Rabies — Not just for your dog to worry about

The infection begins with some general weakness, a fever, a headache; just like a regular old flu. But then, the beast’s rabid bite starts prickling and itching. Within days you become confused, agitated, and anxious. As your brain continues to swell, you start to behave abnormally and irrationally. Soon you experience paranoia and hallucinations, progressing to full-blown delirium. You can’t sleep and you’re inexplicably terrified of water. An end to the madness comes soon after, as death approaches almost invariably within 2 to 10 days of the first symptoms.

This isn’t a zombie horror movie, but a very real and terrible illness with a familiar name — rabies.

From the Latin rabies, meaning “madness”

Rabies virus is most commonly transmitted through infected saliva, from the bite of a rabid animal. There have also been very rare cases of people getting rabies when contagious material from the infected animal, like saliva, got directly into their eyes, mouth, nose, or a wound.

Rabies causes about 55,000 human deaths annually worldwide, with 95% of human deaths due to rabies occurring in Asia and Africa.

According to the CDC, “once clinical signs of rabies appear, the disease is nearly always fatal.” Survival is extremely rare once a person starts showing signs of rabies. There have been less than 10 documented cases of humans surviving from clinical rabies, and only two of those cases have not had a history of prevention or treatment measures.

Risk for Travellers

Rabies is found all over the world, on all continents except Antarctica. There are, however, some countries that report no indigenous cases of rabies and are thus referred to as “rabies-free”.

The risk for travellers of getting rabies depends on their destination and the activities that they will undertake during their trip. Quite simply, the more likely you are to be bitten or scratched by a rabies infected animal, the higher your risk of contracting rabies.

Travellers who are at a higher risk include those participating in activities that put them in close contact to animals (cave exploration, camping, or hiking in areas where rabies is found), as well as those who work in close contact with animals (veterinarians, animal control or wildlife workers, and laboratory workers). Children are also at a higher risk as they are more likely to play with animals and less likely to report being bitten or scratched.

Do I really need a rabies vaccination?

The rabies vaccination involves 3 injections with the vaccine, all of which should be received before travel. The vaccination can be quite expensive. Also, if you do get exposed to rabies, you still must seek medical attention, whether you have received the vaccine or not. The vaccine just helps to simplify the treatment of rabies, and provide protection when someone does not realize they have been exposed or if treatment is delayed.

Rabies vaccination is recommended for certain international travellers, based on a few different factors:

  • Rabies prevalence in their destination country
  • Availability of antirabies medication
  • Activities they plan on participating in
  • Duration of their stay

The CDC has constructed a table that sums up their recommendations for rabies vaccination, which can be found here. Basically, the vaccine is only recommended for travellers that will be in close contact with animals, like veterinarians, animal handlers, field biologists, cavers, missionaries, biologists, and certain laboratory workers.

Avoid stray animals

If you want to prevent rabies, you must prevent animal bites. And to do that, the most important thing to remember is to avoid stray animals! As an animal lover myself, I know this may be difficult for some travellers. That stray doggie or kitty may look very sweet and fluffy and in need of some serious cuddles, but think twice.

Extensive studies have shown that the rabies virus can be excreted in the saliva of infected animals several days before they show symptoms. So, animals with rabies won’t always be foaming at the mouth and acting erratically. Sometimes they won’t show any symptoms at all and may lash out and bite without any provocation.

Travellers should also avoid contact with other wildlife. Bats are common carriers of rabies and some bats have very small teeth which may not produce an obvious bite mark.

If you do get bitten, wash the wound thoroughly and immediately with soap and clean water. Seek medical attention immediately. Postexposure prophylaxis ( (medication to prevent infection following exposure to the virus) must be administered as soon as possible after exposure. The decision to start postexposure prophylaxis will depend on the rabies risk in your area, your exposure, and the animal you were exposed to.