Rabies exposure among Norwegian missionaries working abroad

Based on the results of an inquiry among 296 Norwegian missionaries and Foreign Aid workers, we present some observations on the present rabies situation in several African countries, India and Bangladesh, Equador and Bolivia. Traditionally these countries receive a large proportion of our missionaries and Foreign Aid personnel. The incidence of rabies varies considerably in the areas covered by this investigation. When calculated for the mean length of stay (4 to 5 years) the average rating of physical exposure to proven or suspected rabies was 16% per household and 7% per individual household member. The risk of exposure was higher with children (10%) than adults (6%). the family dog equalled the stray dog as the source of suspected infection. Of the 48 persons who had been recommended post-exposure vaccination two thirds had only tended or been licked by the offending animal. However, in such animals the ratio of proven or highly probable rabies to non-proven or unknown diagnosis was 2:1. The rabies situation was considered as a minor factor of psychic stress by two thirds of the responding persons, even in highly epizootic countries. The results of this study may be of some value in the process of forming a policy for pre-exposure prophylaxis against rabies for people who are going to stay for a prolonged period of time in these areas of the world.