Vaccine 25 (2007) 2656–2663 Animal-associated injuries and related diseases among returned travellers: A review of the GeoSentinel Surveillance Network Philippe Gautret a,∗ , Eli Schwartz b , Marc Shaw c , Georges Soula d , Pierre Gazin a,d,e , Jean Delmont a,d , Philippe Parola a,d , Marie Jos´ e Soavi a , Elizabeth Matchett f , Graham Brown f , Joseph Torresi f , for the GeoSentinel Surveillance Network 1 a Service des Maladies Infectieuses et Tropicales, AP-HM, Hˆ opital Nord, 13015 Marseille, Cedex 05, France b Center for Geographical Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel c Worldwise Travellers Health and Vaccination Center, Auckland, New Zealand d Centre de Formation et Recherche en M´ edecine et Sant´ e Tropicale (CFRMST), Facult´ e de M´ edecine, Marseille, France e Institut de Recherche pour le D´ eveloppement (IRD), Marseille, France f Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Australia Received 28 September 2006; received in revised form 6 November 2006; accepted 5 December 2006 Available online 3 January 2007 Abstract Background: Increased travel to exotic destinations around the world is escalating the risk of exposure to animal-associated injuries with a risk of acquiring rabies. Methods: We have examined data reported to GeoSentinel Surveillance Network to highlight characteristics of animal-associated injuries in travellers. Results: A total of 320 cases were reported from 1998 to 2005. Travellers were predominantly tourists from developed countries with median travel duration of 23 days. A pre-travel encounter was recorded in 45.0% of the cases. A significantly greater proportion of patients with animal-related injuries were female compared to other travel associated diagnosis (54.7% versus 47.4%) and were most likely patients aged <15 years (6.2% versus 2.6%). The proportionate morbidity for sustaining an animal bite was higher among travellers visiting Southeast Asia (3.9%) and the rest of Asia (2.2%) compared to Australia–New Zealand (1.9%), Africa (1.0%), Latin America (0.8%), North America (0.9%) and Europe (1.2%). Seventy-five percent of cases occurred in countries endemic for rabies. Dogs were involved in 51.3% of cases, monkeys in 21.2%, cats in 8.2%, bats in 0.7% and humans in 0.7%. The higher likelihood for animal-related injuries among female travellers was dependant on the animal species involved, with monkeys accounting for the majority of injuries. In contrast, males were more likely to be injured by dogs. Only 66.1% of all patients reported with animal-related injury received rabies post-exposure prophylaxis. Conclusions: This data shows that animal-associated injuries are not uncommon among returned travellers presenting to GeoSentinel sites. The highest proportion of injuries was recorded in travellers to Asia, mostly in regions, which are endemic for rabies, and this had led to a requirement for PEP. © 2006 Elsevier Ltd. All rights reserved. Keywords: Travellers; Rabies; Animal-associated injuries ∗ Corresponding author. Tel.: +33 4 91 96 89 35; fax: +33 4 91 96 89 38. E-mail address: philippe.gautret@club-internet.fr (P. Gautret). 1 See Appendix A. 1. Introduction Increased travel to exotic destinations around the world is escalating the risk of exposure to animal-related injuries. In many parts of the developing world, where rabies risk is high, 0264-410X/$ – see front matter © 2006 Elsevier Ltd. All rights reserved. doi:10.1016/j.vaccine.2006.12.034