Rabies immunoprophylaxis strategy in travelers

We present data from a two-year study of foreign travelers with possible exposure to rabies virus who presented to the only clinics in Nepal that provided modern rabies vaccine. Of 395 000 foreign tourists and residents who visited Nepal during the study period, 62 required post-exposure rabies immunoprophylaxis. Dog bites accounted for 76% of the exposures, while 20% were due to monkey bites. Sixty-three percent of wounds involved the lower extremity. Seventy-eight per cent of wounds were 2 cm or less in length. The mean length of time between exposure and treatment was 3 days, and 90% received consultation or treatment within 9 days. The safety, expense, and convenience of pre-exposure rabies immunization versus post-exposure immunoprophylaxis alone are discussed.