Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; IHU-Méditerranée Infection, Marseille, France.
National Referral Unit for Imported Tropical Diseases. Department of Internal Medicine. Hospital Universitario La Paz-Carlos III, IdiPAZ, Madrid, Spain.
Travel Med Infect Dis. 2020 Jul-Aug;36:101766. doi: 10.1016/j.tmaid.2020.101766. Epub 2020 Jun 7.
Sixty cases of rabies in international travellers from 1990 to 2012 were previously reviewed. We present here an update of rabies cases in international travellers from 2013 to 2019.
We systematically reviewed the existing literature and collected 23 cases of rabies in individuals who crossed an international border between the time of infection and diagnosis, or who were infected following expatriation or migration.
Most cases were in male adult travellers and diagnosed in Europe and the Middle East, with most exposures in Asia or in Africa. Migrants originating from rabies-endemic low-and-middle income countries and their descendants accounted for two thirds of cases. Other cases were in tourists, business travellers and expatriates. Median travel duration (excluding migration trip) was 60 days (range 7-240 days). Most cases were due to dog bites and most common clinical presentation was furious rabies. In most patients (74%), no rabies post-exposure prophylaxis (RPEP) was administered before rabies symptoms appeared. Other patients received incomplete RPEP series.
Rabies should be suspected in any patient with encephalitis or paralysis who travelled to, or migrated from a rabies-endemic country. Comprehensive information about a rabies risk should be given to travellers to rabies endemic countries, notably migrants visiting friends and relatives.
此前曾对 1990 年至 2012 年期间来自国际旅行者的 60 例狂犬病病例进行了回顾。在此，我们更新了 2013 年至 2019 年期间来自国际旅行者的狂犬病病例。
我们系统地回顾了现有文献，并收集了 23 例在感染到诊断期间跨越国际边界的个体或在移居或移民后感染狂犬病的病例。
大多数病例是男性成年旅行者，在欧洲和中东地区诊断出狂犬病，大多数暴露发生在亚洲或非洲。来自狂犬病流行的中低收入国家的移民及其后代占病例的三分之二。其他病例是游客、商务旅行者和侨民。中位旅行时间（不包括移民旅行）为 60 天（范围 7-240 天）。大多数病例是由狗咬伤引起的，最常见的临床表现是狂躁型狂犬病。在大多数患者（74%）中，在出现狂犬病症状之前，未进行狂犬病暴露后预防（RPEP）。其他患者接受了不完全的 RPEP 系列。
对于前往狂犬病流行国家或从狂犬病流行国家移民的任何出现脑炎或瘫痪的患者，都应怀疑患有狂犬病。应向前往狂犬病流行国家的旅行者，特别是探亲访友的移民，提供有关狂犬病风险的全面信息。
