Rabies is a viral infection that is transmitted through a bite or scratch from an infected mammal. The virus travels throughout the body via the nervous system and eventually causes death.
What are the symptoms of Rabies?
After someone is infected, symptoms usually appear within three to twelve weeks, but the incubation period can vary from ten days to seven years.
Early symptoms of Rabies include fever and pain and tingling at the wound site. As symptoms progress they generally present as either furious or dumb Rabies. Furious Rabies is more common and is characterised by anxiety and psychological disturbances including confusion, agitation, delirium, rage, hallucinations, and fear of water. Dumb Rabies occurs in approximately 20–30 percent of patients, and presents with paralysis.
Once symptoms appear, a person rarely survives, generally dying of cardio and respiratory failure within 14 days.
How can I get Rabies?
Most human cases of Rabies are caused by animal bites or scratches that break the skin, but you can become infected if a rabid animal licks you on broken skin such as a cut or on your mucous membranes (eyes, nose, or mouth).
Your risk of getting Rabies depends on the location, purpose, and duration of your trip, as well as your access to medical care. If you are travelling to areas where Rabies is endemic and you will potentially be in close contact with mammals, you may be at risk, particularly if you plan to camp, hike, explore caves, or cycle in rural areas.
Because the Rabies virus is present in the nervous system of infected animals, veterinarians and laboratory workers who work with animals and animal tissues are also at risk.
Children are also considered to be at high risk because they often play with animals and may not always report bites or scratches.
Where can I get Rabies?
Rabies occurs worldwide. Most human deaths occur in Asia and Africa, where dogs are the main carriers of the disease.
Bats infected with Rabies have become a public health concern in the Western Hemisphere. Other potential carriers in North America include skunks, raccoons, and foxes. Livestock may also be infected.
What vaccines are available for Rabies?
Rabies differs from many other infections because it can be prevented after exposure to the virus, if an infected person receives the vaccine before symptoms appear. There are two types of Rabies vaccines approved by the World Health Organization: purified cell culture (CCV) and embryonated egg-based (EEV).
How many shots will I need?
People who have not been exposed to Rabies are given a series of three injections. You receive your second dose seven days after your first dose and your third dose 21 or 28 days after your first dose. You must complete the three-dose series before you travel, so it is important to get your first shot at least a month before your departure date.
Will I need a booster?
If you continue to be at high risk of exposure to Rabies (e.g. veterinarians, wildlife workers, those travelling to high risk areas that are far from major medical centers), a blood test may be recommended every two years to determine whether you need a booster.
How can I prevent Rabies?
- Avoid animal bites and contact with bats.
- Assume that all stray animals and bats have Rabies.
- Do not pick up, pet, or handle unfamiliar animals.
- Do not approach or try to attract wild or stray animals.
- Get vaccinated.
If you are going to areas where Rabies is endemic and you are at potentially high risk of coming into contact with rabid animals, particularly if you will have limited or no access to medical care, talk to your travel medicine consultant about the benefits of vaccination. The Rabies vaccine is recommended for children travelling with you who are too young to understand the importance of avoiding animals and who may not report their contact with animals.
What is the treatment for Rabies?
If an animal bites or scratches you or licks you on an open wound or your mucous membranes such as your eyes, nose, or mouth, IMMEDIATELY:
- Clean the wound or contact area thoroughly. Wash and flush the area with soap and water for at least 15 minutes. This can help prevent the onset of Rabies.
- Seek medical assistance to assess your risk and discuss treatment options.
Treatment given after exposure to the virus (called post-exposure prophylaxis) is very effective at preventing Rabies, as long as you receive it promptly after exposure and before any symptoms appear.
If you have been vaccinated for Rabies before, you will normally receive two additional doses of vaccine over three days.
If you have not been vaccinated for Rabies before, you will normally receive four doses of vaccine over 28 days. You may also need Rabies immunoglobulin (RIG), depending on your type of exposure. Because many developing countries do not have RIG available, immediate transfer to a medical center where RIG is available may be required.
When you return to Canada, see your health care provider, and tell them about your exposure and any treatment you received.