{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:43:15Z","timestamp":1788968595650,"version":"build-2803163510"},"reference-count":18,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"unspecified","delay-in-days":76,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2021]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Rabies post-exposure prophylaxis (R-PEP) including wound treatment, vaccination and application of rabies immunoglobulin (RIG) is essential in preventing rabies mortality. Today, Germany is officially declared free from terrestrial rabies and rabies is only found in bats. However, physicians in A&amp;E Departments are frequently consulted on the need for R-PEP. We retrospectively analysed patients who received R-PEP at the A&amp;E Department of the University Hospital Bonn between 01.01.2013 and 30.06.2019. Demographic data, travel history, clinical and laboratory findings, previous rabies vaccinations and R-PEP vaccination regimen were recorded. During the study period, 90 patients received R-PEP at the University Hospital Bonn, in 10 cases without indication for R-PEP. Altogether, we found deviations from R-PEP guidelines in 51% (<jats:italic>n<\/jats:italic> = 41\/80). Infiltration of RIG was missed in 12 patients and incorrectly administrated in 24 patients. Furthermore, vaccination scheme was incorrect in 11 patients. Correct wound washing and documentation of tetanus status was missing in 14% and 63% of patients, respectively. Despite rabies elimination in Germany patients frequently seek advice for R-PEP, the majority returning from foreign travel. Our data show that there is a high need for education on indication for R-PEP before and after travel and for implementation of precise R-PEP guidelines in daily clinical practice.<\/jats:p>","DOI":"10.1017\/s0950268821000601","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T09:05:14Z","timestamp":1616058314000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":11,"title":["Rabies post-exposure prophylaxis in Germany \u2212 What are the challenges?"],"prefix":"10.1017","volume":"149","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0201-6546","authenticated-orcid":false,"given":"P.","family":"Meyerhoff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Manekeller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Saleh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Boesecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Schlabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.C.","family":"Wasmuth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"van Bremen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.M.","family":"Eis-H\u00fcbinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"von Fischer-Treuenfeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Menting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.K.","family":"Rockstroh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Schwarze-Zander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"S0950268821000601_ref12","doi-asserted-by":"publisher","DOI":"10.3201\/eid2104.141479"},{"key":"S0950268821000601_ref5","volume-title":"Rabies","year":"2020"},{"key":"S0950268821000601_ref1","volume-title":"Global Elimination of Dog-Mediated Human Rabies","year":"2016"},{"key":"S0950268821000601_ref10","first-page":"1","article-title":"Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the advisory committee on immunization practices. 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Available at https:\/\/apps.who.int\/iris\/handle\/10665\/272364. Accessed 30 Sep 2020."},{"key":"S0950268821000601_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2011.11.007"},{"key":"S0950268821000601_ref7","doi-asserted-by":"publisher","DOI":"10.2807\/ese.18.18.20474-en"},{"key":"S0950268821000601_ref17","doi-asserted-by":"publisher","DOI":"10.1111\/jtm.12085"},{"key":"S0950268821000601_ref18","doi-asserted-by":"publisher","DOI":"10.1111\/jtm.12024"},{"key":"S0950268821000601_ref8","unstructured":"8. RKI (1999) Tollwut. Available at https:\/\/www.rki.de\/DE\/Content\/Infekt\/EpidBull\/Merkblaetter\/Ratgeber_Tollwut.html. Accessed 30 Sep 2020."},{"key":"S0950268821000601_ref6","volume-title":"Rabies: Annual Epidemiological Report for 2018","year":"2019"},{"key":"S0950268821000601_ref14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0006951"},{"key":"S0950268821000601_ref2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aaf6984"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268821000601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,5,14]],"date-time":"2021-05-14T08:56:48Z","timestamp":1620982608000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268821000601\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021]]},"references-count":18,"alternative-id":["S0950268821000601"],"URL":"https:\/\/doi.org\/10.1017\/s0950268821000601","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2021. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e119"}}