Learn more about Rabies and how Peak Pharmacy Travel Clinics can help protect you with our range of travel vaccinations.
Here, we will explain how you can get the Rabies virus, the symptoms and how you can prevent the disease. Find your nearest Peak Pharmacy Travel Clinic using the link below:
About The Vaccine
Vaccine: Rabies (known as Rabipur)
Dose: Primary immunisation is 3 doses over a period of 28 days. Rapid protection can be achieved through 3 doses over 7 days with a booster dose 12 months later.
Route: Intramuscular Injection
Booster: Usually every 2-5 years depending on the risk
Transmission: Spread through bite or scratch of an animal with Rabies
What is Rabies?
Rabies is a viral infection caused by the Rabies lyssavirus. It can be found in over 150 countries around the world and on every continent (except Antarctica). Whilst Rabies is present worldwide 95% of all deaths occur in Asia and Africa. Poor rural and remote communities are disproportionality affected by the disease with 80% of all cases occurring in these areas.
The virus is transmitted to humans through a bite, scratch or lick of an open wound from an infected mammal.
Rabies is a very serious but preventable disease and if left untreated virtually all infected patients will die. Around 29 million individuals receive post-exposure treatment each year.
Once infected symptoms typically manifest 2-3 months later, however it can be as quick as 1 week or even as long as 18 years.
Symptoms of Rabies include high temperature (fever), unexplained pain and tingling around the wound site. As the disease progresses the virus spreads to the central nervous system and spinal cord causing progressive and fatal inflammation.
There are two types of rabies, furious and paralytic. Symptoms of furious rabies include excitability, fear of water and fear of fresh air. Death occurs just a few days later. The second form of rabies, paralytic rabies is a much slower form of the disease that causes widespread muscle paralysis. Eventually, this leads to a coma and then death.
How do you get Rabies?
Rabies is a disease that affects mammals and is transmitted through the saliva of an infected animal. This means an animal bite, possibly a scratch and or a lick of an open wound. In 99% of cases, the infected animal is a domestic dog. Rabies does exist in wild mammal populations as well as domestic animal populations, for example, monkeys.
Why am I at risk of Rabies?
Travellers don’t usually set out to get rabies, or even be in a situation where rabies may be a problem. The fact is travel to any region of the world with rabies can be a risk.
High-risk activities like working with animals, and this includes bats, will increase your risk of getting rabies. The majority of cases do not occur in this group of travellers though. Most cases occur through an unprovoked attack from a household animal like a dog or cat. Any incident, especially an unprovoked attack should be considered serious, and prompt post-exposure treatment (vaccination) should be obtained.
What should I do if I am possibly exposed to Rabies?
You should seek medical attention as soon as possible.
Thoroughly wash the wound with soap and water and then disinfect the wound with 40-70% Alcohol or povidone-iodine solution.
Cover the wound with a simple dressing to prevent bacterial infection of the area. DO NOT get the wound stitched until post-exposure treatment has been started.
Antibiotic therapy to prevent wound infection and a tetanus vaccine should also be considered.
Rabies Post-Exposure Vaccination
Prior to stitching up the wound post-exposure treatment should be considered. Rabies is typically a disease of poor rural communities and access to suitable treatment is often hard to obtain.
There is a bit of a myth that you must obtain post-exposure treatment within 24 hrs, this is incorrect. Post-exposure treatment should be sought as soon as possible. The location of the wound can significantly increase your risk. Injuries to the face (closer to the brain) represent a greater risk than a wound on the leg. It is for this reason that children are often disproportionally affected by rabies as bites primarily occur on the face.
If you have not been vaccinated against Rabies, then time is of the essence to obtain the treatment. A course of 4 rabies vaccines should be administered over 3 weeks and depending on the wound location, and rabies status of the animal (if known) live rabies antibodies should also be administered. Live antibodies are very hard to obtain in developing countries!
Sound complex? That’s because it is and it is very likely to ruin your trip with trips to the doctor and unnecessary worry. the best way to prevent Rabies infection is by being vaccinated before it happens.
Rabies Vaccination (pre-exposure)
Our Peak Pharmacy travel clinics are able to provide Rabies vaccination prior to travel to help protect you against Rabies, especially if you are visiting Asia or Africa. Rabies vaccination is an inactivated vaccine that is administered into your upper arm (deltoid muscle) by an injection.
A typical course of a Rabies vaccine, for example, Rabipur consists of 3 doses spread over 3-4 weeks. If you are travelling sooner, don’t worry. Our pharmacists can get you immunised in just 7 days, although you will need a booster dose after 1 year.
After an initial course of 3 to 4 injections has been completed an average traveller is “protected” for around 10 years. A single booster dose can be taken when required to provide an additional 10 years of cover.
Rabies is a very serious disease and immunised individuals should still visit a hospital should an incident occur. The reason for this is obvious. Rabies is nearly always fatal, and we don’t know how well your body has responded to the vaccine. For this reason, another 2 doses are administered to make doubly sure you have enough protection.
This simplified regimen means less disruption to your trip and less worry for you and your family.
What side effects could I expect from a Rabies vaccine?
As mentioned earlier Rabies vaccines are safe and effective; side effects of the rabies vaccine are infrequent. Inactivated vaccines like the Rabies vaccines cannot cause the disease we are vaccinating you against. Typical adverse events are usually limited to:
- Injection site reactions like a sore arm or redness swelling or tenderness at the injection site
- Low-grade fever (greater than 37.5C)
- Fatigue and Tiredness
These symptoms will usually resolve within a few days and can be managed with paracetamol or a cold compress. Further information on adverse events can be found in the patient leaflet.
Can I get a Rabies vaccine free from my doctor?
Yes and No. Rabies vaccination is not available free on the NHS for travellers.
There are some exceptions these include registered bat handlers who require vaccination for their job and post-exposure treatment on return to the UK.
Registered bat handlers should speak to their GP about obtaining vaccination.
If you require post-exposure treatment on return to the UK specialist advice should be sought. Our teams at Peak Pharmacy cannot assist. Contact your nearest Public Health England Health Protection Team