What is rabies?
Rabies is a dangerous viral infection endemic to many countries. Rabies is present in all continents, except Antarctica, with over 95 percent of human deaths occurring in the Asia and Africa regions. Rabies occurs in warm-blooded mammals (both domestic and wild mammals including bats) and is transmitted to man, most often by a bite or scratch from an infected animal, usually a dog. Rabies can also be transmitted when body fluids from an infectious animal (usually saliva) come in to contact with mucous membranes (e.g. on the eyes, nose or mouth) or broken skin.
There is no cure or treatment for rabies. Once the infection has taken hold, it is almost always lethal. If you are travelling to a country with a high rabies risk, it is advised that you protect yourself with a preventative rabies vaccine. As medical treatment is not always readily available in countries with a high risk, you may need to protect yourself with a rabies injection before leaving the country.
Rabies is not common in western travellers. The World Health Organization (WHO) describes it as a neglected tropical disease predominantly affecting poor and vulnerable populations in remote rural locations. However, it has been estimated that 0.4 percent of travellers have experienced an at-risk bite per month of stay in a rabies-endemic country. It is important that travellers visiting rabies endemic areas are aware of the risk and know what to do if they are bitten or scratched. PET can be expensive and difficult to obtain in some areas.
Countries at risk?
Rabies occurs on all continents and is endemic to over 150 countries. The rabies virus kills over 55 000 people every year, primarily in Africa and Asia.
Rabies virus is found in the saliva of an infected animal. The virus is transmitted to humans by a bite or scratch, or when saliva from an infected animal comes into contact with broken skin or mucous membranes (eyes, nose, or mouth). Very rarely, rabies has been contracted following laboratory exposure to the virus or after transplantation of organs from an infected individual. Except for transmission following organ transplant, person to person transmission has never been proven.
Following exposure, the virus travels to the central nervous system via the peripheral nerves. The virus replicates in the brain and disseminates to many different tissues. It is passed from animals to humans, usually as a result from an animal bite. Once the virus has entered the bloodstream, it quickly spreads to the brain and nervous system, causing rabies symptoms such as itchiness at the infection site, fever and an irrational fear of water. Rabies patients also typically show aggressive behaviour.
Every year, more than 15 million people receive a post-exposure vaccination to prevent the disease from breaking out after an animal bite. Many of those affected by human rabies are children, who are drawn to animals and often unaware of the dangers.
Countries with a particularly high risk of rabies include all countries in the African continent, large parts of Asia and South America. Before travelling, always ensure you are aware of the rabies risk at your travel destination.
You should avoid touching animals while abroad and always seek medical help if you have been bitten. Although rabies is most commonly caught from dogs, the illness can be transmitted by all animals which carry the virus, including bats.
If you notice any bites or scratches after being in contact with an animal, wash the wound carefully and seek advice at a local hospital. If you are travelling with children, please ensure they are aware that they must not touch any animals.
Rabies can still be prevented after a bite or scratch if post exposure treatment is given without delay. However, once the disease has broken out and the patient is showing symptoms it is almost always fatal.
Very common side effects:
muscle and joint pain
mild pain and redness at the site of injection
feeling generally unwell
swollen lymph nodes
Common side effects:
minor skin reactions, such as hives or a rash
shortness of breath
bruising at site of injection
The rabies vaccine is an inactivated vaccine, therefore, it does not contain the live rabies virus. This means that you cannot get rabies from the rabies vaccine.
Treatment should be given one month before travelling.
3 doses: 0, 7 and 28(21 days if lack of time) DAYS
Rapid Regime: 0, 3 and 7 DAYS
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