753(19)30027-2
doi: 10.1016/j.medcli.2018.12.015
pii:
doi:
Substances chimiques
Immunoglobulins
0
Rabies Vaccines
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
spa
Sous-ensembles de citation
IM
Pagination
55-58Informations de copyright
Copyright © 2019 Elsevier España, S.L.U. All rights reserved.