Rabies is a virus spread from infected animals to humans through bites, scratches and exposure of broken skin to animal saliva. If not properly treated and rabies develops, the disease is always fatal. Rabies is present in most countries in the world. Countries that pose greatest risk to Australian travellers include India and Bali, however tens of thousands of deaths occur in Asia and Africa every year.
Travellers to rabies affected countries should therefore always avoid close contact with either wild, stray or domestic animals; in particular dogs, cats, monkeys and bats. Nearly half of those bitten by suspect rabid animals are children under 15 years of age. In general young children are more likely to approach animals and less likely to report bites and scratches.
No tests are available to diagnose rabies infection in humans before the onset of disease. Once symptoms develop, the disease is beyond treatment and inevitably fatal.
Can I be vaccinated against Rabies
Pre-travel vaccination requires 3 shots over 3 to 4 weeks. If exposure then occurs overseas, 2 quick booster vaccine doses are given 3 days apart. Recommendation for pre-travel rabies vaccination is based on an assessment of the likelihood of contact with potentially rabid animals and the availability of adequate and timely healthcare for post exposure treatment. Those considered at high risk are travellers working with animals, those travelling to remote places (where treatment will be difficult to find) and those travelling for a long time or living overseas.
What if I am been bitten or scratched by an animal whilst in a rabies risk country?
Those travellers not pre-vaccinated require a more complicated treatment regime to prevent rabies. This is often more difficult or impossible to obtain in developing countries.
The first step after any bite or scratch is local treatment of the wound immediately after exposure. This includes thorough washing of the wound with soap and water. Then sterilise the wound with iodine or chlorhexidine. Seek medical advice as soon as possible. Apply pressure to the wound if bleeding, but do not stitch. As soon as possible obtain a course of rabies vaccine that meets WHO recommendations. Human Rabies immunoglobulin is also highly recommended but often not available overseas. Correct treatment soon after exposure to rabies is effective. Deaths occur when there is a delay or no treatment at all.