Rabies is a disease that is normally transmitted to people by a scratch or bite from an infected animal (usually a dog). The infection is potentially fatal immediately symptoms begin to appear. The virus affects the central nervous system leading to increased brain and spinal cord damage.

Incidents of human rabies are often unreported so it’s not easy to offer definitive figures on the occurrence worldwide. It is estimated that the number of deaths from rabies is 59,000 people every year. Apart from imported rabies cases that led to the deaths of 25 people in the UK between 1902 and 2005, rabies infection in travellers is very rare.

Animal scratches and bites are a common occurrence. It is therefore vital for travellers visiting places where rabies happens to be aware of the risk involved and know what to do in case they are scratched or bitten by an animal. The infection is preventable if the right post-exposure prophylaxis (PEP) is given quickly. However, PEP can be costly and difficult to access in some regions.

Prevention

While travelling, avoid contact with either domestic or wild animals. Travellers should also:

– Not to approach animals.

– Not to try to pick up an abnormally tame animal or one that appears to be sick.

– Not to offer food  to stray animals or by be careless with litter.

Note that some activities may draw attention to dogs (e.g. running, cycling).

The following advice can be provided regarding first aid in case of possible rabies exposure:

– Immediate action is needed; begin treatment immediately after exposure.

– Throughly wash the wound using soap and running  clean water for a few minutes.

– Disinfect the wound use either an iodine solution (tincture or an aqueous solution of povodone-iodine) or 40-70% alcohol.

– Dress the wound.

– Seek urgent medical attention about the need for PEP and get possible antibiotics to stop the wound from infection.

– The traveller may require to get a Tetanus vaccine his vaccination status is if not up-to-date.  Wound suturing should be rescheduled until PEP is done.

Rabies Vaccine

Everyone who is at constant or frequent risk of being exposed should be provided with the pre-exposure vaccine. People in these risk categories include:

– laboratory workers who routinely handle the rabies virus.

– individuals who regularly handle bats.

– those who frequently handle imported animals.

– animal workers who normally travel to rabies risk regions.

– medical workers in rabies risk places who may directly come in contact with rabies-infected patients.

A number of international travellers visiting rabies-affected regions are thought to be at ‘infrequent risk’. However, pre-exposure vaccines are indicated for those whose activities in the area increase the risk of getting rabies.

For countries with rabies in wild and domestic animals these travellers include;

– those visiting places where getting PEP and medical care is in short supply.

– those planning to get involved in activities such as cycling and running.

– long-stay travellers (planning to stay for more than one month).

Pre-exposure vaccination is proposed for a small group of individuals travelling to countries where rabies has only been reported in wild animals or bats.