Rabies is a severe viral infection transmitted to humans by animals. It affects the brain and nervous system. Virus in the animal's saliva is transmitted through a bite or when the rabid animal licks an open cut or wound. On rare occasions the virus can be inhaled, e.g. from exposure to air in caves which are densely populated with rabid bats. In developing countries dogs and monkeys are the most common source of human infections. However bats, skunks, cats and foxes can also transmit it. Rabbits, squirrels, chipmunks, rats and mice are rarely infected, but theoretically any mammal with teeth can spread rabies.
Animal behaviour is NOT a reliable sign as to whether an animal is rabid, as the animal can look healthy while the rabies is slowly growing within its brain. The only only guaranteed way to tell is by killing the animal and examining its brain.
Most countries within Asia, Africa and South America have infected regions. Countries with a significant rabies problem include Bangladesh, Bolivia, China, Colombia, Ecuador, El Salvador, Ethiopia, Guatemala, India, Mexico, Nepal, Peru, Philippines, Sri Lanka, Tanzania, Thailand, & Vietnam. There is also rabies In Europe and North America, but many animals there are vaccinated against rabies and the risk is lower. Many countries are rabies free, such as the UK, Japan and New Zealand. Islands in Indonesia are also infected, including Bali.
Worldwide, there are at least 55,000 human deaths each year from rabies. Approximately half of these occur in India.
The average incubation period (the time between being bitten and when symptoms occur) is 3 -12 weeks, but can be anywhere between 4 days and several years. There are usually no symptoms during the incubation.
· Pain, itching or tingling at the site of the wound
Coma, cardiac or respiratory failure, and almost always death.
The most effective preventative measure is to avoid contact with animals. Children are particularly vulnerable to animal bites, and are more likely to have severe bites. They are also less likely to report that they have been bitten or scratched. Cyclists are also at a higher risk of getting bitten. Other high-risk groups include cave explorers, botanists & naturalists and animal handlers, e.g. zoologists, veterinarians and abattoir workers. Travellers visiting high-risk countries for longer than 30 days should consider vaccination. Anyone going to a remote area or a country where it will be difficult to obtain post-exposure treatment should also consider vaccination.
There is a choice of route of vaccines;
Both courses should be commenced 6-8 weeks before departure. A blood test can be performed at regular intervals (1-2 yearly) to confirm ongoing immunity. Alternatively, if time is short before high-risk travel, a booster can be given.
This does NOT eliminate the need for post-exposure vaccination, however it does mean;
The most important treatment is to clean the wound thoroughly.
It is important to receive treatment as soon as possible as the likelihood of success decreases the longer the treatment is delayed. If treatment is given within 48 hours it is likely to be 100% successful.
If you have had pre-exposure vaccinations, we still recommend that you obtain medical care within 7 days. If you have not had pre-exposure vaccinations, seek medical attention as soon as possible, preferably within 48 hours.
The problem of rabies is enormous and most developing countries are unable to do much to prevent it. In parts of India, 1 in 500 hospital admissions are due to rabies from dog bites. 3 in 10 dogs caught in Bangkok carry the rabies virus.
whilst overseas in areas with rabies and if you are unlucky enough to be exposed,SEEK MEDICAL ADVICE IMMEDIATELY.
Updated August 2021.