RABIES

Rabies is a fatal but preventable viral disease. It can spread to people and pets if they are bitten or scratched by a rabid animal. (source)


For further information please contact your physician or pharmacist.

Key facts

  • Rabies is a vaccine-preventable viral disease, which occurs in more than 150 countries and territories.(1)
  • Infection causes tens of thousands of deaths every year, mainly in Asia and Africa.(1)
  • Dogs are the main source of human rabies deaths, contributing up to 99% of all rabies transmissions to humans.(1)
  • 40% of people bitten by suspect rabid animals are children under 15 years of age.(1)
  • Immediate and extensive washing and local treatment of the bite wound or scratch as soon as possible after a suspected exposure reduces the risk of rabies virus infection.(1,2)
  • Rabies is virtually 100% fatal once clinical symptoms appear.(1)
  • Rabies vaccinations are highly effective, safe and well tolerated.(4)
  • If you are travelling to a country where rabies is widespread, you should consult your doctor about the possibility of receiving preexposure vaccination against rabies.(5)

What is rabies?

Rabies is a vaccine-preventable, zoonotic, viral disease. Once clinical symptoms appear, rabies is virtually 100% fatal. In up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans.(1,2)
The rabies virus infects the central nervous system.(1) If a person does not receive the appropriate medical care after a potential rabies exposure, the virus can cause disease in the brain, ultimately resulting in death.(1,2)
People are usually infected following a deep bite or scratch from an animal with rabies.(1) Transmission can also occur if saliva of infected animals comes into direct contact with human mucosa or fresh skin wounds.(1)
Human-to-human transmission through bites or saliva is theoretically possible but has never been confirmed.(1,2)
Video Rabies

Where does rabies occur?

Rabies is present on all continents, except Antarctica, with over 95% of human deaths occurring in the Asia and Africa regions.(1)

Who is at risk of contracting rabies?

  • All travellers in areas where rabies occurs.(1,2)
  • Globally, rabies deaths are underreported and children between the ages of 5–14 years are frequent victims.(1)
  • People are usually infected following a deep bite or scratch from an animal with rabies, and transmission to humans by rabid dogs accounts for 99% of cases.(1)
  • Bat rabies is also an emerging public health threat in Australia and Western Europe. (1)

What are the symptoms and lasting effects of rabies?

  • The incubation period for rabies is typically 2–3 months but may vary from 1 week to 1 year, dependent upon factors such as the location of virus entry and viral load.(1)
  • Pain and paresthesia at the site of exposure are often the first symptoms of disease. The disease then progresses rapidly from a nonspecific, prodromal phase with fever and vague symptoms to an acute, progressive encephalitis. The neurologic phase may be characterized by anxiety, paresis, paralysis and of other signs of encephalitis; spasms of swallowing muscles can be stimulated by the sight, sound, or perception of water (hydrophobia); and delirium and convulsions can develop, followed rapidly by coma and death.(2)
  • Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive.(1,2)

How can rabies be treated?

  • Once clinical symptoms appear, rabies is virtually 100% fatal.(1) Most patients are managed with symptomatic and palliative supportive care.(2)
  • The first-aid measure includes immediate and thorough flushing and washing of the wound for a minimum of 15 minutes with soap and water.(1)
  • If you are bitten, scratched, or unsure and as rabies is a lethal disease, medical advice should be sought immediately to determine your risk for rabies or other illnesses.(3)
  • For people who have never been vaccinated against rabies previously, postexposure prophylaxis (PEP) should always include administration of both HRIG and rabies vaccine.(6)
  • People who have been previously vaccinated should receive HRIG and rabies vaccine.(6)

References

  1. WHO Fact sheet. Rabies. Online available: https://www.who.int/news-room/fact-sheets/detail/rabies (Last accessed December 2021)
  2. Centers for Disease Control and Prevention. Yellow Book 2020. Chapter 4 Travel-Related Infectious Diseases. Rabies. Online available:https://wwwnc.cdc.gov/travel/yellowbook/2020/travel-related-infectious-diseases/rabies (Last accessed December 2021)
  3. Centers for Disease Control and Prevention. Rabies Exposure. Online available: https://www.cdc.gov/rabies/exposure/index.html (Last accessed December 2021)
  4. WHO. Vaccinating against rabies to save lives. Online available: https://www.who.int/activities/vaccinating-against-rabies-to-save-lives (Last accessed December 2021)
  5. Centers for Disease Control and Prevention. Rabies. Prevention. Preexposure Vaccinations. Online available: https://www.cdc.gov/rabies/specific_groups/travelers/pre-exposure_vaccinations.html (Last accessed December 2021)
  6. Centers for Disease Control and Prevention. Rabies. Prevention. Rabies Postexposure Prophylaxis (PEP). Online available. https://www.cdc.gov/rabies/medical_care/index.html (Last accessed December 2021)
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