Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Section of Pediatric Infectious Diseases, Boston Medical Center and Boston University School of Medicine, Boston, MA, USA.
J Travel Med. 2015 Nov-Dec;22(6):403-9. doi: 10.1111/jtm.12237. Epub 2015 Sep 29.
Japanese encephalitis (JE) and rabies are serious vaccine preventable diseases which are an important consideration for travelers to Asia.
Five Boston-area travel clinics collected demographic data, trip information, and interventions for travelers to Asia seen at pre-travel consultations from March 1, 2008, through July 31, 2010. We evaluated travelers for proportion vaccinated for JE and rabies, those traveling for >1 month, and whether travelers had adequate time to complete the JE series (clinic visit ≥28 days before departure) and rabies pre-exposure prophylaxis (clinic visit ≥21 days before departure).
Among 15,440 travelers from five Boston Area Travel Medicine Network travel clinics, Asia was the most common destination region, visited by 5,582 (36%) of travelers. Among these travelers, 4,810 (86%) planned to travel to only one Asian subregion. Median trip duration was 17 days, with more than 20% traveling for >1 month. The most common destinations were South (41%), Southeast (26%), and East (23%) Asia. Of those traveling to South, Southeast, or East Asia, over one-third with trips >1 month had insufficient time to complete a series for either JE or rabies vaccine. Overall, only 10% of travelers were vaccinated (past and pre-travel visit) for either JE or rabies, with lowest percentages among travelers visiting friends and relatives. Most travelers received advice on vector precautions (96%) and rabies prevention, which included avoiding animal contact, washing wounds, and obtaining appropriate post-exposure prophylaxis (88%).
Given the insufficient time for completion and relatively low vaccination rates, greater awareness of earlier pre-travel consultations, at least 4-6 weeks before travel, and accurate risk assessment for travelers are important. Effective counseling about vector avoidance, rabies, and animal bite prevention and management remains critical.
日本脑炎（JE）和狂犬病是严重的可通过疫苗预防的疾病，对于前往亚洲的旅行者来说是一个重要的考虑因素。
五个波士顿地区旅行诊所收集了 2008 年 3 月 1 日至 2010 年 7 月 31 日期间在旅行前咨询中为前往亚洲的旅行者提供的人口统计学数据、旅行信息和干预措施。我们评估了旅行者接种 JE 和狂犬病疫苗的比例、旅行时间超过 1 个月的旅行者比例，以及旅行者是否有足够的时间完成 JE 系列（诊所就诊距离出发日期≥28 天）和狂犬病暴露前预防（诊所就诊距离出发日期≥21 天）。
在五个波士顿地区旅行医学网络旅行诊所的 15440 名旅行者中，亚洲是最常见的目的地地区，有 5582 名（36%）旅行者前往亚洲。在这些旅行者中，4810 名（86%）计划只前往一个亚洲次区域。旅行的中位数时间为 17 天，超过 20%的旅行者旅行时间超过 1 个月。最常见的目的地是南亚（41%）、东南亚（26%）和东亚（23%）。在前往南亚、东南亚或东亚的旅行者中，超过三分之一的旅行者旅行时间超过 1 个月，无法完成 JE 或狂犬病疫苗的系列接种。总体而言，只有 10%的旅行者（过去和旅行前就诊时）接种了 JE 或狂犬病疫苗，其中前往探亲访友的旅行者接种率最低。大多数旅行者接受了有关蚊虫预防措施（96%）和狂犬病预防的建议，包括避免与动物接触、清洗伤口和获得适当的暴露后预防措施（88%）。
鉴于完成接种所需的时间不足和相对较低的疫苗接种率，旅行者应更早进行旅行前咨询，至少在旅行前 4-6 周进行咨询，并对旅行者进行准确的风险评估。关于蚊虫避免、狂犬病和动物咬伤预防和管理的有效咨询仍然至关重要。
