Rabies prophylaxis for travellers

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Dear Editor,
I read the article by Wieten and colleagues¹ with great interest. The authors investigated risk factors of rabies exposure among travellers. However, I have some comments concerning this study.

In line with the recommendations of World Health Organization, postexposure prophylaxis (PEP) is not indicated for category I rabies suspected contacts.² However, ten persons in their study who received PEP had category I contact.

In their study, the median time between departure and animal-associated injury was found to be 9 days (IQR: 5-17 days). It is well known that protective antibodies against rabies vaccination begin to appear at postvaccination day 7.³ So, departure time can be scheduled at least seven days after pre-exposure prophylaxis.


DISCLOSURES

Conflict of interest: none declared.


REFERENCES

1. Wieten RW, Tawil S, van Vugt M, Goorhuis A, Grobusch MP. Risk of rabies exposure among travellers. Neth J Med. 2015;73:219-26. 
2. WHO Expert Consultation on rabies: first report, October 2004. 
3. Gozdas HT. Immune response following postexposure rabies prophylaxis. Hum Vaccin Immunother. 2015;11:1878.