Circumstances and management of 72 animal bites among long-term residents in the tropics

Abstract

Little is known about rabies exposure among expatriates living in warm climates. Recommendations on pre-exposure prophylaxis are therefore controversial. This study assesses the post-exposure management of Swiss and German expatriates after potential rabies exposures. Dogs were involved in 69% of all incidents. Less than half of the owned dogs were vaccinated against rabies. Only 24–30% of post-exposure treatments were correct according to WHO recommendations. Expatriates with pre-exposure vaccination appear to be complacent about post-exposure treatment. The decision to give pre-exposure vaccination to expatriates in warm climate countries or to rely on post-exposure rabies vaccination depends on the available quality of treatment and must be carefully assessed prior to a stay abroad. Information on rabies risk must be better disseminated and vaccination of owned animals improved.