Gautret Philippe, Shaw Marc, Gazin Pierre, Soula Georges, Delmont Jean, Parola Philippe, Soavi Marie José, Brouqui Philippe, Matchett D Elizabeth, Torresi Joseph
Service des Maladies Infectieuses et Tropicales, Hôpital Nord, Marseille, France.
J Travel Med. 2008 Jan-Feb;15(1):25-30. doi: 10.1111/j.1708-8305.2007.00164.x.
There is little published information available describing rabies pre- and postexposure prophylaxis (PEP) in tourists returning to their home country and seeking care for animal-associated injuries, especially those associated with a rabies risk.
We analyzed 261 travelers seeking care on returning to their home country following an animal-related injury acquired abroad. Information on individual cases of rabies (PEP) including preexposure status, type of contact with a potentially rabid animal, type of animal, and the nature of rabies PEP was collected by retrospectively analyzing records from May 1997 to May 2005.
The majority of injuries were acquired in South-east Asia and North Africa. Only 6.8% of injured patients were previously vaccinated against rabies, while 75.4% of the cohort experienced a severe injurious contact with animals (World Health Organization category III). Of travelers who sustained a high-risk injury, only 24% received both vaccination and rabies immune globulin,(RIG) while 76% received vaccination only. Of the travelers who did not receive RIG, 43% had received a first dose of vaccine more than 7 days after return and before presenting to a clinic in their home country.
This study highlights important deficiencies in rabies PEP for travelers who acquire high-risk, animal-associated injuries in rabies-endemic countries, with the majority not receiving adequate PEP or experiencing a substantial delay before receiving rabies vaccination.
关于回国后因动物致伤而寻求治疗的游客，尤其是那些有感染狂犬病风险的游客的狂犬病暴露前和暴露后预防（PEP），公开的信息很少。
我们分析了261名在国外遭受动物致伤后回国寻求治疗的旅行者。通过回顾性分析1997年5月至2005年5月的记录，收集了狂犬病（PEP）个案信息，包括暴露前状态、与潜在狂犬病动物的接触类型、动物种类以及狂犬病PEP的性质。
大多数致伤事件发生在东南亚和北非。只有6.8%的受伤患者之前接种过狂犬病疫苗，而75.4%的队列经历了与动物的严重致伤接触（世界卫生组织III级）。在遭受高风险致伤的旅行者中，只有24%接受了疫苗接种和狂犬病免疫球蛋白（RIG），而76%只接受了疫苗接种。在未接受RIG的旅行者中，43%在回国后7天以上、在其本国就诊之前接受了第一剂疫苗。
本研究突出了狂犬病流行国家中遭受高风险、与动物相关致伤的旅行者在狂犬病PEP方面的重要不足，大多数人未接受充分的PEP或在接种狂犬病疫苗前经历了显著延迟。
