High time to prioritize rabies prevention—a new paradigm

2020 ◽  
Vol 27 (7) ◽  
Author(s):  
Robert Steffen ◽  
Davidson H Hamer
Keyword(s):  
Typhoid Fever ◽  
Hepatitis A ◽  
High Time ◽  
Post Exposure Prophylaxis ◽  
New Paradigm ◽  
Post Exposure ◽  
Rabies Exposure ◽  
Exposure Prophylaxis ◽  
Rabies Prevention

Almost 500 patients consulted a GeoSentinel clinic annually for post-exposure prophylaxis after a potential rabies exposure as compared to approximately 20 for hepatitis A and 40 for typhoid fever. Travellers’ response after potential rabies exposure is alarmingly inadequate. Thus, rabies pre-exposure prophylaxis should now become the #1 travel vaccine intervention.

Rabies exposure in travellers to Asia, the Middle East, Africa, South and Central America—a German Airport study

2020 ◽  
Vol 27 (7) ◽  
Author(s):  
Christian Heitkamp ◽  
Daniel Robert Stelzl ◽  
Michael Ramharter ◽  
Silja Bühler
Keyword(s):  
Middle East ◽  
Medical Care ◽  
East Africa ◽  
Central America ◽  
Post Exposure Prophylaxis ◽  
Cross Sectional ◽  
High Exposure ◽  
Post Exposure ◽  
Rabies Exposure ◽  
Exposure Prophylaxis

Abstract Background Rabies causes thousands of deaths worldwide and trips to rabies endemic countries are popular. Travellers are often uncertain whether pre-exposure prophylaxis (PrEP) is advisable since they find it difficult to estimate the exposure risk during travel and the availability of post-exposure prophylaxis in endemic regions. The aim of this study was to determine the potential rabies exposures in travellers and to assess their knowledge on rabies. Secondly, we explored the access to appropriate post-exposure medical care in respective countries. Methods We conducted a cross-sectional study at Frankfurt Airport. Returning adult travellers arriving from Asia, the Middle East, Africa, South and Central America were invited to participate in this questionnaire-based study while waiting in the baggage claim area. Results Over a one-month recruitment phase in March 2019, we enrolled 3066 travellers; 2929 were included in the analysis. The gender ratio was balanced; the median age was 42 years (range 18–83 years). Participants arrived from Asia (46%), Africa (29%), Central/South America (13%), the Middle East (8%) and the Caribbean (8%). Forty-five per cent sought pretravel advice and 22% received ≥2 injections of rabies PrEP. Travellers with pretravel advice from tropical medicine specialists reached significantly higher knowledge scores than others. We found that potential rabies exposure occurred in 2.0% (57/2915) of travellers with 31% (13/42) of the contacts being unprovoked; 19% (8/42) of the exposed sought medical care and 3/8 were adequately treated before returning to Germany. Risk factors for animal exposure were: male sex, young age, trips to Asia and a long stay abroad (>4 weeks). Conclusions A total of 2% of returning travellers (n = 2915) experienced a potential rabies exposure during their journey. A majority of the exposed individuals did not seek medical care; those seeking medical care were often treated inadequately. Rabies information must be emphasised during pretravel counselling and PrEP should be offered generously, especially to travellers with high exposure risks.

scholarly journals Effectiveness of hepatitis A vaccination as post-exposure prophylaxis

2016 ◽  
Vol 13 (2) ◽  
pp. 423-427 ◽  
Author(s):  
Ignasi Parrón ◽  
Caritat Planas ◽  
Pere Godoy ◽  
Sandra Manzanares-Laya ◽  
Ana Martínez ◽  
...  
Keyword(s):  
Hepatitis A ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

scholarly journals Hepatitis A vaccination for post-exposure prophylaxis in persons aged 40 years and older

Vaccine ◽  
2014 ◽  
Vol 32 (25) ◽  
pp. 2939 ◽  
Author(s):  
Noele P. Nelson ◽  
Trudy V. Murphy ◽  
Brian J. McMahon
Keyword(s):  
Hepatitis A ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

Field effectiveness of hepatitis A vaccine and uptake of post exposure prophylaxis following a change to the Australian guidelines

Vaccine ◽  
2014 ◽  
Vol 32 (42) ◽  
pp. 5509-5513 ◽  
Author(s):  
Evan Freeman ◽  
Glenda Lawrence ◽  
Jeremy McAnulty ◽  
Sean Tobin ◽  
C. Raina MacIntyre ◽  
...  
Keyword(s):  
Hepatitis A ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

Hepatitis A: post-exposure prophylaxis

Vaccine ◽  
2003 ◽  
Vol 21 (19-20) ◽  
pp. 2234-2237 ◽  
Author(s):  
Gloria Taliani ◽  
Giovanni Battista Gaeta
Keyword(s):  
Hepatitis A ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

scholarly journals Evaluation of Hepatitis A Vaccine in Post-Exposure Prophylaxis, The Netherlands, 2004-2012

PLoS ONE ◽  
2013 ◽  
Vol 8 (10) ◽  
pp. e78914 ◽  
Author(s):  
Jane Whelan ◽  
Gerard J. Sonder ◽  
Lian Bovée ◽  
Arjen Speksnijder ◽  
Anneke van den Hoek
Keyword(s):  
The Netherlands ◽  
Hepatitis A ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

scholarly journals Evaluation of dog anti rabies vaccination centres and post exposure prophylaxis against rabies centres in an urban area

2018 ◽  
Vol 5 (4) ◽  
pp. 1535
Author(s):  
Rambadan P. Chauhan
Keyword(s):  
Urban Area ◽  
Animal Husbandry ◽  
Health Department ◽  
Post Exposure Prophylaxis ◽  
Voluntary Organizations ◽  
Public Health Department ◽  
Post Exposure ◽  
Rabies Exposure ◽  
Exposure Prophylaxis ◽  
Rabies Vaccination

Background: In spite of availability of vaccine, many rabies cases continue to occur. Is this due to the improper functioning of vaccination centres? Objective of the study was to evaluate the performance of dog anti rabies vaccination centres, for vaccination of pet dogs (DARVCs) and post exposure prophylaxis against rabies (PtEPAR) centres for humans for suspected rabies exposure in an urban area.Methods: The study was carried out during 1989-90, by way of observations, interviews and analysis of records maintained at various institutes. For observations procedures like dog licensing, dog vaccination, dog catching in fields, keeping them in kennels and their destruction, human post exposure prophylaxis against rabies viz. history taking by a physician, his advice to patients, procedure of vaccination and local wound care.Results: All (9) MCGB (Municipal Corporation of greater Bombay) run DARVCs and one (25%) DAHD (district animal husbandry department, Bombay suburbs) run DARVC had unsatisfactory services. Three (75%) DAHD run DARVCs and all three voluntary organizations run DARVCs (100%) had satisfactory services. The practices at PtEPAR centres and the knowledge of the doctors appointed there were dismally poor for post exposure prophylaxis against rabies. Only 2 (5.88%) PtEPAR centres were fit to provide PtEPAR services.Conclusions: Significant findings included poor dog anti-rabies vaccination services involving negligible number of dogs every year, dismally poor performances by the human post exposure prophylaxis against rabies centres, lack of pre-exposure prophylaxis to high risk individuals, ignorance on the part of physicians and pathologists regarding availability of rabies diagnostic services in this urban area, poor surveillance by public health department and lack of co-ordination among various institutes.

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