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Rabies
Rabies is a viral infection that causes brain infection which results in death.
The symptoms usually occur after two or three months, but the incubation can vary between one week and several years. A fatal outcome can only be prevented by taking immediate action after a possible infection (see below).
Infection occurs by inoculation of saliva from an infected mammal through a bite or scratch wound or by a lick on mucous membranes or on a wound. Rabies can also be transmitted by minor injuries, such as when a bat bumps into someone.
Injuries caused by bats are always considered as a risk. To date, there have been no reports of human cases of rabies caused by bites from rodents, such as rabbits, hares or mice. For travellers, high-risk incidents mainly occur with dogs, cats and monkeys.
Risk areas
Rabies occurs all over the world.
On the Indian sub-continent, Southeast Asia, Africa and parts of Latin America, rabies can occur in pets, such as dogs (see map). The risk for travellers is highest in these countries. When rabies still occurs in dogs, this is mentionad in the country information.
In North America and parts of Eastern Europe, rabies only occurs in wild mammals.
In other regions, such as Western Europe, the disease only occurs in bats.
Prevention
Avoid contact with animals
Stay far away from mammals that may be infected.
Never touch animals, even if they are dead.
Do not stroke them, feed them or play with them, even if they look healthy and cute.
Preventive rabies vaccination
Preventive vaccination consists of two doses with a minimum interval of one week. The vaccine Rabipur® is available in Belgium.
Using this risk score, you can calculate if preventive vaccination is recommended for you. After a potential exposure, booster vaccines (post-exposure vaccines) are required.
Different schedules apply for people who are immunocompromised.
Actions after risk contact
Wash the wound thoroughly with soap and water for 15 minutes, because the virus is very sensitive to cleaning agents.
Then disinfect the wound thoroughly with iodine (for example iso-Betadine®) or ethanol 60-80%.
Consult a doctor as soon as possible to determine the post-exposure policy (PEP), even if you have been vaccinated.
Travel assistance insurance
Call the travel assistance insurance for advice on reliable medical facilities. The vaccines and RIG are not always available in tropical and subtropical countries, meaning that urgent repatriation is sometimes required. The International Society of Travel Medicine (ISTM) publishes a list of travel clinics offering rabies vaccination and anti-rabies immunoglobulins.
Post-exposure vaccination
After a high-risk contact, a doctor will determine if you need post-exposure (PEP) vaccination.
For people who have not received pre-exposure prophylaxis (PrEP) for rabies, this consists of a series of four or five vaccinations and sometimes the administration of anti-rabies immunoglobulins (MARIG or HRIG).
People with normal immunity, who did have rabies PrEP, need only receive two booster vaccinations.
Did you wake up with a bat in your room?
Bites caused by bats often go unnoticed. Bats can transmit rabies. Consult a doctor as soon as possible to determine the further policy.
In case of symptoms
Seek medical advice if you suffer any symptoms.
Additional information for doctors
