Rabies

• 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⁾

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)

• 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⁾

• 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)

• 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⁾