Travel-related potential rabid animal post-exposure consultation at the Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok, Thailand
2
Issued Date
2025-07-01
Resource Type
ISSN
14778939
eISSN
18730442
Scopus ID
2-s2.0-105008242628
Journal Title
Travel Medicine and Infectious Disease
Volume
66
Rights Holder(s)
SCOPUS
Bibliographic Citation
Travel Medicine and Infectious Disease Vol.66 (2025)
Suggested Citation
Charoenwisedsil R., Soravipukuntorn T., Panyatanakun K., Pisutsan P., Looareesuwan P., Asawapaithulsert P., Imad H.A., Schneitler S., Piyaphanee W., Matsee W. Travel-related potential rabid animal post-exposure consultation at the Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok, Thailand. Travel Medicine and Infectious Disease Vol.66 (2025). doi:10.1016/j.tmaid.2025.102870 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110879
Title
Travel-related potential rabid animal post-exposure consultation at the Thai Travel Clinic, Hospital for Tropical Diseases, Bangkok, Thailand
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: 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. Methods: 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. Results: 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. Conclusions: 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.