Human Rabies in France in 2004: Current Status and Management
Twenty people died of rabies in France between 1970 and 2003 (compared to 55,000 per year worldwide), with 80% of these deaths occurring upon return from a trip to Africa (the Maghreb and Sub-Saharan Africa). Dogs were implicated in nine out of ten cases, and children were the most commonly affected. Furthermore, while indigenous rabies in carnivores has been eradicated since 1998, the risk persists, primarily due to the illegal importation of animals. Transmission occurs via saliva, even during the preclinical phase, through bites, scratches, or contact with mucous membranes or broken skin. Human-to-human transmission has never been demonstrated outside of (corneal) transplants. The average incubation period, ranging from one to three months, allows for vaccination or serovaccination to be initiated. Full-blown rabies presents as encephalitis or a fatal paralytic syndrome, but initial clinical diagnosis is difficult and often delayed. In cases of suspected rabies, the National Rabies Reference Center (Institut Pasteur) guides the collection of samples and their transport under optimal conditions, enabling results to be obtained in less than five days. For those in close contact, the risk of infection is theoretical if standard hygiene rules are followed. Vaccination, which is the responsibility of rabies centers, is considered only once the diagnosis has been established, and only for individuals who have been exposed or for whom the medical history is unreliable (children under six years of age). Prevention relies on informing travelers, especially those heading to Africa, about the danger of approaching (or even bringing in!) an animal (especially a dog), and the importance of following vaccination recommendations, particularly for young children who are old enough to walk
Author(s): Peigue Lafeuille H, Bourhy H, Abiteboul D, Astoul J, Cliquet F, Goudal M, Lerasle S, Mailles A, Montagne MC, Morer I, Rotivel Y, Floret D
Publishing year: 2004
Pages: 551-60
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