Traveler Exposures to Animals: A GeoSentinel Analysis

BACKGROUND: Human coexistence with other animals can result in both intentional and unintentional contact with a variety of mammalian and non-mammalian species. International travelers are at risk for such encounters; travelers risk injury, infection, and possibly death from domestic and wild animal bites, scratches, licks, and other exposures. The aim of the present analysis was to understand the diversity and distribution of animal-related exposures among international travelers. METHODS: Data from January 2007 through December 2018 from the GeoSentinel Surveillance Network were reviewed. Records were included if the exposure was non-migration travel with a diagnosis of an animal (dog, cat, monkey, snake, or other) bite or other exposure (non-bite); records were excluded if the region of exposure was not ascertainable or if another, unrelated acute diagnosis was reported. RESULTS: A total of 6470 animal exposures (bite or non-bite) were included. The majority (71%) occurred in Asia. Travelers to 167 countries had at least one report of an animal bite or non-bite exposure. The majority (76%) involved dogs, monkeys, and cats, although a wide range of wild and domestic species were involved. Almost two-thirds (62.6%) of 4395 travelers with information available did not report a pretravel consultation with a healthcare provider. CONCLUSIONS: Minimizing bites and other animal exposures requires education (particularly during pretravel consultations) and behavioral modification. These should be supplemented by the use of pre-exposure rabies vaccination for travelers to high-risk countries (especially to those with limited access to rabies immunoglobulin), as well as encouragement of timely (in-country) post-exposure prophylaxis for rabies and Macacine alphaherpesvirus 1 (herpesvirus B) when warranted.