Article by Sue Jonesie

What is rabies and how serious can it be?

Rabies is a dangerous, infectious disease caused by a virus that gets into your body usually from an animal bite, scratch, or when an animal licks you on broken skin or mucous membranes, such as your nose or mouth. this is most often a dog, but bats, cats, or any other warm blooded animal can also carry rabies. Person-to-person spread of rabies has only been reported in exceptional circumstances. Children are at particular risk of rabies. Rabies is a very serious infection because, once symptoms appear, it is nearly always fatal, causing between 40,000 to 70,000 deaths worldwide each year. A fatal case of rabies contracted in a wildlife centre, South Africa

In 2009, a young woman from Northern Ireland died from rabies. it is thought that the woman acquired the disease after being bitten by a dog whilst she was working at an animal sanctuary in South Africa three years previously. Rabies symptoms?

If you are bitten, scratched or licked (where the skin is broken) by a dog or other warm blooded animal, always seek urgent medical attention. Rabies is preventable if wound cleansing and vaccination are given soon after the bite or scratch. Early symptoms can be non-specific. The disease then progresses to paralysis, followed by coma and death. without intensive care, death occurs during the first seven days of illness. Early symptoms may include: Itching and tingling at the wound site Fever Headache Muscle ache Excessive tiredness The onset of rabies is unpredictable. Very rarely symptoms can start as soon as four days after the bite or scratch. usually people with rabies start to notice the early symptoms about 3-12 weeks after being bitten or scratched. However, symptoms may be delayed by many years giving a false illusion that the danger has passed.

What to do if you are bitten or scratched

1) Immediately clean the wound, ideally by flushing under a running tap for a few minutes and washing with soap and water. Encourage limited bleeding. 2) If possible apply antiseptic or 40-50% alcohol (whisky or other spirit can be used). 3) Regardless of whether you have completed a rabies vaccination course, you should always seek urgent medical advice. If possible avoid having the wound stitched (sutured) straight away. 4) A healthcare professional should assess your level of risk and may recommend further preventative vaccinations (called post-exposure prophylaxis). apart from the obvious health protection it is really worth being vaccinated against rabies before you travel because you will only need two further vaccinations, given over two days after a bite or scratch. People who haven’t had the rabies vaccine usually need five post-exposure vaccines given over a month and possibly rabies immunoglobulin for quick protection. Rabies immunoglobulin is in short supply worldwide and is very difficult to get hold of. The course of five vaccines can be very disruptive to travel plans, as the person and possibly their travel companions) needs to remain near to a clinic. 5) Contact the local British Embassy or Consulate for advice if you are having difficulties finding a clinic with the vaccines. see the back page of this leaflet for contact details. in the heat of the moment, it may not be possible to find out the animal’s owner’s name and address, but if you remember, leave your own contact details and ask them to get in touch if the animal gets sick or dies within 2 weeks. ask if the animal has a rabies certificate. following travel health nurse advice

If a travel health nurse has told you that rabies vaccination is recommended for you, there is no doubt that your travel plans put you at-risk from rabies. If they say you should consider rabies vaccination you need to weigh-up the cost of the vaccine against the potential risk. Many people prefer to take no chances with their health. travel health nurse advice is based on: Up-to-date information on whether rabies is a problem in the place you are travelling to Your chance of coming into contact with infected animals The medical facilities available if you were to come into contact with a potentially rabid animal The duration of your stay all travel vaccination recommendations can change because of disease outbreaks and seasonal variations but travel health nurses have access to daily updates and are specialists in travel health services.

Arrange your vaccinations at least a month before you travel

Optimum rabies vaccination requires a course of three injections, which should be given over 21-28 days. If you have made your travel plans late and have less than 21 days before you travel, contact your Travel Clinic immediately. They may be able to recommend an alternative based on the time available. Rabies protection: summary of action to be taken

Arrange your vaccinations at least a month before you travel

Optimum rabies vaccination requires a course of three injections, which should be given over 21-28 days

If you have less than 21 days before you travel, contact your Travel Clinic for alternative advice

Try to get the full vaccine course

Travel Health Clinics offer convenient opening times and our staff will do all they can to fit in with your schedule so you get the protection you need

Know what to do if you are bitten or scratched by an animal

Clean the wound. Seek urgent medical help, even if you have been vaccinated – prompt action could save your life

about the Author

MASTA provide expert travel health advice and have a large network of travel clinics.

If you would like to find out more about Rabies, or travel vaccinations, then please visit our website.

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