Alice Self , Troy McNeill , Andrew Ingleton , Thomas R. Browne , Leena Gupta
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引用次数: 0
Abstract
Background
The nature and frequency of rabies and Australian Bat Lyssavirus (ABLV) exposures requiring post-exposure treatment (PET) in metropolitan Sydney residents has not previously been described. We assessed the trends in PET use in this population, the nature of exposures, geographic distribution, and timeliness and completeness of PET provided, comparing between local and overseas exposures.
Methods
A retrospective case series analysis of potential rabies and ABLV exposures in residents of Sydney Local Health District reported to the public health unit between January 1, 2013 and December 31, 2023.
Results
Data were available for 595 exposed persons; 477 (80 %) were overseas exposures, and 118 (20 %) were local ABLV exposures. PET was administered in 587 (99 %) exposures. Overseas exposures were mostly due to bites from monkeys, and the majority occurred in Asia (92 %), specifically in Indonesia. Local exposures were mostly due to megabat injuries. Bat testing occurred following 25 % of local exposures, with a 20 % ABLV positivity rate. Inadequate wound management was reported in 45 % of exposures. PET was markedly delayed (commenced greater than 14 days after exposure or a mid-schedule delay) in 26 % of overseas and 7 % of local exposures and incomplete in 15 % of overseas and 4 % of local exposures. Only 8 % of exposed persons received pre-exposure prophylaxis (PrEP).
Conclusion
Cost reduction strategies and measures to improve adherence and accessibility to PET, such as prepositioned stock and standing orders, should be explored. Improving public health risk communication about animal avoidance and appropriate treatment if exposed may also reduce delayed and incomplete PEP. Australian travelers to rabies-endemic countries should be routinely counselled on the benefits of PrEP.
期刊介绍:
Travel Medicine and Infectious Disease
Publication Scope:
Publishes original papers, reviews, and consensus papers
Primary theme: infectious disease in the context of travel medicine
Focus Areas:
Epidemiology and surveillance of travel-related illness
Prevention and treatment of travel-associated infections
Malaria prevention and treatment
Travellers' diarrhoea
Infections associated with mass gatherings
Migration-related infections
Vaccines and vaccine-preventable disease
Global policy/regulations for disease prevention and control
Practical clinical issues for travel and tropical medicine practitioners
Coverage:
Addresses areas of controversy and debate in travel medicine
Aims to inform guidelines and policy pertinent to travel medicine and the prevention of infectious disease
Publication Features:
Offers a fast peer-review process
Provides early online publication of accepted manuscripts
Aims to publish cutting-edge papers