Rabies is a fatal viral infection that is spread from animals to humans which causes acute inflammation of the spinal cord and brain.
The virus is carried in the saliva of infected animals so it can only be transmitted by a bite or lick mainly from dogs, cats, primates and bats, but in some cases can be other animals. There is currently no treatment for Rabies, but progression of the disease can be delayed through vaccination.
Countries at risk
Rabies occurs worldwide. Over 15 million people are exposed to potentially rabid animals annually with approximately 40,000 to 70,000 deaths every year. Low-risk areas include mainland Europe and the UK, Australia, North America and Japan; travelling almost anywhere else in the world carries some level of risk of exposure to Rabies.
Infected mammals can spread the Rabies virus through bites, scratches or even a lick onto broken skin. Travellers are advised to avoid contact with animals in high-risk areas. All mammals are susceptible to the virus, including skunks, jackals, mongooses, foxes, raccoons, dogs, cats, monkeys and bats.
Dogs account for the majority of human deaths, with most of these occurring in South East, East and Central Asia, Africa, and the Indian subcontinent. Bats cause most human Rabies deaths in the USA and Canada, and have recently begun to emerge as a health threat in Western Europe, South and Central America and Australia.
Signs and symptoms
The first symptoms of Rabies are usually similar to the flu, including fever and headaches. There may also be pain at the area of the bite, developing within days, to symptoms of anxiety, confusion and agitation. As the disease progresses further, the person may experience delirium, abnormal behaviour, hallucinations, and insomnia.
Once the clinical signs of Rabies appear, the disease is nearly always fatal. Treatment is typically limited to supportive care.
A course of three injections of the vaccine (Rabies BP or Rabipur) will cover against Rabies and is recommended for travellers to high-risk areas who may be exposed to Rabies because of their chosen travel activities and/or limited access to post-exposure medical care.
In the event of possible exposure to Rabies, urgent medical attention should be sought, even in those who have received pre-exposure vaccines.