Rabies

Rabies is a fatal viral disease of the central nervous system. It is transmitted via the saliva of an infected mammal, usually a dog, cat or monkey, in a bite or scratch. The skin must be broken for transmission to be possible, except in the case of a lick on a mucous membrane such as inside the mouth.

Other sources are the fox in Europe, raccoons in the USA. Other potential sources include bats, squirrels and rodents.

In areas where rabies is reported, any warm blooded, furry animal can potentially carry the virus.  The virus travels from the bite site to the brain of the victim. The incubation period can vary from 7 days to many years. Symptoms only occur once the virus reaches the brain. From that point on, the disease is almost 100% fatal.

Rabies occurs in more than 150 countries world-wide with more than 50,000 deaths annually. Dogs are the responsible for 99% human rabies with almost half of the deaths in children under 15 years old.

Afghanistan, Algeria, Azerbaijan, Bahrain, Bali, Bangladesh, Benin, Bolivia, Burkina Faso, Burundi, Cambodia, Cameroon, Central African Republic, Chad, China, Colombia, Comoros, Congo, Cote D’Ivoire, Democratic People’s Republic of Korea, Democratic Republic of the Congo, Djibouti, Dominican Republic, Ecuador, El Salvador, Eritrea, Egypt, Equatorial Guinea, Eswatini, Ethiopia, Georgia, Ghana, Guinea, Guinea-Bissau, Guyana, Haiti, India, Indonesia, Iran, Iraq, Kazakhstan, Kenya, Kyrgyzstan, Laos, Lebanon, Lesotho, Liberia, Libya, Madagascar, Malawi, Malaysia, Mali, Mauritania, Mexico, Mongolia, Morocco, Mozambique, Myanmar, Namibia, Nepal, Nicaragua, Niger, Nigeria, Oman, Pakistan, Philippines, Rwanda,  Saudi Arabia, Senegal, Sierra Leone, Somalia, South Africa, Sri Lanka, Sudan, Syria, Tajikistan, Tanzania, Thailand, Timor Leste, Togo, Tunisia, Turkey, Uganda, Uzbekistan, Vietnam, Yemen, Zambia, Zimbabwe.

Armenia, Cuba, Guatemala, Honduras, Israel, Jordan, Moldova, Russia, Venezuela.

Animal bites occur quite frequently in travellers.  Many occur in countries where human rabies is reported.

A recent airport study, undertaken in Germany, found 2% of returning travellers had experienced an animal exposure.  Exposures were more likely to occur in Asia (46%), Africa (29%), Central and South America (13%) and the Middle East (8%).  Thirty one percent were reported as unprovoked. Only 19% of those reporting bites sought medical advice and in less than half was the treatment considered adequate for a potential rabies exposure.  This supports the findings of a study of exposures in expatriate workers where the medical management was considered adequate in less than 30% of cases. Risk factors for an animal exposure were identified in the German study. These included male sex, young age trips to Asia and longer stays overseas.  A low awareness of the risk of rabies exposure has been found in several studies.

On average, 3-4 rabies deaths are reported in travellers annually. A number of cases are likely not reported.

Rabies deaths are preventable. 

Excellent rabies vaccines are available for long term protection and post-exposure prophylaxis is very effective, in the event of an exposure. 

According to the World Health Organisation (WHO) an estimated 29 million people receive post-exposure prophylaxis for rabies every year.

Do not: Pick up dogs or cats, or feed monkey's. 

The message is a simple one:

Do not engage with animals while overseas.

If you are unfortunate to have an exposure, seek medical advice as soon as possible.