Characteristics and Potential Quality Indicators for Evaluating Pre-travel Consultations in Japan Hospitals: the Japan Pretravel Consultation Registry (J-PRECOR)

2021 ◽  
Author(s):  
Kei Yamamoto ◽  
Yusuke Asai ◽  
Issaku Nakatani ◽  
Kenichi Hayashi ◽  
Hidenori Nakagawa ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Medical Information ◽  
National Income ◽  
Human Rabies ◽  
Risk Category ◽  
Post Exposure Prophylaxis ◽  
Malaria Prophylaxis ◽  
Overseas Travel ◽  
Prevention Methods ◽  
Exposure Prophylaxis

Abstract BackgroundAwareness of pre-travel consultation (PTC) and prevention methods of overseas travel-related diseases is low in Japan, and understanding of PTC among Japanese travelers and medical professionals remains low. A multicenter registry was established to examine PTC in Japan. This study assessed the PTC implementation rate and examined indicators to be used as criteria for data-quality evaluation.MethodsClients who presented for PTC at 17 facilities registered between February 1, 2018, and May 31, 2020, were included. Medical information was retrospectively extracted via a web-based system. Correlations between vaccination risk categories and advice/intervention proportions by facility were evaluated by Spearman’s ordered phase relations (α=0.05).ResultsOf 9,700 eligible clients (median age, 32 years; 880 (9.1%) aged <16 years and 549 (5.7%) aged ≥65 years), the most common travel duration was ≥181 days (35.8%), higher among younger clients. The most common reason for travel was business (40.5%); the US (1,118 [11.5%]) and Asia (4,008 [41.3%]) were the most common destination and continent, respectively. Vaccine number (median 3 per person) increased after PTC except for tetanus toxoid. Only 60.8% of clients recommended for malaria prophylaxis received anti-malarial agents. The gross national income, incidence of human rabies, typhoid fever, and falciparum malaria, and dengue risk category were associated with the percentage of hepatitis-A vaccine, explaining rabies post-exposure prophylaxis, typhoid-fever vaccination, malaria-prophylaxis prescription, and mosquito repellants, respectively.ConclusionsAlthough the characteristics of travelers differ, the quality of PTC should improve to address, for example, the lower rate of acceptance of malaria prophylaxis in Japan.

scholarly journals Benefit–Risk Assessment of the French Surveillance Protocol of Apparently Healthy Biting Dogs and Cats for Human Rabies Prevention

2021 ◽  
Vol 8 (7) ◽  
pp. 132
Author(s):  
Guillaume Crozet ◽  
Tiffany Charmet ◽  
Florence Cliquet ◽  
Emmanuelle Robardet ◽  
Barbara Dufour ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Traffic Accidents ◽  
Scenario Tree ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Policy Makers ◽  
Benefit Risk Assessment ◽  
Surveillance Protocol ◽  
Exposure Prophylaxis ◽  
Apparently Healthy

In France, apparently healthy dogs and cats that bite humans must undergo an observation period of 15 days with three veterinary visits to ascertain that they remain healthy, indicating that no zoonotic transmission of rabies virus occurred via salivary presymptomatic excretion. This surveillance protocol is mandatory for all pets that have bitten humans, despite France’s rabies-free status in non-flying mammals (i.e., a very low rabies risk). In this context, we aimed to perform a benefit–risk assessment of the existing regulatory surveillance protocol of apparently healthy biting animals, as well as alternative surveillance protocols. A scenario-tree modelling approach was used to consider the possible successions of events between a dog or cat bite and a human death attributed to either rabies or to lethal harm associated with the surveillance protocol (e.g., lethal traffic accidents when traveling to veterinary clinics or anti-rabies centers). The results demonstrated that the current French surveillance protocol was not beneficial, as more deaths were generated (traffic accidents) than avoided (by prompt post-exposure prophylaxis administration). We showed here that less stringent risk-based surveillance could prove more appropriate in a French context. The results in this study could allow policy-makers to update and optimize rabies management legislation.

scholarly journals Post-exposure prophylaxis vaccination rate and risk factors of human rabies in mainland China: a meta-analysis

2018 ◽  
Vol 147 ◽  
Author(s):  
D. L. Wang ◽  
X. F. Zhang ◽  
H. Jin ◽  
X. Q. Cheng ◽  
C. X. Duan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Meta Analysis ◽  
Mainland China ◽  
Vaccination Rate ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Eastern Region ◽  
Post Exposure ◽  
Exposure Prophylaxis

AbstractRabies is one of the major public health problems in China, and the mortality rate of rabies remains the highest among all notifiable infectious diseases. A meta-analysis was conducted to investigate the post-exposure prophylaxis (PEP) vaccination rate and risk factors for human rabies in mainland China. The PubMed, Web of Science, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical and Wanfang databases were searched for articles on rabies vaccination status (published between 2007 and 2017). In total, 10 174 human rabies cases from 136 studies were included in this meta-analysis. Approximately 97.2% (95% confidence interval (CI) 95.1–98.7%) of rabies cases occurred in rural areas and 72.6% (95% CI 70.0–75.1%) occurred in farmers. Overall, the vaccination rate in the reported human rabies cases was 15.4% (95% CI 13.7–17.4%). However, among vaccinated individuals, 85.5% (95% CI 79.8%–83.4%) did not complete the vaccination regimen. In a subgroup analysis, the PEP vaccination rate in the eastern region (18.8%, 95% CI 15.9–22.1%) was higher than that in the western region (13.3%, 95% CI 11.1–15.8%) and this rate decreased after 2007. Approximately 68.9% (95% CI 63.6–73.8%) of rabies cases experienced category-III exposures, but their PEP vaccination rate was 27.0% (95% CI 14.4–44.9%) and only 6.1% (95% CI 4.4–8.4%) received rabies immunoglobulin. Together, these results suggested that the PEP vaccination rate among human rabies cases was low in mainland China. Therefore, standardised treatment and vaccination programs of dog bites need to be further strengthened, particularly in rural areas.

scholarly journals Human rabies post-exposure prophylaxis relative to the disease epidemiological status

2019 ◽  
Vol 24 (1) ◽  
pp. 315-322 ◽  
Author(s):  
Bruno Fonseca Martins da Costa Andrade ◽  
Taísa Santos de Melo Andrade ◽  
Luzia Helena Queiroz
Keyword(s):  
Rabies Vaccine ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Paulo State ◽  
Technical Manual ◽  
Prophylactic Measures ◽  
Exposure Prophylaxis ◽  
Main City ◽  
Technical Recommendations

Abstract This study evaluated the prophylactic measures adopted after attacks by dogs and cats in the main city of Northwester São Paulo State, based on the technical manual for post-exposure treatment, considering the not controlled (1990-1996) and controlled (1997-2010) rabies status. A retrospective analysis was done using the data from the SINAN records (W64-CID10) between 1990 and 2010. In most cases, the accidents were mild (76.9%), and biting animals were healthy (75.4%); therefore, no treatment was needed in 53.3% of the cases. In 64.6% of cases, the prescribed PEP treatment was inappropriate. The most indicated PEP treatments consisted of vaccine and RIG (43.4%), and either three doses of mouse brain vaccine or two doses of cell culture vaccine (76.5%), during the not controlled and controlled rabies periods, respectively. The treatment was more appropriate and followed the technical recommendations during controlled rabies periods compared to not controlled (p < 0.0001) periods. However, excessive application of RIG and rabies vaccine was observed in both periods.

scholarly journals Human rabies post exposure prophylaxis at the Pasteur Institute of Dakar, Senegal: trends and risk factors

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mamadou Korka Diallo ◽  
Alpha Oumar Diallo ◽  
Anta Dicko ◽  
Vincent Richard ◽  
Emmanuelle Espié
Keyword(s):  
Risk Factors ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Pasteur Institute ◽  
Post Exposure ◽  
Exposure Prophylaxis

High time to prioritize rabies prevention—a new paradigm

2020 ◽  
Vol 27 (7) ◽  
Author(s):  
Robert Steffen ◽  
Davidson H Hamer
Keyword(s):  
Typhoid Fever ◽  
Hepatitis A ◽  
High Time ◽  
Post Exposure Prophylaxis ◽  
New Paradigm ◽  
Post Exposure ◽  
Rabies Exposure ◽  
Exposure Prophylaxis ◽  
Rabies Prevention

Almost 500 patients consulted a GeoSentinel clinic annually for post-exposure prophylaxis after a potential rabies exposure as compared to approximately 20 for hepatitis A and 40 for typhoid fever. Travellers’ response after potential rabies exposure is alarmingly inadequate. Thus, rabies pre-exposure prophylaxis should now become the #1 travel vaccine intervention.

scholarly journals Current Rabies Vaccines Do Not Confer Protective Immunity against Divergent Lyssaviruses Circulating in Europe

Viruses ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 892 ◽  
Author(s):  
Juan E. Echevarría ◽  
Ashley C. Banyard ◽  
Lorraine M. McElhinney ◽  
Anthony R. Fooks
Keyword(s):  
Protective Immunity ◽  
Rabies Vaccine ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Efficient Tool ◽  
Imported Case ◽  
Health Authorities ◽  
European Health ◽  
Preventive Vaccination ◽  
Exposure Prophylaxis

The use of the rabies vaccine for post-exposure prophylaxis started as early as 1885, revealing a safe and efficient tool to prevent human rabies cases. Preventive vaccination is the basis for the control of canine-mediated rabies, which has already been eliminated from extensive parts of the world, including Europe. Plans to eliminate canine-mediated human rabies by 2030 have been agreed upon by international organisations. However, rabies vaccines are not efficacious against some divergent lyssaviruses. The presence in European indigenous bats of recently described lyssaviruses, which are not neutralised by antibody responses to existing vaccines, as well as the declaration of an imported case of an African lyssavirus, which also escapes vaccine-derived protection, leaves the European health authorities unable to provide efficacious protective vaccines to some potential situations of human exposure. All these circumstances highlight the need for a universal pan-lyssavirus rabies vaccine, able to prevent human rabies in all circumstances.

Recurrent Temporary Paralysis Reported After Human Rabies Post-Exposure Prophylaxis

2014 ◽  
Vol 62 (3) ◽  
pp. 222-227 ◽  
Author(s):  
V. M. Dato ◽  
E. R. Campagnolo ◽  
D. U. Shah ◽  
M. J. Bellush ◽  
C. E. Rupprecht
Keyword(s):  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

Problems in human rabies post-exposure prophylaxis management

2007 ◽  
Vol 5 (3) ◽  
pp. 189-193 ◽  
Author(s):  
Saowaluck Tepsumethanon ◽  
Veera Tepsumethanon ◽  
Thanphet Tantawichien ◽  
Kanitta Suwansrinon ◽  
Henry Wilde
Keyword(s):  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

scholarly journals How geographic access to care shapes disease burden: the current impact of post-exposure prophylaxis and potential for expanded access to prevent human rabies deaths in Madagascar

2020 ◽  
Author(s):  
Malavika Rajeev ◽  
Hélène Guis ◽  
Glenn Edosoa ◽  
Chantal Hanitriniaina ◽  
Anjasoa Randrianarijaona ◽  
...  
Keyword(s):  
Rabies Vaccine ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Travel Times ◽  
Middle Income ◽  
Geographic Access ◽  
Post Exposure ◽  
Canine Rabies ◽  
Middle Income Countries ◽  
Exposure Prophylaxis

AbstractBackgroundPost-exposure prophylaxis (PEP) is highly effective at preventing human rabies deaths, however access to PEP is limited in many rabies endemic countries. The 2018 decision by Gavi to add human rabies vaccine to its investment portfolio should expand PEP availability and reduce rabies deaths. We explore how geographic access to PEP impacts the rabies burden in Madagascar and the potential benefits of improved provisioning.Methodology & Principal FindingsWe use travel times to the closest clinic providing PEP (N=31) as a proxy for access. We find that travel times strongly predict reported bite incidence across the country. Using resulting estimates in an adapted decision tree framework we extrapolate rabies deaths and reporting and find that geographic access to PEP shapes burden sub-nationally. We estimate 960 human rabies deaths annually (95% Prediction Intervals (PI):790 - 1120), with PEP averting an additional 800 deaths (95% PI: 800 (95% PI: 640 - 970) each year. Under these assumptions, we find that expanding PEP to one clinic per district could reduce deaths by 19%, but even with all major health centers provisioning PEP (1733 additional clinics), we still expect substantial rabies mortality. Our quantitative estimates are most sensitive to assumptions of underlying rabies exposure incidence, but qualitative patterns of the impacts of travel times and expanded PEP access are robust.Conclusions & SignificancePEP is effective at preventing rabies deaths, and in the absence of strong surveillance, targeting underserved populations may be the most equitable way to provision PEP. Our framework could be used to guide PEP expansion and improve targeting of interventions in similar endemic settings where PEP access is geographically restricted. While better PEP access should save many lives, improved outreach and surveillance is needed and if rolled out with Gavi investment could catalyze progress towards achieving zero rabies deaths.Author SummaryCanine rabies causes an estimated 60,000 deaths each year across the world, primarily in low- and middle-income countries where people have limited access to both human vaccines (post-exposure prophylaxis or PEP) and dog rabies vaccines. Given that we have the tools to prevent rabies deaths, a global target has been set to eliminate deaths due to canine rabies by 2030, and recently, Gavi, a multilateral organization that aims to improve access to vaccines in the poorest countries, added human rabies vaccine to it’s portfolio. In this study, we estimated reported bite incidence in relation to travel times to clinics provisioning PEP, and extrapolate human rabies deaths in Madagascar. We find that PEP currently averts around 800 deaths each year, but that the burden remains high (1000 deaths/ year), particularly in remote, hard-to-reach areas. We show that expanding PEP availability to more clinics could significantly reduce rabies deaths in Madagascar, but our results suggest that expansion alone will not eliminate deaths. Combining PEP expansion with outreach, surveillance, and mass dog vaccination programs will be necessary to move Madagascar, and other Low- and Middle-Income countries, forward on the path to rabies elimination.

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