10 Important Facts Every Traveller Should Know About Rabies

During our recent travels through South East Asia, we got to witness a part of the world where nature and civilization coexist very much side to side.

From monkeys relaxing around tourists sites and stealing from the visitors in Kuala Lumpur, to giant bats flying overhead in Bangkok, the wild world doesn’t get pushed back quite as easily as it does back home. 

Of course, with this proximity to nature also comes an increased risk of diseases, of which rabies is perhaps the greatest danger. When it comes to this terrible illness, you’ll want to be as prepared as possible.

So, before you step foot on that airplane or set out on your next adventure, here are the 10 key insights every traveler should have about rabies.

What is Rabies?

Rabies, also known as hydrophobia, is an extremely dangerous disease caused by a number of viruses, with the rabies virus (Rabies lyssavirus) being the main cause of infection.

The disease only affects mammals, including humans, and can be found in both wild and domestic animals.

How does Rabies spread?

Rabies is usually spread via the bite of an infected animal.

Since the virus is found in the saliva, and it needs to enter the bloodstream in order to infect a new host, a bite is is the most common method of transmission. However, you may also be at risk if a potentially infected animal scratched you, or licked you on or near an open wound!

While almost all mammals can be potential carriers of rabies, dogs are the most common source of infection, and account for 99% of all cases worldwide. While much less common, cats can also transmit rabies (we even had a little scare ourselves one night in Bangkok). 

Catching rabies from a wild animal is much less common, but it is still very possible. Among wild animals, bats are by far the most common source of the virus, followed by skunks, raccoons and foxes. 

Where can Rabies be found?

Rabies is found on every continent with the exception of Antarctica, however the vast majority of infections and deaths happen in Africa and Asia. The disease is more common in rural areas, where you are more likely to encounter stray animals who themselves might have come in contact with wildlife carrying the virus.

In the rest of the world, mandatory vaccinations of pets and campaigns to treat wildlife have almost entirely eradicated rabies. With that said, cases and fatalities are still reported every year, so remain cautious no matter where you are.

How can you check if you have Rabies?

There is no way to self-diagnose rabies. If you fear you’ve come into contact with an infected animal, the best you can do is to get yourself to a doctor as soon as possible to be evaluated and treated.

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How long before symptoms appear?

The time between the initial infection and the first symptoms is what is called the incubation period. While there are variations depending on the location and severity of the wound, rabies will generally start showing symptoms between a month to four months after infection.

What are the symptoms and stages of Rabies?

After entering the bloodstream through an open wound, the rabies virus will begin travelling towards the brain and the central nervous system. Once it reaches it, it will cause progressively more severe inflammation, with flu-like symptoms being the first to appear. As the damage worsens, the victim will experience neurological symptoms such as anxiety, confusion and hallucinations.

The infected individual also commonly develops a fear of water, as the disease causes extremely painful throat spasms that make it almost impossible to swallow any liquid, including saliva. This is what gives rabies the name hydrophobia (from the Greek hydro, meaning water, and phobia, meaning fear). This is also what contributes to the image of rabies victims “foaming at the mouth”.

Finally, the diseases ends with delirium, coma and death. This usually occurs just a few days after the initial onset of symptoms. 

Is Rabies fatal?

Rabies is arguably the deadliest viral disease in the world.

While it can be easily cured if treated on time, it is virtually 100% fatal once symptoms have developed. Even though there are experimental treatments, once the disease has progressed beyond that point there is no possible cure, and the only thing doctors can do is try to keep the patient comfortable until the end.

As of 2023, only 29 people are known to have survived. That is of little consolation, considering that over 50.000 die every year. 

Is Rabies contagious?

While rabies is extremely contagious via the saliva, it still needs to enter the bloodstream, and there are so far no reported cases of humans infecting each other. You also cannot catch rabies like you would, for example, the flu. A person with rabies sneezing or coughing will not transmit the disease, nor will touching an infected individual.

Is there a vaccine against Rabies?

A rabies vaccine does exist, and it is very effective at delaying or stopping the virus. The vaccine usually consists of three doses given over a period of 28 days, but there are variations based on the time available.

It is important to remember, however, that the rabies vaccine is not 100% effective at preventing the disease, and you should still seek medical help if you believe you might have been infected.

While not essential, this preventative treatment is recommended when travelling to areas where rabies is more common, or if you are going be working in close contact with wild animals. For example, I was recommended to receive the full vaccination before volunteering in a reserve in South Africa. In addition, getting vaccinated will mean a less expensive treatment in case of exposure. 

All in all, while getting jabbed three times is not fun, it’s worth it knowing that you have an additional level of safety.

Pro tip: Remember to schedule your vaccination at least a few months before your departure; Even if you have the 3 doses administered close to each other, you’ll still need about a month before the vaccine is fully effective! 

Can Rabies be cured?

Rabies cannot be cured, but it is easily preventable if treatment is given within the first 10 days.

The treatment, known as postexposure prophylaxis, consists of a dose of antibodies and a dose of vaccine on the day of exposure, followed by three more doses of vaccine at intervals of 3, 7 and 14 days. Also, while you might have heard horror stories of giant needles being jabbed into the stomach, that was part of an old treatment that is, for the most part, completely phased out.

When it comes to rabies, prevention is the best cure.

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Here are a few steps to reduce your chances of coming into contact with the disease:

• Be extra careful in rural areas, where domesticated animals are more likely to come into contact with wild ones;

• Avoid coming close to or touching stray animals, especially dogs;

• Keep your distance from wild animals, especially if they behave strangely and do not show fear;

• Treat any injury caused by a potential carrier animal as an emergency and see a doctor as soon as possible;

• Get informed on the prevalence of rabies in the country you intend on visiting, especially when travelling to Africa and Asia.

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