Bantjes S E, Ruijs W L M, van den Hoogen G A L, Croughs M, Pijtak-Radersma A H, Sonder G J B, Swaan C M, Haverkate M R
National Coordination Centre for Communicable Disease Control, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands.
Infectious Disease Control, Public Health Service West-Brabant, PO Box 3024, 5003 DA, Tilburg, the Netherlands.
Travel Med Infect Dis. 2022 May-Jun;47:102316. doi: 10.1016/j.tmaid.2022.102316. Epub 2022 Mar 27.
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.
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.
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.
Pre-travel advice should take the identified predictors into account to provide better targeted information and pre-exposure prophylaxis.
及时进行暴露后预防（PEP）可预防狂犬病。对于未接种疫苗的人，PEP包括多次接种疫苗以及根据指征使用狂犬病免疫球蛋白（RIG）。由于RIG稀缺，可通过预防动物接触和暴露前接种疫苗来限制对PEP的需求。我们旨在确定旅行者中可能感染狂犬病的决定因素，以提供更具针对性的旅行前建议。
进行了一项病例对照研究。病例定义为在狂犬病流行国家有可能感染狂犬病的人（根据世界卫生组织分类指南为II级或III级损伤）。对照组在旅行期间未报告暴露情况。进行了多变量逻辑回归分析。
纳入了229例病例和1427例对照。可能感染狂犬病的预测因素（p < 0.05）为年龄较小、男性、前往西亚或东南亚、参观猴园、拥有宠物、曾访问过同一国家以及自认为是经验丰富的旅行者。负面预测因素为商务旅行、探亲访友以及害怕动物。
旅行前建议应考虑已确定的预测因素，以提供更具针对性的信息和暴露前预防措施。
