Ask your GP about the risk of rabies if you are going overseas. Rabies is found in over 150 countries, including destinations in Asia, Africa, the Americas and Europe.
Rabies has reappeared in Bali over the last 3 years and over 100 deaths have been reported as of June 2011. A risk for travellers is at the monkey temples where at least 6% of visitors are bitten by macaque monkeys.
Rabies is a viral infection usually caught from the bite or scratch of an infected domestic or wild animal (e.g. dog or monkey).
Symptoms typically occur 1-3 months after exposure but can appear within a week. Initially, a flu-like illness develops with pain, tingling or burning at the wound site.
The virus then spreads to the brain and spinal cord causing anxiety, paralysis, confusion and convulsions. Once symptoms develop, rabies is nearly always fatal. Death usually follows within 1-2 weeks.
How to prevent rabies
Preventative strategies are vital as there is no effective treatment once symptoms appear. The first rule is to avoid close contact with wild and domestic animals overseas. This is especially important for children. Forty per cent of people bitten by animals suspected of having rabies are under 15 years old.
Travellers to areas in rabies-affected countries should consider vaccination before they leave, especially when longer trips are planned. Vaccination is also recommended for vets, animal handlers, cavers and certain laboratory workers who are at a higher risk of being exposed to the rabies virus.
A course of 3 injections of rabies vaccine before departure is effective and well tolerated. Possible side effects include a sore arm and headache. Make sure you are also up-to-date for tetanus and other routine vaccinations as well.
Treatment after a bite or scratch
If you are bitten or scratched in a region known to have rabies, you must seek medical attention urgently.
Flush and wash the wound thoroughly with warm, soapy water for at least 15 minutes and then apply povidine-iodine antiseptic.
Vaccination is required as soon as possible:
- If you have not been vaccinated, 5 doses of rabies vaccine plus a dose of rabies immunoglobulin (RIG) are given.
- If you have been vaccinated you need 2 additional doses of rabies vaccine.
Pre-travel rabies vaccination makes the management of a bite or scratch from an animal infected with rabies easier because fewer doses of vaccine are needed and RIG is not required. RIG is difficult or even impossible to obtain in many countries and often people return home early to get treatment.
For more information about rabies, speak to your GP before you travel.