Predictors of possible exposure to rabies in travellers: A case-control study.

BACKGROUND

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.

METHOD: 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.

RESULTS

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.

CONCLUSIONS

Pre-travel advice should take the identified predictors into account to provide better targeted information and pre-exposure prophylaxis.