Rabies is a severe and fatal disease caused by the rabies virus. The virus infects the nervous system and brain. The virus is spread to humans through contact with the saliva or nervous tissue of an infected animal (alive or dead). It is usually transmitted by a bite of rabid animal but has also rarely been spread to humans through open wounds (such as a scratch) or mucous membranes.
Symptoms of rabies usually start 3-8 weeks after being infected but could take several years. Symptoms begin with fever and headache, progressing over the next few days to symptoms of anxiety, confusion, abnormal behaviour, difficulty swallowing and spasms of the swallowing muscles, excessive drooling, fear of water, delirium and convulsions followed by coma and death. Once symptoms begin death will usually occur within 7-14 days.
How can I prevent rabies while traveling?
Avoiding contact with stray animals while traveling is the best way to prevent rabies. The pre-exposure vaccine series can also help to prevent rabies.
Who should receive the pre-exposure rabies vaccine?
The rabies pre-exposure vaccine is recommended for:
- Rabies laboratory workers, rabies biologicals production workers & bat biologists
- Veterinarians and staff, animal control workers, wildlife biologists and wildlife workers
- Hunters and trappers in high risk such as the far north.
- Cave spelunkers
- Travelers to foreign countries with known rabies risk, depending on length of travel, planned activities, and access to to post-exposure rabies treatment
Rabies pre-exposure vaccine schedule:
The pre-exposure vaccination consists of a series of 3 injections given on days 0, 7, and 21 or 28.
A booster dose is recommended for individuals who have received the vaccine for travel only if there is a subsequent exposure. High and moderate risk individuals should have a blood test every 6 months and 2 years respectively.
Rabies post-exposure treatment:
What to do if bitten by an animal while travelling:
1. Wash the wound thoroughly with soap and warm water for at least 15 minutes. Cleaning the wound immediately greatly reduces the risk of infection.
2. Seek medical attention immediately for rabies treatment (rabies treatment only works to prevent rabies if it is given before symptoms begin).
For travellers who have completed the pre-exposure rabies series:
Two doses of the rabies vaccine are needed on day 0 and 3 after the exposure (these doses do not need to be the same brand as the pre-exposure vaccine series).
For travellers who have not received the pre-expsure rabies series:
Post-exposure treatment should be given as soon as possible (ideally within 24 hours) after exposure and should still be started regardless of time since exposure (even if several months have passed). Unvaccinated travellers need rabies immunoglobulin (RIG) on the day of exposure, as well as a series of 4 rabies vaccines on day 3, 7, 14 and 28 (or 5 doses in travellers with a compromised immune system).
The availability of RIG is limited in many countries. If access to RIG is delayed the vaccine series should still be started as soon as possible. RIG can then be given until day 7 after the first rabies vaccine was given. Some developing countries still use rabies vaccines grown in animal brains (these can be identified if the traveller is offered a large volume injection (5mL) daily for about 14-21 days). Travellers should not accept these vaccines but travel to where acceptable rabies and RIG are available.
If you receive treatment outside of Canada, obtain the name of the RIG and vaccines provided and consult your Canadian doctor or public health unit to ask for advice when you return home.
Call us at 604-251-1975 to arrange an appointment or to receive further information about the rabies vaccine.