Rabies
What is it and how is it spread?
Rabies is a disease caused by a virus that is passed on to humans by mammals. The virus is introduced from the animal’s saliva via a bite or scratch, and is normally caught from dogs, but can also be spread by bats, monkeys or cats. It can also be spread when saliva from an infected animal comes into contact with broken skin, or the eyes, nose or mouth. Rabies affects the central nervous system, and once symptoms develop, is almost always fatal.1,2
Who is at risk?
Rabies is found on all continents except Antarctica. The risk is highest in countries where the virus circulates in dogs. Most human rabies cases occur in Africa and Asia, mainly in rural communities. In countries considered rabies free, rabies has been wiped out in land mammals, but some bats may carry a rabies-like virus which they can pass on to humans.1,2
What are the symptoms?
It usually takes between 3-12 weeks for people to show symptoms, but can range from 4 days or up to 19 years.2 Rabies initially causes numbness or tingling around the wound site, headache, fever and general weakness. The disease progresses to muscle spasms, hallucinations, confusion, paralysis and eventually death. There are two types of rabies, the more common 'furious' rabies, and the less common paralytic or 'dumb' rabies.1,2
How can it be prevented?
You should avoid contact with wild or domestic animals (including bats) during travel. Travellers should be aware that certain activities (such as running and cycling) may attract dogs. You should avoid:2
- Approaching animals
- Being bitten, scratched or licked by animals
- Attempting to pick up an unusually tame animal or one that appears to be unwell
- Attracting stray animals by offering food or dropping litter
Children are particularly at risk from being bitten and potentially catching rabies and should be discouraged from approaching animals even if they do not appear to be unwell.1,2
Vaccination may be recommended if you will be trekking, working, living or travelling in affected areas, especially rural areas where there may not be easy access to medical facilities. Some people may need a vaccination because of their jobs, such as bat handlers and those working in animal quarantine centres.1
If you think you, or your child, might have been exposed to the rabies virus, you must always seek urgent medical help – even if you have previously had the rabies vaccine.1
How can it be treated?
Rabies cannot be treated once symptoms have appeared. Urgent medical advice should be sought following any potential exposure to the rabies virus, even if pre-exposure vaccination was received.1
General advice states that, following a bite or scratch, saliva should be thoroughly washed off with soap and water and the wound irrigated with iodine solution or alcohol. A doctor may recommend rabies and tetanus vaccine, as well as rabies immunoglobulin soon after exposure, depending on the exposure and risk of disease.1
Where can I get further information?
If you have any questions or concerns about exposure to rabies, please speak to your doctor or a travel health practitioner for more information.
Make sure you contact your GP or travel health practitioner in plenty of time before you travel to discuss the ways you can help to keep yourself healthy whilst away. You should try and contact them at least 4–6 weeks before your trip.
After your trip, you should contact your GP if you develop a fever or notice any other unusual symptoms.
The information provided is a summary that was up to date when this article was published; however, recommendations may be updated from time to time. Please always consult with your doctor, nurse or pharmacist well in advance of travelling.
References
1. Fit For Travel. Rabies. Available at: https://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/rabies. Accessed February 2024. 2. Travel Health Pro. Rabies. Available at: https://travelhealthpro.org.uk/factsheet/20/rabies. Accessed February 2024.
MAT-XU-2203067(v2.0) | February 2024
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