Rabies
What is Rabies?
Rabies remains to date the most lethal infectious disease known to humans[1]. It is a viral infection transmitted via the saliva of infected mammals. It causes tens of thousands of deaths each year with most cases occurring in Asia and Africa[2].
The virus attacks the central nervous system causing fatal inflammation of the brain and spinal cord.
Rabies has been found on all continents apart from Antarctica with 95% of human fatalities reported in regions of Asia and Africa[2].
How is rabies spread?
Rabies can be contracted by humans through an infected animal bite or scratch. In some rare cases it can be transmitted if the animal licks an open wound or if you get their saliva in your mouth or eyes. It is not spread via unbroken skin or between humans.
Dog bites account for 99% of cases although bats are a major source of rabies in the Americas. Bat-transmitted rabies is also considered an emerging public threat in Australia and Western Europe[2].
Examples of Most Common Carriers:
-
Dogs
99% of cases
-
Bats
major source in the Americas
-
Raccoons
-
Foxes
-
Jackals
-
Cats
-
Mongooses
What are the signs and symptoms?
The time between exposure to the rabies virus and the first sign of symptoms typically ranges between 3 to 12 weeks but can be earlier or later than this. Without treatment rabies will most likely be fatal. Rabies can present itself in two forms:
Furious rabies
- Signs of hyperactivity
- Hydrophobia (fear of water)
- Aerophobia (fear of drafts or fresh air)
- Cardio-respiratory arrest
- Fatal outcome
Paralytic rabies
- Gradual muscle paralysis
- Coma
- Fatal outcome
Other symptoms include
- High temperature
- Headaches
- Anxiety
- Hallucinations
- Over-salivating or frothing at the mouth
AM I AT RISK?
You’re most likely to be at risk of contracting rabies if you fit the following groups and circumstances:
- Travellers to rabies-affected areas who plan to spend time doing outdoor activities
- Expatriates living in areas with a high rabies exposure risk
- Laboratory workers handling live rabies viruses
- Wildlife rangers and animal disease control staff
- People who may come into contact with infected mammals such as vets, vet students, dog carers, walkers and groomers
You should also consider immunising children living or travelling to high-risk areas as they may play with animals and receive more severe bites or be less likely to report them.
Protecting yourself against rabies
Rabies is a vaccine-preventable disease.
What to expect from the rabies vaccination
The pre-exposure rabies vaccine is the most effective way to safe-guard against rabies transmission. The vaccine is injected into your upper arm in three separate doses – normally given over a 28-day period. You should leave enough time before you are due to travel to receive the three vaccinations. You should be able to get the vaccine at your GP, travel centre or pharmacy.
Booster vaccination
If you have had the vaccination over a year ago, you should discuss getting a booster dose with your health provider to maintain protection against the rabies infection.
Post-exposure prophylaxis (PEP) for rabies
After contact with rabies, PEP aims to stop the virus from entering the central nervous system. If this treatment is carried out soon after exposure, it can prevent the onset of symptoms and death.
The treatment involves extensive cleaning of the wound, a course of rabies vaccine and rabies immunoglobulin (RIG).
More Information
Learn more about rabies from:
- Global Alliance for Rabies Control
- World Health Organization
- Centers for Disease Prevention and Control (CDC)
- European Centre for Disease Prevention and Control (ECDC)
References
- NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082082/ accessed 01/04/20
- WHO, https://www.who.int/news-room/fact-sheets/detail/rabies accessed 24/03/20
- WHO, https://www.who.int/ith/rabies2018.png?ua=1 accessed 01/04/20
- NCBI, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2244672/ accessed 10/06/20