What is rabies? How did it originate?
Rabies is a preventable but potentially fatal viral disease that attacks the central nervous system. It was first recorded around 4,000 years ago and is endemic in over 150 countries worldwide. The virus can affect mammals of all kinds. The first human vaccination against the disease was given in 1885, and despite being preventable, rabies currently kills approximately 59,000 people every year.
What are the symptoms of rabies?
There are two types of rabies, furious rabies and paralytic rabies. In the early stages, both kinds present symptoms similar to many other diseases, including a high fever, headache, and general discomfort and fatigue.
As the disease develops, furious rabies causes muscle spasms in the diaphragm and throat, which leads to a fear of water due to an inability to swallow, while overproduction of saliva causes foaming at the mouth. Infected persons feel anxiety and often display violent, confused or hyperactive behaviour, and experience hallucinations, paralysis, coma and then death.
In paralytic rabies, also known as dumb rabies, the primary symptom is muscle weakness, which leads to paralysis, starting from the infection site and spreading to other parts of the body with fatal results.
Symptoms can appear within hours of infection, or up to 12 weeks later. For this reason, it’s important to seek medical advice after a bite or scratch in a high risk area, even if you feel fine.
How is rabies transmitted?
Rabies is spread in the saliva of an infected animal via a bite or scratch. Any mammal can carry the virus, but the most common carriers are dogs, bats, foxes, raccoons, jackals, mongooses and cats.
99% of human deaths from rabies worldwide are a result of infection by a rabid dog.
What is the transmission seasonality?
Rabies rates are not generally seasonal but there is some evidence that infection rates from bats are lower during colder months due to hibernation patterns.
What is a rabies certificate?
A rabies certificate is issued to prove an animal or human has been vaccinated and should be carried when travelling to different countries where they require it. Examples can be found on the CDC website.
Is rabies curable?
Once symptoms appear, rabies is usually always fatal. However, if treatment begins before symptoms appear, it is very effective in curing the disease.
If you are bitten or scratched in a high risk area of the world, immediately wash the area with soap and running water for several minutes, disinfect with an iodine-based disinfectant or alcohol, and dress the wound. Seek professional medical help as soon as possible, and explain that you have been scratched or bitten.
Medical treatment should begin within a few hours of contact with a rabid animal, and involves further jabs of the rabies vaccine and possibly immunoglobulin, which helps your body fight the virus.
How to prevent rabies?
The best way to prevent rabies is by vaccination.
When travelling to a place where there is a risk of rabies, the NHS recommends you avoid all contact with animals, alive or dead, as the signs of infection are not always obvious.
It is important to explain the dangers of rabies to any children you are travelling with, and ensure they tell you if an animal scratches, bites or licks them. If they do come into contact with any animal, check carefully for any wounds so action can be taken against the disease.
Even if you have had the rabies vaccination, you should seek medical treatment if you come into contact with an animal that may have rabies.
How long before a trip do you have to get rabies vaccine?
Vaccination against rabies requires a course of treatment which takes up to four weeks to complete. You should therefore start the course at least one month before you leave on your trip.
Who should get the rabies vaccine?
If you are planning to visit a place where rabies is common, you are advised to get vaccinated.
This is especially important if you plan to stay for more than a month, or if access to medical treatment is limited, or you plan to do any high risk activities, for example cycling, running or exploring the wilderness.
If you are pregnant you are advised to get vaccinated if there is a high risk you could be exposed to rabies and there is a lack of access to medical care.
Some people are advised to get vaccinated due to exposure to the virus through their work. This includes people handling bats or imported animals in quarantine centers, and laboratory workers who handle samples of the rabies virus.
Who should not get the rabies vaccine?
The vaccine is not recommended for people who have previously experienced an allergic reaction to the rabies vaccine, or who have severe allergies.
If you have HIV/AIDS or cancer, or are taking medications that affect your immune system, the vaccination is not recommended.
Should any of the above applies to you, contact your doctor for further advice on whether or not you should have the vaccination.
If you have come into contact with an animal with rabies, you will need to get vaccinated anyway as part of your post-exposure treatment.
What is the minimum age requirement for rabies vaccine?
According to the World Health Organization (WHO), the rabies vaccine can be given to people of all ages, including infants under 1 year.
What is the effectiveness of the rabies vaccine?
Both the WHO and CDC rate the rabies vaccine as safe and effective at preventing rabies.
Post-exposure treatment is nearly 100% effective if it’s started before any symptoms of rabies appear.
What are the side effects of the rabies vaccine?
Mild side effects usually last a few days, and include redness, pain, swelling and itchiness at the vaccination site, headaches, stomach upset, aching muscles and dizziness.
In rarer cases, you may experience joint pain, fever and hives on the skin. Serious side effects are extremely rare.
How many jabs are needed?
You need at least three doses of the vaccine to be protected. The second jab is given a week after the first, and the third is administered either 21 or 28 days after the first jab.
Those with a weak immune system will need another jab four weeks after the first, plus a dose of rabies immunoglobulin with the first jab, to help the body fight the virus faster.
How long does it last for?
You are advised to get a booster vaccine to extend protection one year after initial vaccination, if you plan to travel to a high risk area again.
People whose jobs expose them to a high risk of catching rabies should get a booster jab every six months to two years.
Your doctor can advise you on the best course of action for ongoing protection.