Volume 21, Number 4—April 2015
CME ACTIVITY - Synopsis
Animal-Associated Exposure to Rabies Virus among Travelers, 1997–2012
, Kira Harvey, Prativa Pandey, Poh Lian Lim, Karin Leder, Watcharapong Piyaphanee, Marc Shaw, Susan C. McDonald, Eli Schwartz, Douglas H. Esposito, Philippe Parola, and for the GeoSentinel Surveillance Network
Table 1
Characteristics of 2,697 patients who sought care for an animal exposure and received rabies postexposure prophylaxis at GeoSentinel Surveillance Network sites, January 1997–December 2012, by animal species*
| Patient characteristic | Animal |
|||||
|---|---|---|---|---|---|---|
| Dog | NHP | Cat | Bat | Other† | Total‡ | |
| No. patients | 1,618 | 638 | 271 | 46 | 126 | 2,697 |
| Male sex, no. (%) | 891 (55) | 269 (42) | 125 (46) | 21 (46) | 54 (43) | 1,360 (51) |
| Age, y, no. (%) | ||||||
| <14 | 160 (10) | 65 (10) | 50 (19) | 2 (4) | 14 (11) | 291 (11) |
| 15-44 | 1,027 (64) | 460 (72) | 151 (56) | 28 (61) | 75 (60) | 1,739 (65) |
| 45-64 | 340 (21) | 103 (16) | 56 (21) | 16 (35) | 33 (26) | 548 (20) |
| >65 |
87 (5) |
9 (1) |
13 (5) |
0 |
4 (3) |
113 (4) |
| Reason for travel | ||||||
| Tourism | 1,016 (63) | 590 (92) | 183 (68) | 31 (67) | 89 (71) | 1,908 (71) |
| Visiting friends/relatives | 264 (16) | 6 (1) | 41 (15) | 1 (2) | 11 (9) | 323 (12) |
| Business | 206 (13) | 18 (3) | 25 (9) | 2 (4) | 13 (10) | 264 (10) |
| Missionary/volunteer/researcher/aid worker | 82 (5) | 15 (2) | 14 (5) | 7 (15) | 10 (8) | 127 (5) |
| Student | 36 (2) | 7 (1) | 7 (3) | 4 (9) | 3 (2) | 57 (2) |
| Other§ |
13 (1) |
2 (<1) |
1 (<1) |
1 (2) |
0 |
16 (1) |
| Region of exposure, no. (%)¶ | ||||||
| Southeast Asia | 570 (36) | 414 (66) | 99 (37) | 10 (22) | 37 (30) | 1,129 (43) |
| South-Central Asia | 406 (26) | 146 (23) | 21 (8) | 3 (7) | 22 (18) | 598 (23) |
| Northeastern Asia | 217 (14) | 13 (2) | 25 (9) | 0 | 6 (5) | 261 (10) |
| North Africa | 76 (5) | 6 (1) | 45 (17) | 1 (2) | 9 (7) | 137 (5) |
| Latin America | 121 (8) | 15 (2) | 7 (3) | 21 (46) | 10 (8) | 174 (7) |
| Sub-Saharan Africa | 55 (3) | 18 (3) | 16 (6) | 1 (2) | 16 (13) | 106 (4) |
| Middle East | 47 (3) | 3 (<1) | 38 (14) | 0 | 2 (2) | 90 (3) |
| Eastern Europe | 40 (3) | 2 (<1) | 4 (2) | 1 (2) | 4 (3) | 51 (2) |
| Western Europe | 28 (2) | 3 (<1) | 6 (2) | 4 (9) | 5 (4) | 46 (2) |
| Oceania | 14 (1) | 0 | 1 (<1) | 2 (4) | 1 (1) | 18 (1) |
| North America | 3 (<1) | 1 (<1) | 2 (1) | 3 (7) | 8 (6) | 17 (1) |
| Caribbean | 8 (1) | 2 (<1) | 2 (1) | 0 | 3 (2) | 15 (1) |
| Australia | 1 (<1) | 0 | 0 | 0 | 2 (2) | 3 (<1) |
*NHP, nonhuman primate. Data include 4 patients of unknown sex, 6 patients of unknown age, 4 patients of unknown country of residence, 52 patients whose region of exposure was unknown or unable to be ascertained, and 1 patient whose purpose of travel was unknown.
†Bear (n = 1), camel (n = 1), Nasua spp. coatis (n = 4), cow (n = 1), donkey (n = 2), fox (n = 1), hamster (n = 2), horse (n = 5), human (n = 1), lion (n = 2), mongoose (n = 1), meercat (n = 2), mouse (n = 5), opossum (n = 1), rabbit (n = 2), raccoon (n = 2), rat (n = 12), rodent (n = 4), squirrel (n = 11), tiger (n = 6), and other, unspecified (n = 60).
‡Two patients were exposed to >1 animal; 1 patient was exposed to cat and dog, and 1 patient was exposed to dog and other (tiger).
§This category includes immigration (n = 8), medical tourism (n = 8), and military (n = 1).
¶For explanation of GeoSentinel Surveillance Network regions, see Figure 2 (http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6203a1.htm).
1Additional members of the GeoSentinel Surveillance Network who contributed data are listed at the end of this article.