Rabies pretravel vaccination

This review sought to describe the recent findings on the epidemiology of rabies exposure and rabies cases in travelers and to discuss possible cost-saving measures that could be used to increase pretravel vaccination coverage in travelers.

On the basis of global data, most cases of rabies in travelers are associated with dog bites, occur in adults who are commonly migrants, and are not necessarily associated with long-term travel. The incidence of injuries to travelers caused by potentially rabid animals is approximately 0.4% per month of stay. Dogs account for 51% of cases, and the remaining animals, notably monkeys, carry a lower risk of rabies transmission. Travel to Southeast Asia, India, and north Africa, young age, and traveling for tourism are risk factors for potential exposure; the duration of travel is not a risk factor. More than 70% of travelers are not immunized prior to departing and do not receive adequate care when injured.

The intradermal vaccination route has been proven economical, safe, and immunogenic in the population of rabies-endemic areas, and this route of administration has been recently used in travelers from developed countries. The immunity provided by the three-dose series is long-lasting and should be considered an investment for future travel. Abbreviated schedules have been tested for last-minute travelers.