Risk of Rabies and the Traveller's Health

Ashwini Katole; Purushottam Giri

doi:10.51957/Healthline_752_2025

Authors

Ashwini Katole Assistant Professor, Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, India Author https://orcid.org/0000-0001-8976-8259
Purushottam Giri Professor & Head, Department of Community Medicine, Indian Institute of Medical Science & Research (IIMSR) Medical College, Badnapur, India Author https://orcid.org/0000-0002-9461-1464

DOI:

https://doi.org/10.51957/Healthline_752_2025

Keywords:

Endemic, Pre-exposure prophylaxis, Rabies, Traveller, Vaccination

Abstract

Rabies is one of the deadliest infectious diseases. It is prevalent all over the world. As it is spread to humans and some animals by bite, scratch or direct contact with the mucous membrane of the infected animal. Most of the people coming to the African and Asian countries are exposed to rabies, special people coming from where the elimination of canine rabies has been achieved. Most of the travellers are aware of the rabies infection. Travellers know that animals, especially dogs, are the most common source of rabies infection. Most of the travellers don’t have the seriousness of the infection. They don’t find themselves as a potential source of the spread of the rabies infection. The vaccine against rabies infection is the main key to stopping the spread of the disease. Travel clinics are one of the platforms from which people can get all the information regarding infectious diseases occurring in the visiting area. The role of healthcare professionals in recommending rabies vaccination prior to travel to endemic areas is extremely important. The lack of knowledge and awareness of rabies exposure results in a variety of opinions on which travellers should receive pre-exposure prophylaxis (PrEP). It directly influences the recommendation and decision-making as it is based on individual perspective and interpretation rather than statistical data on rabies infection in each country.

References

1. World Health Organization, Key facts; https://www.who.int/news-room/fact-sheets/detail/rabies [Last accessed on 10th May 2025]

2. CDC; https://www.cdc.gov/rabies/about/index.html [Last accessed on 10th May 2025]

3. Shlim DR Preventing rabies: the new WHO recommendations and their impact on travel medicine practice, Journal of Travel Medicine, Volume 25, Issue 1, 2018, tay119, https://doi.org/10.1093/jtm/tay119 DOI: https://doi.org/10.1093/jtm/tay119

4. Altmann M, Parola P, Delmont J, Brouqui P, Gautret P. Knowledge, attitudes, and practices of French travelers from Marseille regarding rabies risk and prevention. Journal of travel medicine. 2009 Mar 1;16(2):107-11. DOI: https://doi.org/10.1111/j.1708-8305.2008.00283.x

5. Gossner C.M, Mailles A, Aznar I, Dimina E, Echevarría J.E, Feruglio S.L, et al. Prevention of human rabies: a challenge for the European union and the European economic area Euro Surveill, 2020;25(38):115-19. doi: 10.2807/1560-7917.ES.2020.25.38.2000158. DOI: https://doi.org/10.2807/1560-7917.ES.2020.25.38.2000158

6. World tourism organization international tourism recovered 84% of pre-pandemic levels through July 2023 World Tour Barom Engl version, 2023;21(3):1-7.

7. Chen LH, Gautret P, Visser LG, Rabies Preexposure Prophylaxis: Application of Updated World Health Organization Position to Travelers. Clinical Infectious Diseases. 2018 Dec 15;67(12):1948-1950 doi: 10.1093/cid/ciy422 DOI: https://doi.org/10.1093/cid/ciy422

8. Marc T.M. Shaw, Brigid O’Brien, Peter A. Leggat, Rabies Postexposure Management of Travelers Presenting to Travel Health Clinics in Auckland and Hamilton, New Zealand, Journal of Travel Medicine, Volume 16, Issue 1, 1 January 2009, Pages 13–17, doi:10.1111/j.1708-8305.2008.00256.x DOI: https://doi.org/10.1111/j.1708-8305.2008.00256.x

9. Van Thiel PP, van den Hoek JA, Etimov F, et al. Fatal case of human rabies (Duvenhage virus) from a bat in Kenya: The Netherlands, December 2007. Euro Surveill. 2008;13. DOI: https://doi.org/10.2807/ese.13.02.08007-en

10. Goorhuis A. Rabies – Netherlands ex India: (Tamil Nadu) canine, human Archive Number: 20140825.2721553. www.promedmail.org [Last accessed on 10th May 2025]

11. Goorhuis A. Rabies – Netherlands ex Haiti, canine, human Archive number 20130625.1791201. www.promedmail.org [Last accessed on 10th May 2025]

12. Gautret P, Parola P. Rabies vaccination for international travelers. Vaccine. 2012 Jan 5;30(2):126-33. DOI: https://doi.org/10.1016/j.vaccine.2011.11.007

13. Marano C, Moodley M, Melander E, DeMoerlooze L, Nothdurft HD. Perceptions of rabies risk: a survey of travellers and travel clinics from Canada, Germany, Sweden and the UK. J Trav Med 2019;26(Suppl 1):S3–S9. doi: 10.1093/jtm/tay062. DOI: https://doi.org/10.1093/jtm/tay062

14. Croughs M, van den Hoogen GAL, van Jaarsveld CHM, Bantjes SE, Pijtak- Radersma AH, Haverkate MR, et al. Rabies risk behaviour in a cohort of Dutch travel clinic visitors: a retrospective analysis. Trav Med Infect Dis 2021;43:102102. doi: 10.1016/j.tmaid.2021.102102. DOI: https://doi.org/10.1016/j.tmaid.2021.102102

15. Bantjes SE, Ruijs WLM, van den Hoogen GAL, Croughs M, Pijtak-Radersma AH, Sonder GJB, et al. Predictors of possible exposure to rabies in travellers: a case- control study. Trav Med Infect Dis 2022;47:102316. doi: 10.1016/j.tmaid.2022.102316. DOI: https://doi.org/10.1016/j.tmaid.2022.102316

16. LaRocque RC, Rao SR, Tsibris A, Lawton T, Barry MA, Marano N, et al. Pre-travel health advice-seeking behavior among US international travelers departing from Boston Logan International Airport. J Trav Med 2010;17(6):387–91. doi: 10.1111/j.1708-8305.2010.00457.x. DOI: https://doi.org/10.1111/j.1708-8305.2010.00457.x

17. Mc Guinness SL, Eades O, Seale H, Cheng AC, Leder K. Pre-travel vaccine information needs, attitudes, drivers of uptake and the role for decision aids in travel medicine. J Trav Med 2023;30(4): taad056. doi: 10.1093/jtm/taad056. DOI: https://doi.org/10.1093/jtm/taad056

18. Human rabies prevention and management [Internet]. Who.int. [cited 2025 May 25]. Available from: https://www.who.int/activities/human-rabies-prevention-and-management