Rabies is a viral infection of the nervous system, spread through the saliva of infected animals, most often by a bite, scratch or lick on broken skin. It is found across Asia, Africa and parts of the Americas, and is almost always fatal once symptoms appear. Travellers reduce their risk by avoiding contact with animals, knowing what to do after any exposure, and, where appropriate, having pre-travel rabies vaccination at Crewe Travel Clinic.
How it spreads
Through the saliva of an infected animal, usually via a bite, but also a scratch or a lick on broken skin or mucous membranes. Dogs cause most human cases worldwide.
Where it occurs
Across much of Asia, Africa and parts of the Americas, with the highest risk where free-roaming dogs are common and medical care is limited. Some countries are rabies-free or carry bat-only risk.
Main symptoms
Early fever, headache and tingling around the wound, followed by anxiety, confusion, muscle spasms, difficulty swallowing and fear of water (hydrophobia).
Who is most at risk
Long-stay travellers, those visiting rural or remote areas, cyclists and runners, people working with animals, and young children, who are more likely to approach animals and not report a bite.
Is a vaccine available
Yes. A safe and effective pre-travel rabies vaccine is given as a short course of injections before departure and is available at Crewe Travel Clinic.
How to reduce your risk
Avoid contact with animals, wash any bite or scratch immediately with soap and running water, seek urgent medical care, and consider pre-travel vaccination for higher-risk trips.
Rabies is a viral infection of the brain and nervous system, spread through the saliva of infected animals, most often via a dog bite, and found across much of Asia, Africa and the Americas. It is almost always fatal once symptoms appear, but it is preventable. Travellers avoid it by not touching animals, washing any bite or scratch immediately and seeking urgent medical care, and, where the risk warrants it, by having the pre-travel rabies vaccine. Crewe Travel Clinic in Crewe, Cheshire offers rabies vaccination and personalised travel health advice.
Rabies is a serious viral infection that attacks the brain and nervous system. It is caused by the rabies virus (and closely related lyssaviruses) and is usually passed to humans through the saliva of an infected animal, most commonly via a bite. Dogs are responsible for the great majority of human rabies cases worldwide, although cats, monkeys, bats and other mammals can also carry and transmit the virus. Rabies is found on every inhabited continent except for a small number of rabies-free countries and territories.
What makes rabies so feared is that, once a person develops symptoms, the disease is almost always fatal. There is effectively no cure at that stage, and treatment is limited to keeping the patient comfortable. The crucial point is that rabies is entirely preventable: prompt and correct treatment after a potential exposure, known as post-exposure treatment, is extremely effective at stopping the virus before it reaches the nervous system. This is why travellers are encouraged to understand the risk and know exactly what to do if they are bitten, scratched or licked by an animal abroad.
The risk to travellers depends on the destination, the length and nature of the trip, and planned activities. Those visiting rural areas, travelling for long periods, cycling or running, working with animals, or going somewhere with limited medical care are at greater risk, as are children, who are more likely to approach animals and less likely to report a bite. At Crewe Travel Clinic in Crewe, Cheshire, a travel health nurse can assess your itinerary and advise whether pre-travel rabies vaccination is recommended and how to respond to any animal contact while you are away.
Rabies is transmitted through the saliva of an infected animal, usually when the virus enters the body through a bite. It can also be passed on through a scratch, or when infected saliva comes into contact with broken skin or with the eyes, nose or mouth. Even a lick over a graze or cut, or a minor nip that breaks the skin, should be treated as a potential exposure. Dogs are by far the most common source of human rabies globally, but the virus is carried by many mammals, including cats, monkeys, foxes, raccoons, jackals and bats. In the UK and Europe, certain bats can carry rabies-like viruses, so bat bites or scratches anywhere should always be taken seriously. Rabies is not spread through ordinary day-to-day contact between people, and you cannot catch it from simply being near an animal; it requires contact with infected saliva or nervous tissue through a wound or mucous membrane.
After a person is exposed to rabies, there is usually an incubation period of several weeks to a few months before any symptoms appear, although it can occasionally be shorter or much longer depending on the site and severity of the wound. Early symptoms are often non-specific and may include fever, headache, tiredness and a tingling, prickling or itching sensation around the site of the original bite or scratch. As the virus reaches the nervous system, more serious neurological symptoms develop, which can include anxiety, confusion, agitation, hallucinations, muscle spasms, difficulty swallowing and a characteristic fear of water (hydrophobia) and of draughts of air. The illness then progresses to paralysis, coma and death. Once these symptoms appear, rabies is almost always fatal, which is why any potential exposure must be treated urgently and before symptoms begin, rather than waiting to see whether illness develops.
Rabies occurs throughout much of the world, with the highest risk to travellers in parts of Asia and Africa where dog rabies is common and access to treatment may be limited. High-risk regions include the Indian subcontinent (such as India, Nepal, Bangladesh, Sri Lanka and Pakistan), South East Asia, China, much of sub-Saharan Africa, and parts of Central and South America. Risk is also present in some areas of Eastern Europe. A number of countries and territories are considered rabies-free or have only bat-related risk, including the UK, Ireland, Japan, Australia, New Zealand and many islands, though local advice should always be checked. Bat-associated rabies-type viruses are found across many parts of the world, including Europe and the UK. In practical terms, the risk is greatest where stray and free-roaming dogs are common, in rural locations, and on longer trips or those far from reliable medical facilities.
Because rabies is almost always fatal once symptoms appear, prevention is built on three things: avoiding animal contact, knowing what to do after a possible exposure, and vaccination where appropriate. Travellers are advised not to touch, feed or approach animals, including apparently friendly dogs, cats, monkeys and other wildlife, and to supervise children closely, as they are more likely to be bitten and may not report it. Avoid handling bats, and do not attempt to help sick or injured animals. If you are bitten, scratched or licked on broken skin by any animal in a risk area, wash the wound immediately and thoroughly with soap and running water for several minutes, apply an antiseptic such as iodine or alcohol if available, and seek medical advice straight away. Post-exposure treatment with rabies vaccine, and in some cases rabies immunoglobulin, is highly effective but must be started promptly. This applies whether or not you have been vaccinated beforehand, although those who have had pre-travel vaccination need fewer doses and do not require immunoglobulin, which can be difficult to obtain in some countries. A safe and effective pre-travel rabies vaccine is available. It is given as a course of injections over a period before departure, with accelerated schedules sometimes possible for those short of time, so it is best to book well ahead of travel. Pre-travel vaccination is generally recommended for those travelling to higher-risk areas, especially on longer trips, in rural or remote locations, where medical care is limited, for activities such as cycling or running, for those working with or around animals, and often for younger children. At Crewe Travel Clinic in Crewe, Cheshire, your travel health nurse will assess your destination, itinerary and activities and advise whether rabies vaccination is recommended for you.
Rabies is passed to humans through the saliva of an infected animal, most often when the virus enters the body through a bite. It can also be transmitted by a scratch, or when infected saliva reaches broken skin or the eyes, nose or mouth. A lick over a graze or a minor nip that breaks the skin should always be treated as a potential exposure. Dogs are responsible for the great majority of human cases worldwide, but many mammals can carry the virus.
Because rabies is almost always fatal once symptoms appear, prevention rests on avoiding animal contact, knowing what to do after a possible exposure, and vaccination where appropriate. Travellers are advised not to touch, feed or approach animals, including apparently friendly dogs, cats and monkeys, and to supervise children closely. Knowing the correct first-aid response to any bite or scratch is just as important as avoidance.
After exposure there is usually an incubation period of several weeks to a few months before any symptoms appear. Early symptoms are non-specific and may include fever, headache and tingling around the wound. As the virus reaches the nervous system, neurological symptoms such as anxiety, confusion, muscle spasms, difficulty swallowing and fear of water develop, progressing to paralysis and death. The critical point is to act after any potential exposure and before symptoms begin, rather than waiting to see whether illness develops.
A safe and effective pre-travel rabies vaccine is available, given as a course of injections over a period before departure, with accelerated schedules sometimes possible for those short of time. Pre-travel vaccination does not remove the need for treatment after a bite, but it simplifies that treatment: those who have been vaccinated need fewer doses and do not require rabies immunoglobulin, which can be difficult to obtain in some countries. At Crewe Travel Clinic, a travel health nurse can advise whether vaccination is recommended for your trip.
The following vaccinations can help protect against Rabies.
Book an appointment with our travel health team for tailored advice on protecting against Rabies.