Pragmatic management of rabies risk in operation DAMAN 50 (Lebanon, October 2024-February 2025): a case study on evidence-based military field medicine.
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| Název: | Pragmatic management of rabies risk in operation DAMAN 50 (Lebanon, October 2024-February 2025): a case study on evidence-based military field medicine. |
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| Autoři: | Gasc T; 13(e) Centre Médical des Armées, 109(e) Antenne Médicale, Saint-Maixent-L'Ecole 79404, France; rôle 1 DAMAN 50, Dayr Kiffa, Lebanon. Electronic address: thomas.gasc@gmail.com., Santinelli Y; Vétérinaire théâtre DAMAN 50, Dayr Kiffa, Lebanon; 1(er) Centre Médical des Armées, 23(e) groupe vétérinaire, bd Henri IV, Paris 75004, France., Marti J; rôle 1 DAMAN 50, Dayr Kiffa, Lebanon; 13(e) Centre Médical des Armées, 107(e) Antenne Médicale, Poitier 86 000, France. |
| Zdroj: | Infectious diseases now [Infect Dis Now] 2025 Nov; Vol. 55 (7), pp. 105136. Date of Electronic Publication: 2025 Aug 21. |
| Způsob vydávání: | Journal Article |
| Jazyk: | English |
| Informace o časopise: | Publisher: Elsevier Masson Country of Publication: France NLM ID: 101775152 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2666-9919 (Electronic) Linking ISSN: 26669919 NLM ISO Abbreviation: Infect Dis Now Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Paris] : Elsevier Masson, [2021]- |
| Výrazy ze slovníku MeSH: | Rabies*/prevention & control , Rabies*/epidemiology , Rabies*/transmission , Military Personnel* , Post-Exposure Prophylaxis*/methods , Military Medicine*, Animals ; Humans ; Cats ; Rabies Vaccines/administration & dosage ; Lebanon/epidemiology ; Evidence-Based Medicine ; France |
| Abstrakt: | Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The French Armed Forces are regularly deployed in areas of endemic rabies, a virus responsible for 59,000 deaths worldwide per year. During Operation DAMAN 50 at the end of 2024, rapid conflict intensification in southern Lebanon at once significantly increased the rabies exposure of French servicemen and decreased access to laboratory analyses. Exposures of military personnel to scratches from cats of unknown rabies status multiplied, putting post-exposure prophylaxis (PEP) stocks under extreme strain. To minimize the risk of a PEP shortage and its consequences, the medical personnel deployed in Operation DAMAN 50 adopted a pragmatic strategy updating existing recommendations. At the individual level, watch-and-see PEP occurred only when veterinary cat observation was possible. In the absence of reliable laboratory service, it was based on pathophysiological, epidemiological, environmental and operational data. On a wider scale, the strategy involved controlling the feline population. Based on the clinical field skills and global appraisal of situations not previously encountered by military practitioners, operational capacity was maintained, while limited vaccine supplies were reserved for patients in dire need. (Copyright © 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved.) |
| Contributed Indexing: | Keywords: Evidence based medicine; Military medicine; Primary care; Rabies; Unique situation |
| Substance Nomenclature: | 0 (Rabies Vaccines) |
| Entry Date(s): | Date Created: 20250823 Date Completed: 20251102 Latest Revision: 20251102 |
| Update Code: | 20251103 |
| DOI: | 10.1016/j.idnow.2025.105136 |
| PMID: | 40848848 |
| Databáze: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br />The French Armed Forces are regularly deployed in areas of endemic rabies, a virus responsible for 59,000 deaths worldwide per year. During Operation DAMAN 50 at the end of 2024, rapid conflict intensification in southern Lebanon at once significantly increased the rabies exposure of French servicemen and decreased access to laboratory analyses. Exposures of military personnel to scratches from cats of unknown rabies status multiplied, putting post-exposure prophylaxis (PEP) stocks under extreme strain. To minimize the risk of a PEP shortage and its consequences, the medical personnel deployed in Operation DAMAN 50 adopted a pragmatic strategy updating existing recommendations. At the individual level, watch-and-see PEP occurred only when veterinary cat observation was possible. In the absence of reliable laboratory service, it was based on pathophysiological, epidemiological, environmental and operational data. On a wider scale, the strategy involved controlling the feline population. Based on the clinical field skills and global appraisal of situations not previously encountered by military practitioners, operational capacity was maintained, while limited vaccine supplies were reserved for patients in dire need.<br /> (Copyright © 2025 The Authors. Published by Elsevier Masson SAS.. All rights reserved.) |
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| ISSN: | 2666-9919 |
| DOI: | 10.1016/j.idnow.2025.105136 |