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Rabies

Rabies
Rabies Risks in Regions Affected

Rabies is a risk throughout the world, as it is carried by many different species of warm-blooded animals with wide-ranging habitats.
Each region has a different primary carrier of the disease. Worldwide, dog bites present the highest risk, especially in Asia and Africa, where most human deaths from Rabies occur.
In North America, bats pose the greatest risk overall, although other animals such as raccoons, skunks and foxes have also been identified as infected with the Rabies virus.

Please consult this map from the World Health Organization (WHO) showing the countries with elevated risk for Rabies transmission:


Rabies Risks based on Traveler Activities

Rabies risk is highest for those travelers whose visit puts them in close proximity to animals, and so activities such as camping, hiking and cave exploring would pose a higher risk of contracting this disease in areas where there are infected animals.
Animal workers such as veterinarians, and children are considered higher risk groups for contracting Rabies.

Rabies Overview

What is Rabies?

Rabies is a serious and often fatal disease, caused by a virus which attacks the nervous system, transmitted from close contact with infected animals, and occurs world-wide.

How do you get Rabies?

Rabies is transmitted through contact with the saliva of an infected animal, either through bites or through licks on broken skin or vulnerable areas such as the eyes, nose, or mouth.

What are the symptoms of Rabies?

Symptoms can appear from several days to several months to even several years to appear, and begin with flu-like symptoms. As the disease progressively attacks the nervous system, psychological symptoms such as confusion or delirium may appear. In 20% of the cases, paralysis develops. Once symptoms appear, rabies is almost always fatal, often following within 7 days of the symptoms appearing.

What are the treatments for Rabies?

Apart from cleaning the wound, injections of a vaccine given after infection can successfully treat the disease, as long as they are received soon after exposure. Given the life-threatening nature of this disease, it is important to seek medical attention as soon as possible, as once symptoms develop, there is no treatment.

How can you prevent getting infected with Rabies?

There are vaccines available to combat Rabies, which are effective both pre-exposure and post-exposure (as long as it is given soon after exposure). There are other preventative measures which can be taken such as avoiding contact with wild or stray animals. Please consult your nearest travel health clinic at least four weeks before you travel for vaccination. Rabies vaccine is covered by Ontario Health Insurance (OHIP), but is not part of the routine childhood immunization schedule. However, if you are traveling to high-risk areas with limited access to post-exposure treatment, it is recommended to receive a full course of vaccination as a preventative measure.

Rabies Symptoms

Rabies has a typical incubation period of from 3 to 8 weeks after infection before symptoms develop, although this period may vary widely from a few days to a few years.
The first signs of infection begin with flu-like symptoms, such as headache, fever and fatigue.
As the disease develops and spreads through the nervous system, if left untreated, more serious symptoms develop:
Most people develop psychological disturbances such as confusion, agitation, rage, delirium, or hydrophobia.
About 20% of infected individuals display alternate, but just as serious symptoms, involving paralysis.
After these serious symptoms appear, death usually occurs within 7 days, and there is no treatment available.

Rabies Prevention

Fortunately there are highly effective vaccines available to both prevent Rabies pre-exposure, as well as to combat Rabies soon after exposure.
However, as noted above, once symptoms develop, there is no treatment available. Pre-exposure vaccination usually requires 3 doses over a period of 3 weeks, although sometimes requires 5 doses over a month, so please consult your local travel vaccination centre at least 4 weeks prior to departure. Rabies vaccine is covered by Ontario Health Insurance (OHIP), but is not part of the routine childhood immunization schedule. However, if you are traveling to high-risk areas with limited access to post-exposure treatment, it is recommended to receive a full course of rabies vaccine as a preventative measure.

Just as important a preventative measure is to avoid animal bites:

  • Take special care when camping, hiking, or cave exploring to avoid animal bites
  • Do not pick up or handle wild or stray animals
  • Bat bites are sometimes difficult to feel or detect
  • There are no consistently reliable visible signs of Rabies infection in wild animals
  • An unprovoked attack or bite by a wild animal may indicate Rabies infection
  • If bitten, licked, or scratched by an animal:
    • Immediately flush the wound with soap and water for at least 15 minutes
    • Immediately seek medical assistance
    • Upon return to Canada, consult a medical professional for an examination