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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. Human cases of rabies occur in Asia, Africa and South and Latin America. 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 20–60 days for people to show symptoms, but can range from 5 days to over a year, and in some very rare cases, many years. Rabies initially causes numbness or tingling around the wound site, headache, fever and general weakness. The disease progresses to muscle spasms, hydrophobia (fear of water) and convulsions, 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, 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, those working in animal quarantine centres and certain HM revenue and customs officers.1

If you think you, or your child, might have been exposed to the rabies virus, you must always seek 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. Medical advice should be sought following any potential exposure to the rabies virus.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. You should avoid having the wound stitched. A doctor may recommend rabies and tetanus vaccine 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.

  1. Fit For Travel. Rabies. Available at: http://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/rabies.aspx. Accessed August 2017.
  2. Travel Health Pro. Rabies. Available at: https://travelhealthpro.org.uk/factsheet/20/rabies. Accessed August 2017.

Date of preparation: November 2017
SAGB.TRAV.17.10.1322j