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Volume 21, Number 4—April 2015
CME ACTIVITY - Synopsis

Animal-Associated Exposure to Rabies Virus among Travelers, 1997–2012

Philippe GautretComments to Author , 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
Author affiliations: Aix Marseille Université, Marseille, France (P. Gautret, P. Parola); Institut Hospitalo-Universitaire Méditerranée Infection, Marseille (P. Gautret, P. Parola); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (K. Harvey, D.H. Esposito); CIWEC Clinic Travel Medicine Center, Kathmandu, Nepal (P. Pandey); Tan Tock Seng Hospital, Singapore (P.L. Lim); Lee Kong Chian School of Medicine, Singapore (P.L. Lim); Monash University, Melbourne, Victoria, Australia (K. Leder); The Royal Melbourne Hospital, Parkville, Victoria, Australia (K. Leder); Mahidol University, Bangkok, Thailand (W. Piyaphanee); Travellers Health and Vaccination Centre, Auckland, New Zealand (M. Shaw); University Hospital of Northern British Columbia, Prince George, British Columbia, Canada (S.C. McDonald); Tel Hashomer and Sackler School of Medicine, Tel Aviv, Israel (E. Schwartz)

Main Article

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).

Main Article

1Additional members of the GeoSentinel Surveillance Network who contributed data are listed at the end of this article.

Page created: March 13, 2015
Page updated: March 13, 2015
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