Pragmatic management of rabies risk in operation DAMAN 50 (Lebanon, October 2024-February 2025): a case study on evidence-based military field medicine - 01/11/25
, Y. Santinelli c, d, J. Marti e, bHighlights |
• | The French Armed Forces are presently deployed in Lebanon, a country where rabies is endemic. |
• | The 2024 conflict drastically increased rabies exposure, while decreasing the possibility to administrate specific treatments and restricting access to laboratory analyses. |
• | French military practitioners carried out a specific and pragmatic strategy to cope with this singular event in an unusual setting. |
Abstract |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Evidence based medicine, Military medicine, Primary care, Rabies, Unique situation
Plan
Vol 55 - N° 7
Article 105136- novembre 2025 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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