Travellers may be more concerned about the risk of rabies exposure following a British woman’s death from the virus after she was scratched by a dog in Morocco.
Yvonne Ford was diagnosed in the UK having developed symptoms on her return from holiday.
Rabies is endemic in parts of Asia, Africa and South America, and there is a risk of contracting the virus from animals in more than 150 countries and territories. Cases among travellers are rare, however.
The virus is almost always fatal although vaccination and early treatment can be effective. Dogs are the main source of human deaths caused by rabies. They account for 99 per cent of transmissions, according to the World Health Organisation.
square NEWS British grandmother dies from rabies after 'scratch' from puppy in Morocco
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It is a viral infection that affects the brain and nervous system.
The virus is spread from contact with the saliva of a wild or domestic animal infected with rabies. This could be from a bite, scratch or the animal licking an open wound.
What you need to know about rabies while travelling
If you are bitten or scratched by an animal, or you are licked by an animal on broken skin, it should be considered a rabies risk. As well as dogs, rabies can be found in cats, bats, monkeys, and other mammals. There are no documented cases of human-to-human transmission. Once symptoms have developed, it is usually fatal.
Symptoms typically appear within three to 12 weeks of exposure, according to the UK Health Security Agency (UKHSA). They may start with fever, a headache and discomfort in the area where you were bitten or scratched.
As the infection progresses, symptoms include confusion, muscle spasms and difficulty swallowing.
Prevention is crucial, according to the UKHSA. Travellers should check if there is a risk of rabies in their destination well ahead of departure.
Book a pre-travel consultation with a health professional to see if a vaccination is recommended (the NHS suggests seeking advice at least eight weeks before travel). Vaccination is most important for those staying in risk areas for more than a month, engaging in outdoor activities or travelling to areas without medical care.
How to avoid exposure while travelling
Animals that appear to be behaving normally can still be infectious. Avoid contact with any wild or domestic animals.
Do not approach any animals Avoid attracting animals: throw rubbish away as soon as you can, and don’t offer animals food Remember that running or cycling can attract dogs If animal saliva gets into your eyes, nose or mouth (if an animal coughs, spits or sneezes near your face, for example), wash your face with clean water as soon as possibleAdvice if you may have been exposed to rabies
The UKHSA advice if you are bitten, scratched or licked on broken skin by an animal in a rabies-endemic country is as follows:
Wash the wound for several minutes, which can significantly reduce the risk of infection (under a running tap, with soap/detergent, then apply a disinfectant such as 70 per cent alcohol and cover the wound with a dressing). Seek medical attention as soon as possible, even if you have been vaccinated. “Post-exposure treatment is highly effective when administered promptly, before symptoms develop,” says the UKHSA. Contact your GP on your return to the UK, even if you received post-exposure therapy overseas or the exposure happened several weeks ago. You may need to continue a course of rabies vaccines. Seek documentation of any treatment given when you receive it abroad, and bring that documentation to your GP. A full course of a vaccine will provide good protection against rabies for most people, according to the UKHSA. If you completed a full-course of pre-exposure vaccine over a year ago and are travelling to a risk area, you can have a single booster dose. Medical advice should still be sought if you are potentially exposed to the virus. Even years after a full course of pre-exposure vaccines, you will only need two additional rabies vaccine doses after exposure and will not need immunoglobulin. Once symptoms develop, there is no effective treatment for rabies.The countries with a high risk of rabies
The UKHSA details all the high-risk and low-risk countries and territories for rabies. See the full list.
Destinations that are likely to be visited by UK travellers and which are high risk for rabies include:
Albania Argentina Bali Bangladesh Belize Bhutan Bolivia Borneo Bosnia and Herzegovina Botswana Brazil Bulgaria (low risk, but foxes high risk) Cambodia Canada (low risk, but foxes, skunks and racoons high risk) China Colombia Costa Rica Croatia (low risk, but foxes high risk) Cuba Czechia (Czech Republic), within 59km border Poland/Slovakia (low risk, but foxes high risk) Dominican Republic Ecuador Egypt El Salvador Gabon The Gambia Georgia Ghana Greenland Guatemala Guyana Hungary (low, but foxes high risk) India Indonesia Jan Mayen and Svalbard (Norway) Jordan Kazakhstan Kenya South Korea Kyrgyzstan Laos Latvia (low risk, but foxes high risk) Lithuania North Macedonia Madagascar Malaysia Mexico Mongolia Montenegro Morocco Namibia Nepal Nicaragua Nigeria Oman Pakistan Panama Paraguay Peru Philippines Poland Puerto Rico South Korea Romania Rwanda Saudi Arabia Senegal Serbia Sierra Leone Slovenia (low risk, but foxes are high risk) South Africa Sri Lanka Tanzania Thailand Tunisia Turkey Uganda USA (low risk, but foxes, skunks and racoons are high) Uzbekistan Vietnam Zambia Zanzibar Zimbabwe Read More Details
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