Rabies FAQ : Travel and Prevention

by CDC

(Page 4 of 7)

Travel

Should I be concerned about rabies when I travel outside the United States?

Yes. Rabies and the rabies-like viruses can occur in animals anywhere in the world. In most countries, the risk of rabies in an encounter with an animal and the precautions necessary to prevent rabies are the same as they are in the United States. When traveling, it is always prudent to avoid approaching any wild or domestic animal.

The developing countries in Africa, Asia, and Latin America have additional problems in that dog rabies is common there and preventive treatment for human rabies may be difficult to obtain. The importance of rabid dogs in these countries, where tens of thousands of people die of the disease each year, cannot be overstated. Unlike programs in developed countries, dog rabies vaccination programs in developing countries have not always been successful. Rates of postexposure prophylaxis in some developing countries are about 10 times higher than in the United States, and rates of human rabies are sometimes100 times higher. Before traveling abroad, consult a health care provider, travel clinic, or health department about your risk of exposure to rabies and how to handle an exposure should it arise.

Should I receive rabies preexposure vaccination before traveling to other countries?

In most countries, the risk of rabies and the precautions for preventing rabies are the same as they are in the United States. However, in some developing countries in Africa, Asia, and Latin America, dog rabies may be common and preventive treatment for rabies may be difficult to obtain. If you are traveling to a rabies-endemic country, you should consult your health care provider about the possibility of receiving preexposure vaccination against rabies. Preexposure vaccination is suggested if:

Rabies Prevention and Control

1. Your planned activity will bring you into contact with wild or domestic animals (for example, biologists, veterinarians, or agriculture specialists working with animals).

2. You will be visiting remote areas where medical care is difficult to obtain or may be delayed (for example, hiking through remote villages where dogs are common).

3. Your stay is longer than 1 month in an area where dog rabies is common (the longer you stay, the greater the chance of an encounter with an animal).

If I get preexposure vaccination before I travel, am I protected if I am bitten?

No. Preexposure prophylaxis is given for several reasons. First, although preexposure vaccination does not eliminate the need for additional therapy after a rabies exposure, it simplifies therapy by eliminating the need for human rabies immune globulin (HRIG) and decreasing the number of doses needed - a point of particular importance for persons at high risk of being exposed to rabies in areas where immunizing products may not be readily available. Second, it may protect persons whose postexposure therapy might be delayed. Finally, it may provide partial protection to persons with inapparent exposures to rabies.

What are some of the circumstances in domestic settings in which rabies exposure may have occurred?

Types of exposures in domestic settings that may pose a risk for rabies include bites, sexual activity, exchanging kisses on the mouth or other direct mucous membrane contact with saliva, and sharing eating or drinking utensils or cigarettes.

What are some circumstances in domestic settings that are not a risk for rabies exposure?

In most cases, interaction with a rabies patient in a household setting is not considered an exposure. Touching a patient is not regarded as an exposure unless saliva may have entered through nonintact skin or through the eyes, nose, or mouth of the household contact. There is no risk involved in changing a patient's bed linens or washing their clothes. Feces, blood, urine, and other patient body fluids are not considered a risk for rabies.

I have been told I need rabies treatment - what does this consist of?

Rabies treatment, called post-exposure prophylaxis (or PEP), consists of a dose of human rabies immune globulin and 5 doses of rabies vaccine given on treatment days 0, 3, 7, 14, and 28. The vaccine is given in a muscle, usually in the upper arm. The treatment is highly effective at preventing rabies following an exposure if given before symptoms of rabies infection appear. If a person has previously received rabies treatment or was pre-vaccinated for rabies, only 2 doses of vaccine (on days 0 and 3) will be given, and human rabies immune globulin is not required. You will be advised by your healthcare provider and local health department where to seek treatment.

I have been told I need rabies treatment - do I need to start this right away?

Rabies treatment should be started as soon as possible. The vaccine is highly effective if begun before clinical signs of rabies appear, and persons should receive PEP if needed no matter how much time has elapsed since the exposure.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.