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Imported Human Rabies Cases Worldwide, 1990–2012
Sixty cases of human rabies in international travelers were reviewed from 1990–2012. A significant proportion of the cases were observed in migrants or their descendants when emigrating from their country of origin or after a trip to visit friends and relatives or for other reasons (43.3%). The case...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3642086/ https://www.ncbi.nlm.nih.gov/pubmed/23658853 http://dx.doi.org/10.1371/journal.pntd.0002209 |
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author | Carrara, Philippe Parola, Phillipe Brouqui, Phillipe Gautret, Philippe |
author_facet | Carrara, Philippe Parola, Phillipe Brouqui, Phillipe Gautret, Philippe |
author_sort | Carrara, Philippe |
collection | PubMed |
description | Sixty cases of human rabies in international travelers were reviewed from 1990–2012. A significant proportion of the cases were observed in migrants or their descendants when emigrating from their country of origin or after a trip to visit friends and relatives or for other reasons (43.3%). The cases were not necessarily associated with long-term travel or expatriation to endemic countries; moreover, cases were observed in travelers after short trips of two weeks or less. A predominance of male patients was observed (75.0%). The proportion of children was low (11.7%). Cases from India and Philippines were frequent (16 cases/60). In a significant proportion of cases (51.1%), diagnosis was challenging, with multiple missed diagnoses and transfers from ward to ward before the final diagnosis of rabies. Among the 28 patients whose confirmed diagnosis was obtained ante-mortem, the mean time between hospitalization and diagnosis was 7.7 days (median time: 6.0 days, range 2–30) including four cases with a diagnosis delayed by 15 or more days. In five cases, a patient traveled through one or more countries before ultimately being hospitalized. Three factors played a role in delaying the diagnosis of rabies in a number of cases: (i) a low index of suspicion for rabies in countries where the disease has been eradicated for a long time or is now rare, (ii) a negative history of animal bites or exposure to rabies, and (iii) atypical clinical presentation of the disease. Clinical symptomatology of rabies is complex and commonly confuses physicians. Furthermore, failure in diagnosing imported cases in more developed countries is most likely related to the lack of medical familiarity with even the typical clinical features of the disease. |
format | Online Article Text |
id | pubmed-3642086 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-36420862013-05-08 Imported Human Rabies Cases Worldwide, 1990–2012 Carrara, Philippe Parola, Phillipe Brouqui, Phillipe Gautret, Philippe PLoS Negl Trop Dis Research Article Sixty cases of human rabies in international travelers were reviewed from 1990–2012. A significant proportion of the cases were observed in migrants or their descendants when emigrating from their country of origin or after a trip to visit friends and relatives or for other reasons (43.3%). The cases were not necessarily associated with long-term travel or expatriation to endemic countries; moreover, cases were observed in travelers after short trips of two weeks or less. A predominance of male patients was observed (75.0%). The proportion of children was low (11.7%). Cases from India and Philippines were frequent (16 cases/60). In a significant proportion of cases (51.1%), diagnosis was challenging, with multiple missed diagnoses and transfers from ward to ward before the final diagnosis of rabies. Among the 28 patients whose confirmed diagnosis was obtained ante-mortem, the mean time between hospitalization and diagnosis was 7.7 days (median time: 6.0 days, range 2–30) including four cases with a diagnosis delayed by 15 or more days. In five cases, a patient traveled through one or more countries before ultimately being hospitalized. Three factors played a role in delaying the diagnosis of rabies in a number of cases: (i) a low index of suspicion for rabies in countries where the disease has been eradicated for a long time or is now rare, (ii) a negative history of animal bites or exposure to rabies, and (iii) atypical clinical presentation of the disease. Clinical symptomatology of rabies is complex and commonly confuses physicians. Furthermore, failure in diagnosing imported cases in more developed countries is most likely related to the lack of medical familiarity with even the typical clinical features of the disease. Public Library of Science 2013-05-02 /pmc/articles/PMC3642086/ /pubmed/23658853 http://dx.doi.org/10.1371/journal.pntd.0002209 Text en © 2013 Carrara et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Carrara, Philippe Parola, Phillipe Brouqui, Phillipe Gautret, Philippe Imported Human Rabies Cases Worldwide, 1990–2012 |
title | Imported Human Rabies Cases Worldwide, 1990–2012 |
title_full | Imported Human Rabies Cases Worldwide, 1990–2012 |
title_fullStr | Imported Human Rabies Cases Worldwide, 1990–2012 |
title_full_unstemmed | Imported Human Rabies Cases Worldwide, 1990–2012 |
title_short | Imported Human Rabies Cases Worldwide, 1990–2012 |
title_sort | imported human rabies cases worldwide, 1990–2012 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3642086/ https://www.ncbi.nlm.nih.gov/pubmed/23658853 http://dx.doi.org/10.1371/journal.pntd.0002209 |
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