Rabies

Latest update: - Authors: Mieke Croughs, Ula Maniewski-Kelner

Rabies is a deadly infection that is caused by a virus. Infection occurs via contact with the saliva of an infected mammal. The virus can enter the body via a bite or a scratch, or by being licked on the mucous membranes or a wound.

In the case of bats, this can even happen unnoticed during your sleep, because the bites are often hard to see afterwards.

Travellers are often bitten, scratched or licked by mammals, particularly by dogs, cats and monkeys.

To date, there have been no reports of human cases of rabies caused by bites from rodents, such as rabbits, hares or mice.

Rabies causes an infection of the brain that always results in death.

The disease symptoms can occur as soon as twelve days after infection, but can also take several months to develop. A fatal outcome can only be prevented by taking immediate action after a possible infection (see below). 

Risk areas

Rabies occurs all over the world. Only New Zealand, Antarctica, large parts of Oceania, Japan, a number of European countries and some islands are free of rabies.

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.

On the Indian sub-continent, Southeast Asia, Africa and parts of Latin America, rabies also occurs in pets, such as dogs (see map). The risk for travellers is highest in these countries. 

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.

Vaccination

Consider getting a vaccination against rabies in the form of a pre-exposure vaccination (PrEP).

In case of symptoms

Have you been bitten or scratched, or licked on the mucous membranes by a potentially infected animal?

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. You may require specific anti-rabies immunoglobulins (MARIG) and a series of rabies vaccinations, of which the first one has to be administered on the same day as the potential infection.

Call the travel assistance insurance for advice on reliable medical facilities. The vaccines and MARIG are not always available in tropical and subtropical countries, meaning that urgent repatriation is sometimes required.

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.

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