Travel & Immunisation Clinic

Rabies

What is Rabies

Rabies is a preventable viral disease of mammals most often transmitted through the bite of a rabid animal.

Which areas harbour Rabies

Despite evidence that control of dog rabies through programs of animal vaccination and elimination of stray dogs can reduce the incidence of human rabies, exposure to rabid dogs is still the cause of over 90% of human exposures to rabies and of over 99% of human deaths worldwide. Because vaccines to prevent human rabies have been available for more than 100 years, most deaths from rabies occur in countries with inadequate public health resources and limited access to preventive treatment. These countries also have few diagnostic facilities and almost no rabies surveillance.

The Illness 

The early symptoms of rabies in people are similar to that of many other illnesses, including fever, headache, and general weakness or discomfort. As the disease progresses, more specific symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation (increase in saliva), difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of these symptoms

Treatment 

Disease prevention includes administration of both passive antibodies, through an injection of human immune globulin and a schedule of injections with rabies vaccine. The immune globulin provides immediate protection .while the bodie’s immunity to rabies is being primed by the rabies vaccine

Recommendations for Travellers 

Pre-exposure treatment

Vaccination is recommended for all travellers who will be living or travelling in endemic areas and who maybe exposed to rabies because of their travel activities i.e. trekking, working or living in rural areas.

Some individuals may require vaccination based upon their occupation. Such occupations include vets, bat handlers, those working in animal quarantine centres and certain HM revenue and customs officers.

Post-exposure treatment

It is imperative to seek medical attention within 24 hours if a bite or scratch is sustained in any rabies endemic area even if pre-travel vaccination has been given.

Saliva should be thoroughly washed off with soap and water and the wound irrigated with iodine solution or alcohol. This is very effective in removing virus from the bite site, providing it is prompt and thorough. Suturing of the wound site should be avoided and tetanus vaccination should be considered.