Travel Medicine and Infectious Disease最新文献

{"title":"Travel-related potential rabid animal post-exposure consultation at the Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok, Thailand","authors":"Rachata Charoenwisedsil ,&nbsp;Tanatorn Soravipukuntorn ,&nbsp;Katawut Panyatanakun ,&nbsp;Phimphan Pisutsan ,&nbsp;Panita Looareesuwan ,&nbsp;Punyisa Asawapaithulsert ,&nbsp;Hisham Ahmed Imad ,&nbsp;Sophie Schneitler ,&nbsp;Watcharapong Piyaphanee ,&nbsp;Wasin Matsee","doi":"10.1016/j.tmaid.2025.102870","DOIUrl":"10.1016/j.tmaid.2025.102870","url":null,"abstract":"<div><h3>Background</h3><div>Rabies exposure remains a significant public health concern in South and Southeast Asia. Despite the disease being vaccine-preventable, international travelers remain at risk of rabies infection due to the limited access to vaccines and immunoglobulin. This retrospective review aims to analyze post-exposure rabies consultations at the Thai Travel Clinic providing insights into epidemiology, risk factors, and post-exposure management for international travelers.</div></div><div><h3>Methods</h3><div>A retrospective study included international travelers of all ages who visited the Thai Travel Clinic at the Hospital for Tropical Diseases in Bangkok, Thailand for potential rabid animal post-exposure management between January 1, 2019, and March 31, 2024.</div></div><div><h3>Results</h3><div>Among 306 international travelers, 91.5 % were healthy with no underlying medical conditions. Approximately 30.9 % traveled in Southeast Asia for less than one month, 46.6 % for one to six months, and 20.8 % for over six months. The majority of bites were from dogs (46.3 %), followed by monkeys (23.9 %) and cat (23.5 %). Common exposure locations included streets (40.1 %), followed by islands or beaches (20.5 %). The median time from arrival in Thailand to animal exposure was 30 days, with 14.7 % bitten within the first week. World Health Organization (WHO) category III rabies wounds accounted for 59.8 % (176/294) of cases. Only 47.5 % (144/303) received the first dose of the rabies vaccine on the day of exposure, and 57.9 % (70/121) experienced delays in receiving rabies immunoglobulin. Additionally, two travelers (2/149; 1.3 %) refused rabies immunoglobulin despite it being clinically indicated. Only 35.3 % (108/306) had pre-travel consultations, and 9.5 % (29/306) of all travelers completed rabies pre-exposure vaccination.</div></div><div><h3>Conclusions</h3><div>Over half of the international travelers delayed initiating rabies vaccine or immunoglobulin after potential rabid animal exposure. As rabies is a fatal yet preventable disease, this review underscores the urgent need to raise awareness about the importance of prompt post-exposure management. Strengthening traveler education and advocating for pre-exposure immunization are critical strategies to mitigate risks and improve outcomes.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102870"},"PeriodicalIF":6.3,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Travel to the tropics: Impact on gut microbiota","authors":"T. Mlangeni ,&nbsp;C. Jian ,&nbsp;H.K. Häkkinen ,&nbsp;W.M. de Vos ,&nbsp;A. Salonen ,&nbsp;A. Kantele","doi":"10.1016/j.tmaid.2025.102869","DOIUrl":"10.1016/j.tmaid.2025.102869","url":null,"abstract":"<div><h3>Background</h3><div>Visitors to low- and middle-income countries (LMICs) encounter numerous new intestinal microbes, including diarrhoeal pathogens and multidrug-resistant (MDR) bacteria, such as extended-spectrum β-lactamase-producing <em>Enterobacterales</em> (ESBL-PE). Consequently, many develop travellers’ diarrhoea (TD) and/or become colonised by ESBL-PE. We explored the impact of LMIC travel, TD, and ESBL-PE/diarrheal pathogen colonisation on gut microbiota.</div></div><div><h3>Methods</h3><div>The present study included 92 participants from the clinical vaccine trial OEV123, who spent 12 days in Benin, West Africa, and provided exploratory pre- and post-travel stool microbiota samples. The samples were subjected to quantitative polymerase chain reaction (qPCR) to detect diarrhoeal pathogens and 16S rRNA gene amplicon sequencing for microbiota profiling.</div></div><div><h3>Results</h3><div>Travel significantly altered gut microbiota, showing reduced richness, decreased α-diversity, and a 40-fold increase in <em>Escherichia/Shigella.</em> qPCR detected diarrhoeagenic <em>Escherichia coli</em> (DEC) in post-travel stools of 89 % of the 92 participants. No specific microbiota signatures were linked to TD or ESBL-PE acquisition. Participants acquiring multiple DEC pathotypes had higher pre-travel levels of <em>Ruminococcaceae</em> and <em>Coprococcus</em> spp., while their post-travel microbiota was enriched with oxygen-tolerant and oral and upper gastrointestinal tract-associated taxa.</div></div><div><h3>Conclusion</h3><div>Travel to an LMIC significantly impacted intestinal microbiota. Individuals with high pre-travel proportions of <em>Ruminococcaceae</em> and <em>Coprococcus</em> spp. acquired a greater DEC pathotype diversity. However, no specific pre-travel microbiota profile was identified as protective against or predisposing to TD or acquisition of MDR bacteria.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102869"},"PeriodicalIF":6.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effects of pharmacological interventions for the prevention of acute mountain sickness: A systematic review and Bayesian network meta-analysis","authors":"Junyan Wang ,&nbsp;Nan Lian ,&nbsp;Kuo Tang ,&nbsp;Yan Deng ,&nbsp;Tao Li","doi":"10.1016/j.tmaid.2025.102868","DOIUrl":"10.1016/j.tmaid.2025.102868","url":null,"abstract":"<div><h3>Background</h3><div>Acute Mountain Sickness (AMS), the most prevalent high-altitude illness, necessitates effective preventive measures due to rising sudden high-altitude exposure from tourism and occupational activities. Current Pharmacological prophylaxis lack robust comparisons, dose optimization, and confounder-adjusted analysis.</div></div><div><h3>Methods</h3><div>This network meta-analysis (NMA) included 28 randomized controlled trials (RCTs), evaluated healthy individuals with a rapid ascent to &gt;2500 m, compared 13 drugs for AMS incidence, severe AMS (SAMS) incidence, Lake Louise Score (LLS), peripheral oxygen saturation (SpO2), and pulmonary artery pressure (PAP). Quality was evaluated using Cochrane Risk of Bias tools and CINeMA (Confidence in Network Meta-Analysis) for evidence grading. Network meta-regression adjusted for ascent altitude and exposure duration to identify “time” windows or “height” windows.</div></div><div><h3>Results</h3><div>250 mg BID acetazolamide (OR = 0.31, 95 %CI: 0.20–0.47) demonstrated a 5-day preventive efficacy window, while 375 mg BID acetazolamide (OR = 0.31, 95 %CI: 0.18–0.54) showed a shorter 3-day window. 4 mg BID dexamethasone (OR = 0.29, 95 %CI: 0.16–0.54) and 600 mg TID ibuprofen (OR = 0.44, 95 %CI: 0.3–0.64) also significantly reduced AMS incidence. No pharmacological interventions reduced SAMS incidence. After altitude adjustment, sildenafil (40 mg TID; MD = −1.11, 95 %CI: 2.01–0.25) attenuated altitude-induced PAP elevation.</div></div><div><h3>Conclusion</h3><div>Moderate-dose acetazolamide (125–250 mg BID) effectively prevents AMS with a longer prophylactic window compared to high-dose regimens (375 mg BID). There is no pharmacological intervention to prevent SAMS and no high-quality evidence to prevent high-altitude-induced PAP elevation. Our findings delineate the efficacy duration of acetazolamide across doses, while underscoring the imperative for robust clinical trials to advance the evidence base.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102868"},"PeriodicalIF":6.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for strongyloidiasis among selected populations in Taiwan: Prevalence, associated factors, and outcomes","authors":"Sung-Hsi Huang ,&nbsp;Yen-Lin Chen ,&nbsp;Hao-Yu Lin ,&nbsp;Aristine Cheng ,&nbsp;Lih-Yu Chang ,&nbsp;Yi-Chia Huang ,&nbsp;Po-Hsien Kuo ,&nbsp;Yueh-Feng Wen ,&nbsp;Chia-Jung Liu ,&nbsp;Chia-Hao Chang ,&nbsp;Wei-Shun Yang ,&nbsp;Kai-Hsiang Chen ,&nbsp;Pin-Ru Chu ,&nbsp;Chi-Wei Tseng ,&nbsp;Yi-Ching Su ,&nbsp;Li-Hsin Su ,&nbsp;Li-Ta Keng ,&nbsp;Chi-Ying Lin ,&nbsp;Un-In Wu ,&nbsp;Hsin-Yun Sun ,&nbsp;Kua-Eyre Su","doi":"10.1016/j.tmaid.2025.102866","DOIUrl":"10.1016/j.tmaid.2025.102866","url":null,"abstract":"<div><h3>Background</h3><div>When and how to screen for strongyloidiasis in high-income countries remain to be elucidated. This study aimed to investigate the prevalence, associated factors, and outcome of strongyloidiasis in Taiwan and proposed clinical criteria for serological screening.</div></div><div><h3>Methods</h3><div>Adults who were immunocompromised or about to undergo iatrogenic immunosuppression (proactive-screening cohort) and those with clinical presentations suggesting strongyloidiasis (diagnosis-driven cohort) were prospectively enrolled at five hospitals in Taiwan. Serum anti-<em>Strongyloides</em> IgG was determined by two enzyme-linked immunosorbent assays (ELISAs). Stool samples were obtained for microscopy and cultures. Prevalence of confirmed/probable strongyloidiasis, as defined by identification of characteristic larvae from stool or testing positive for both ELISAs, was calculated. Factors associated with strongyloidiasis were identified in multivariable analysis. Six-month mortality was compared between participants with and without strongyloidiasis using Cox proportional hazards model.</div></div><div><h3>Results</h3><div>From January 2021 to June 2024, confirmed/probable cases of strongyloidiasis were identified in 1.9 % and 4.8 % of the participants in proactive-screening and diagnosis-driven cohorts, respectively. Multivariable analysis revealed that skin and skin structure infection (adjusted odds ratio [aOR] 3.180), gastrointestinal bleeding of unknown causes (aOR 3.229), and hemoglobin &lt;10 g/dl (aOR 4.300) were independently associated with strongyloidiasis. Six-month mortality was 33.3 % in participants with confirmed/probable strongyloidiasis, higher than that in those without strongyloidiasis (11.4 %), but not statistically significant after adjusting for age, sex, and clinical severity (p = 0.09).</div></div><div><h3>Conclusions</h3><div>Strongyloidiasis continued to occur among at-risk populations in Taiwan. Screening strategies are needed to improve the detection of this neglected parasitic infection in Taiwan and other high-income countries.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102866"},"PeriodicalIF":6.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical neurological symptoms at high altitude: a systematic literature review","authors":"Wiktor Łagowski ,&nbsp;Olga Grodzka ,&nbsp;Izabela Domitrz","doi":"10.1016/j.tmaid.2025.102867","DOIUrl":"10.1016/j.tmaid.2025.102867","url":null,"abstract":"<div><h3>Background</h3><div>Acute Mountain Sickness (AMS) is a prevalent and potentially debilitating condition affecting individuals who participate in high-altitude journeys, mostly above 2500 m. The main symptoms of AMS, listed in the Lake Louise Symptom score used to diagnose AMS, are headache, dizziness, nausea, and fatigue. However, mountaineering can also be associated with other neurological disturbances. Most records related to neurological disorders associated with high-altitude medicine focus on AMS and its typical neurological symptoms indicated in official criteria. Other conditions related to acute exposure to high altitudes are high-altitude headaches (HAH), which usually precede AMS and high-altitude cerebral oedema (HACE), which can be a complication of AMS or appear independently.</div></div><div><h3>Methods</h3><div>This review aimed to describe studies that included atypical neurological symptoms, which appear during acute exposure to high altitudes and are not mentioned in the criteria of AMS or HACE. Four databases, PubMed, Embase, Web of Science, and Medline Ultimate, were screened. PROSPERO registration ID for this review is CRD420250654251.</div></div><div><h3>Findings</h3><div>Studies that met our inclusion criteria presented symptoms related to well-known conditions, such as stroke, deep cerebral vein thrombosis, seizures, or transient neurological dysfunctions. Moreover, cranial nerve palsies, olfactory threshold impairment, multiple sclerosis worsening, or speech, memory, and sensation disturbances were described in patients at high altitudes.</div></div><div><h3>Conclusions</h3><div>This review shows that high altitude may be an inducing factor in other neurological disturbances besides AMS, HAH, and HACE symptoms. The growing popularity of high-altitude stays should be associated with increasing knowledge about the unusual neurological symptoms that may occur.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102867"},"PeriodicalIF":6.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144072378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The first possible case of airport Zika virus infection in the EU/EEA","authors":"Jana Kerlik ,&nbsp;Ján Hockicko ,&nbsp;Mária Avdičová ,&nbsp;Monika Musilová ,&nbsp;Veronika Tarkovská ,&nbsp;Elena Tichá ,&nbsp;Hana Zelená","doi":"10.1016/j.tmaid.2025.102864","DOIUrl":"10.1016/j.tmaid.2025.102864","url":null,"abstract":"<div><div>Since 2019, when the first autochthonous cases of ZIKV disease were observed in EU/EEA countries, no other locally acquired ZIKV disease cases have been reported in EU/EEA.</div><div>Our case of ZIKV disease in 2024 had a history of flying from Slovakia to Italy and back through Hungary. Since other human routes of ZIKV transmission have been ruled out, we describe the first case of possible ZIKV transmission through airport mosquitoes in EU/EEA.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102864"},"PeriodicalIF":6.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143931829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Congenital tuberculosis in a preterm neonate linked to female genital tuberculosis in a migrant mother: A case report","authors":"Ludo Mahieu ,&nbsp;Aikaterini Barka ,&nbsp;Wouter Arrazola de Oñate ,&nbsp;Veerle Matheeussen ,&nbsp;Koen Vanden Driessche","doi":"10.1016/j.tmaid.2025.102859","DOIUrl":"10.1016/j.tmaid.2025.102859","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102859"},"PeriodicalIF":6.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, attitudes, practices and vaccine acceptance towards seasonal influenza vaccination among international travelers: a cross-sectional survey in Thailand","authors":"Pathomthep Leowattana ,&nbsp;Viravarn Luvira ,&nbsp;Noppadon Tangpukdee ,&nbsp;Panita Looareesuwan ,&nbsp;Tanaya Siripoon ,&nbsp;Thundon Ngamprasertchai ,&nbsp;Suparat Phuanukoonnon ,&nbsp;Pornthep Chanthavanich","doi":"10.1016/j.tmaid.2025.102863","DOIUrl":"10.1016/j.tmaid.2025.102863","url":null,"abstract":"<div><h3>Background</h3><div>Influenza is a common but preventable disease. International travelers encounter significant risks in contracting influenza.</div></div><div><h3>Methods</h3><div>The cross-sectional, questionnaire-based study was conducted on international travelers while visiting the Thai Travel Clinic at the Hospital for Tropical Diseases in Bangkok, Thailand.</div></div><div><h3>Results</h3><div>From May to November 2024, 250 Thai and 229 non-Thai international travelers were enrolled. Most participants reported sufficient knowledge about influenza, with 86.4 % achieving a score of ≥60 % while expressing mild concern of infection [mean perceived risk score of 3.1 ± 2.4 (range from 0 to 10)]. When regarding preventive measures, 72.2 % reported regular hand hygiene, while only 19.4 % regularly wore masks in public. Influenza vaccine acceptance was 38.2 %. The most influential reason for vaccination was healthcare personnel's advice. In the multivariable analysis, the independent factors which affected vaccine acceptance were travelers' nationality, age, purpose of travel, destination country, and perceived risk score.</div></div><div><h3>Conclusion</h3><div>International travelers had sufficient influenza knowledge but low awareness relating to influenza prevention methods and influenza vaccinations. Low vaccine acceptance rates were observed among international travelers. Travel consultations should focus on influenza awareness while traveling and associated preventative measures.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102863"},"PeriodicalIF":6.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oropouche Fever: An imported case underscoring the importance of clinical and epidemiological vigilance","authors":"M. Migueres ,&nbsp;C. Garnier ,&nbsp;P. Trémeaux ,&nbsp;G. Durand ,&nbsp;G. Martin-Blondel ,&nbsp;L. Pezzi ,&nbsp;J.-M. Mansuy","doi":"10.1016/j.tmaid.2025.102862","DOIUrl":"10.1016/j.tmaid.2025.102862","url":null,"abstract":"","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"66 ","pages":"Article 102862"},"PeriodicalIF":6.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rabies post-exposure treatment in metropolitan Sydney residents, 2013–2023: A retrospective case-series analysis","authors":"Alice Self ,&nbsp;Troy McNeill ,&nbsp;Andrew Ingleton ,&nbsp;Thomas R. Browne ,&nbsp;Leena Gupta","doi":"10.1016/j.tmaid.2025.102856","DOIUrl":"10.1016/j.tmaid.2025.102856","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":23312,"journal":{"name":"Travel Medicine and Infectious Disease","volume":"65 ","pages":"Article 102856"},"PeriodicalIF":6.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}