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  • Title: Characteristics of Travelers to Asia Requiring Multidose Vaccine Schedules: Japanese Encephalitis and Rabies Prevention.
    Author: Walker XJ, Barnett ED, Wilson ME, Macleod WB, Jentes ES, Karchmer AW, Hamer DH, Chen LH, Boston Area Travel Medicine Network (BATMN).
    Journal: J Travel Med; 2015; 22(6):403-9. PubMed ID: 26420372.
    Abstract:
    BACKGROUND: Japanese encephalitis (JE) and rabies are serious vaccine preventable diseases which are an important consideration for travelers to Asia. METHODS: Five Boston-area travel clinics collected demographic data, trip information, and interventions for travelers to Asia seen at pre-travel consultations from March 1, 2008, through July 31, 2010. We evaluated travelers for proportion vaccinated for JE and rabies, those traveling for >1 month, and whether travelers had adequate time to complete the JE series (clinic visit ≥28 days before departure) and rabies pre-exposure prophylaxis (clinic visit ≥21 days before departure). RESULTS: Among 15,440 travelers from five Boston Area Travel Medicine Network travel clinics, Asia was the most common destination region, visited by 5,582 (36%) of travelers. Among these travelers, 4,810 (86%) planned to travel to only one Asian subregion. Median trip duration was 17 days, with more than 20% traveling for >1 month. The most common destinations were South (41%), Southeast (26%), and East (23%) Asia. Of those traveling to South, Southeast, or East Asia, over one-third with trips >1 month had insufficient time to complete a series for either JE or rabies vaccine. Overall, only 10% of travelers were vaccinated (past and pre-travel visit) for either JE or rabies, with lowest percentages among travelers visiting friends and relatives. Most travelers received advice on vector precautions (96%) and rabies prevention, which included avoiding animal contact, washing wounds, and obtaining appropriate post-exposure prophylaxis (88%). CONCLUSION: Given the insufficient time for completion and relatively low vaccination rates, greater awareness of earlier pre-travel consultations, at least 4-6 weeks before travel, and accurate risk assessment for travelers are important. Effective counseling about vector avoidance, rabies, and animal bite prevention and management remains critical.
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