Predictors of possible exposure to rabies in travellers: A case-control study

Travel Med Infect Dis. 2022 May-Jun:47:102316. doi: 10.1016/j.tmaid.2022.102316. Epub 2022 Mar 27.

Abstract

Background: Timely administration of post-exposure prophylaxis (PEP) can prevent rabies. For non-vaccinated persons, PEP consists of multiple vaccinations and rabies immunoglobulin (RIG) on indication. Since RIG is scarce, the need for PEP could be restricted through preventing animal contact and pre-exposure vaccination. We aimed to identify determinants for possible rabies exposure among travellers to provide more targeted pre-travel advice.

Method: A case-control study was performed. Cases were defined as persons with a possible rabies exposure (category II or III injury according to WHO classification guidelines) in a rabies endemic country. Controls did not report exposure during travel. Multivariable logistic regression was performed.

Results: 229 cases and 1427 controls were included. Predictors (p < 0.05) of possible rabies exposure were young age, male sex, travelling to Western or Southeastern Asia, visiting a monkey park, pet ownership, previously visited the same country and considering oneself an experienced traveller. Negative predictors were travelling for business, visiting friends and relatives, and fear of animals.

Conclusions: Pre-travel advice should take the identified predictors into account to provide better targeted information and pre-exposure prophylaxis.

Keywords: Animal associated incidents; Case-control study; Rabies; Travel.

MeSH terms

  • Animals
  • Case-Control Studies
  • Humans
  • Immunoglobulins
  • Male
  • Phobic Disorders
  • Post-Exposure Prophylaxis
  • Rabies Vaccines*
  • Rabies virus*
  • Rabies* / epidemiology
  • Rabies* / prevention & control
  • Travel

Substances

  • Immunoglobulins
  • Rabies Vaccines

Supplementary concepts

  • Zoophobia