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The shift in rabies epidemiology in France: time to adjust rabies post-exposure risk assessment
- Perrine Parize1 , Laurent Dacheux1 , Florence Larrous1 , Hervé Bourhy1 , the French network of antirabies clinics2
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View Affiliations Hide AffiliationsAffiliations: 1 Institut Pasteur, Unit Lyssavirus Dynamics and Host Adaptation, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, Paris, France 2 The members of the network are listed at the end of the articlePerrine Parizeperrine.parize pasteur.fr
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Citation style for this article: Parize Perrine, Dacheux Laurent, Larrous Florence, Bourhy Hervé, the French network of antirabies clinics. The shift in rabies epidemiology in France: time to adjust rabies post-exposure risk assessment. Euro Surveill. 2018;23(39):pii=1700548. https://doi.org/10.2807/1560-7917.ES.2018.23.39.1700548 Received: 02 Aug 2017; Accepted: 11 Feb 2018
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Abstract
The epidemiology of rabies in France and western Europe has changed during the past 22 years. In France, rabies in non-flying terrestrial mammals was declared to be eliminated in 2001, and the risk of rabies is now limited to contact with bats, rabid animals illegally imported from rabies-enzootic countries and traveller exposure in enzootic areas. We analysed the epidemiology of rabies in France from 1995 to 2016, describing and analysing data on human rabies surveillance as well as data on post-exposure prophylaxis (PEP) collected from the network of French antirabies clinics. Over the study period, seven individuals were diagnosed with rabies in France, all of whom were infected outside mainland France. PEP data analysis revealed an expected overall decrease in PEP administration for individuals exposed in mainland France, but there was still overuse of anti-rabies drugs, given the very low epidemiological risk. On the other hand, a significant increase in PEP delivered to individuals exposed abroad was evidenced. These epidemiological trends indicate that clear guidelines should be provided to support physicians’ efforts to adjust rabies risk assessment to the evolution of the epidemiological situation.
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