Should I get vaccinated against rabies before I go away?
Death is the usual outcome of a rabies infection if it is not treated promptly. People catch this serious viral infection from animal bites or scratches, which in some cases you can’t avoid. Luckily, you can get a rabies shot for travel.
Dog bites are the most common rabies infection route (99%, according to the World Health Organization), but bats are considered a risk worldwide and cats and monkeys in some areas.
Tens of thousands of people die each year from rabies, mainly in Asia and Africa.
In rabies endemic areas, seek prompt medical advice about an animal bite or scratch.
What are the symptoms of rabies?
After an incubation period, which varies enormously, the patient experiences symptoms including fever, weakness and headache and sometimes tingling at the wound site. Rabies infection causes encephalomyelitis, an inflammation of the spinal cord and brain.
Some patients suffer from furious rabies. They will experience muscle spasms, anxiety and hallucinations, as well as hydrophobia (fear of water and drinking). Death from respiratory failure is the usual outcome and this takes a few days.
Other patients (30%) get paralytic rabies, which has a longer course. Muscles near the bite or scratch become paralysed and then paralysis progresses through the body. The patient falls into a coma and eventually dies. Misdiagnosis of paralytic rabies is common.
Countries with a risk of rabies
Human cases mostly occur in Africa, Asia and South America. Many places in the world are now rabies free, but you do need to check up-to-date information when deciding whether to get a rabies shot for travel.
Do I need a set of rabies jabs?
If you are travelling to remote rural areas, or will be staying for a long period and think you will not be able to access treatment for rabies promptly in event of a bite, get a pre-exposure vaccine. However, even if you have had a rabies shot for travel, seek medical advice swiftly after an animal bite as you will need post-exposure treatment.
Children under 15 suffer 40% of bites by suspected rabid animals, according to the World Health Organization. This is because they may play with dogs, cats or monkeys even if the animal is showing fear or aggression. You should also be aware that children may receive more dangerous bites (such as bites to the face, head and neck) and they may not tell you about a bite. For this reason, children travelling to places where rabies is endemic should be vaccinated with a rabies shot.
If you are planning to work with animals on your trip, healthcare professionals recommend a rabies vaccination. If you will do any activities that increase your risk of animal bites, such as mountain-climbing, caving, running or cycling, ask about a rabies jab.
What should I do if an animal bites me in a country where there is rabies?
Rabies spreads through an animal’s saliva so even a lick on broken skin could potentially infect you. Wash the site immediately with soap and water for 15 minutes and then irrigate with iodine or alcohol. Get medical advice promptly. The practitioner will carry out a risk assessment and then decide on a course of action. There are no tests for rabies.
A post-exposure treatment administered within a few days provides protection, so always seek medical advice if you are in an area where rabies is endemic and an animal bites or scratches you.
What rabies vaccines are available?
There are two rabies shots for travel. These are links to their patient information leaflets (PILs), which will also give information about side effects:
Do I need a rabies booster jab?
After your rabies vaccine, to maintain protection you will need a rabies booster every three to five years. Talk with your healthcare adviser about this.
More information about rabies
The World Health Organization Rabies Factsheet has further details to help you make decisions about protecting yourself from rabies.
