Rabies vaccinations

Rabies information ©CDC

Rabies is a fatal viral disease from animal bites and scratches, that claims 60,000 – 100,000 lives per year worldwide. Every year 15-20 million people need treatment following an animal exposure (bite, scratch or lick) that could have a rabies risk. Less than a handful of people have ever survived rabies as far as we know.It is almost always fatal (Rabies Travel Vaccinations)

Rabies vaccination

Pre-exposure vaccination is a highly effective measure in lowering the risk of this disease following a bite or scratch from a suspected rabid animal. Pre-exposure vaccination does NOT just “buy you time”. Vaccinations against rabies has taken on added importance since human rabies immunoglobulin (the antidote called HRIG) has been in limited supply in the countries where the rabies risk is highest – East Asia (India, Thailand, Vietnam, Cambodia, Laos, Indonesia including Bali, etc.), Sub-Saharan Africa and Latin America.

Rabies prevention, before you go:

Book an appointment for a pre-travel consultation at least 6 weeks before you are due to travel. A rabies vaccine is available for travellers who are considered to be at risk of rabies. Your healthcare provider will be able to talk to you about your risk of rabies and any other disease risks in your chosen destination. Please note that receiving rabies vaccine prior to travel does not eliminate the need for a medical evaluation if you are exposed to a possibly rabid animal during your trip. Urgent medical advice should always be sought following any possible exposure to rabies; additional doses of rabies vaccine may be needed. You can help to ensure you receive the correct treatment after a possible exposure to rabies by keeping a record of your rabies vaccinations with you at all times whilst you are traveling. It is important to show this to the doctor or nurse treating you after any potential rabies exposure. For future trips booster doses may be recommended, so check with your practice nurse or doctor before traveling overseas.

What if you don’t get vaccinated before traveling?

If you do not have rabies vaccination before traveling, you may need more intensive treatment in the event of a potential exposure to rabies, including a treatment called immunoglobulin, which will be followed by 5 doses of the rabies vaccine over the course of the following month. Rabies immunoglobulin is vital for immediate protection but it has been difficult to obtain in some countries for a number of years now. In such cases you may need to quickly travel to a nearby country or home to the UK for immediate treatment. While you are there, what can you do to protect yourself from rabies?

  • Avoid contact with wild and domestic animals
  • Do not approach animals or attempt to pick up an unusually tame animal or one that appears unwell
  • Do not attract stray animals by offering food or by being careless with litter
  • Be aware that certain activities can attract dogs (e.g. running, cycling)
  • Be aware that children are at higher risk of rabies as they are less likely to avoid contact with animals or report a lick or bite.
  • If you are bitten, scratched, or licked on an open wound (such as a cut or a patch of eczema) or mucous membrane (eyes, nose or mouth) you must seek medical attention immediately.

Never think that a wound is so small it can’t be a risk. If the skin is broken then the rabies virus may be able to enter.

What should you do if you are exposed to rabies?

Remember, this is an emergency: seek medical advice without delay, even if you had the rabies vaccine before you traveled.

  • Immediately flush the wound with plenty of soap or detergent under running tap water for at least 15-20 minutes
  • Do not scrub the wound
  • If possible apply an iodine solution or neat alcohol (40-70%)
  • Do not cover the wound or apply a pressure dressing
  • Wash any animal saliva from your face immediately with plenty of water to stop it from getting into your eyes, nose or mouth
  • Seek urgent medical attention with out delay (even if you have had a course of rabies vaccine previously).
  • You might also need antibiotics to prevent the wound becoming infected.

Further information for travellers regarding rabies vaccinations is available from Public Health England in chapter 27 of The Green Book – Rabies

Rabipur rabies vaccination Distribution of risk levels for humans contracting rabies worldwide 2013