Rabies post-exposure prophylaxis of international travellers - Results from two major German travel clinics
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Rabies post-exposure prophylaxis of international travellers - Results from two major German travel clinics. / Saffar, Farah; Heinemann, Melina; Heitkamp, Christian; Stelzl, Daniel Robert; Ramharter, Michael; Schunk, Mirjam; Rothe, Camilla; Bühler, Silja.
In: TRAVEL MED INFECT DI, Vol. 53, 102573, 2023.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Rabies post-exposure prophylaxis of international travellers - Results from two major German travel clinics
AU - Saffar, Farah
AU - Heinemann, Melina
AU - Heitkamp, Christian
AU - Stelzl, Daniel Robert
AU - Ramharter, Michael
AU - Schunk, Mirjam
AU - Rothe, Camilla
AU - Bühler, Silja
N1 - Copyright © 2023. Published by Elsevier Ltd.
PY - 2023
Y1 - 2023
N2 - BACKGROUND: Travel to regions with rabies risk has increased. However, data on adequate rabies post exposure prophylaxis (PEP) abroad is scarce. The aim of this study was to assess the appropriateness of medical management following suspected rabies exposure (SRE) in international travellers.METHOD: A cross-sectional questionnaire-based study in returning travellers with reported SRE who sought post-exposure medical care was conducted in two large German travel clinics.RESULTS: The 75 included SRE cases had a median age of 34 years (range 26-43) and showed a female predominance (59%, 44/75). Most participants returned from Asia (47%, 34/72). About 28% had received pre-exposure prophylaxis (PrEP, ≥2 vaccine doses) (20/71). In 51% the animal was actively approached (34/67). All patients had category II/III exposure according to the World Health Organization (65% category III, 49/75). With 78% (52/67), most patients cleaned the wound after SRE; 36% (24/67) used water and soap. Only 57% (41/72) of participants sought medical care during their trip. Overall, 45% (33/74) received rabies vaccination abroad which corresponds to 80% out of those who sought healthcare (33/41).CONCLUSIONS: Awareness for appropriate first aid and the urgency of seeking timely professional treatment including PEP after an SRE seems to be insufficient in German travellers. Travel practitioners need to educate travellers about rabies risk, prevention measures and the correct behaviour after SRE including adequate wound treatment and seeking immediate medical help for PEP. PrEP should be offered generously especially to travellers with high rabies-exposure risk and those visiting areas with limited healthcare access.
AB - BACKGROUND: Travel to regions with rabies risk has increased. However, data on adequate rabies post exposure prophylaxis (PEP) abroad is scarce. The aim of this study was to assess the appropriateness of medical management following suspected rabies exposure (SRE) in international travellers.METHOD: A cross-sectional questionnaire-based study in returning travellers with reported SRE who sought post-exposure medical care was conducted in two large German travel clinics.RESULTS: The 75 included SRE cases had a median age of 34 years (range 26-43) and showed a female predominance (59%, 44/75). Most participants returned from Asia (47%, 34/72). About 28% had received pre-exposure prophylaxis (PrEP, ≥2 vaccine doses) (20/71). In 51% the animal was actively approached (34/67). All patients had category II/III exposure according to the World Health Organization (65% category III, 49/75). With 78% (52/67), most patients cleaned the wound after SRE; 36% (24/67) used water and soap. Only 57% (41/72) of participants sought medical care during their trip. Overall, 45% (33/74) received rabies vaccination abroad which corresponds to 80% out of those who sought healthcare (33/41).CONCLUSIONS: Awareness for appropriate first aid and the urgency of seeking timely professional treatment including PEP after an SRE seems to be insufficient in German travellers. Travel practitioners need to educate travellers about rabies risk, prevention measures and the correct behaviour after SRE including adequate wound treatment and seeking immediate medical help for PEP. PrEP should be offered generously especially to travellers with high rabies-exposure risk and those visiting areas with limited healthcare access.
U2 - 10.1016/j.tmaid.2023.102573
DO - 10.1016/j.tmaid.2023.102573
M3 - SCORING: Journal article
C2 - 37087082
VL - 53
JO - TRAVEL MED INFECT DI
JF - TRAVEL MED INFECT DI
SN - 1477-8939
M1 - 102573
ER -