Rabies

Rabies is a viral infection which affects, and is carried by, warm-blooded animals (mammals), including bats. Once a person has been infected, the virus travels to the brain and spinal cord. By the time symptoms in humans appear, rabies is invariably fatal, as there is no cure.

Symptoms

Fever, headache, fatigue, tingling, prickling or burning at the site of the wound initially, progressing to agitation, muscle spasms, coma.

How do you catch rabies?
Rabies is spread through bites, scratches and licks from infected animals, including to the eyes, nose or mouth. Dog bites are the most common cause of human infection.

Incubation period
usually between 3 and 12 weeks, but can range from 4 days to 1 year, or longer. Bites or scratches to the head, neck, face and fingers tend to have shorter incubation periods.

Diagnosis
There is no current test for rabies before symptoms start, but when they do the virus can be detected in saliva, spinal fluid, urine and brain tissue. Often the diagnosis is confirmed after death.

Prevention
Travellers should avoid contact with all animals during travel, including pets. Never approach, handle or feed animals while travelling. A pre-exposure course of three vaccines is available for travellers.

Treatment
For all bites, scratches or licks: thoroughly wash the area with soap and water for several minutes, cover the wound, then seek urgent medical attention. Post exposure vaccines may be required. The number of vaccines needed will depend on how many pre-exposure vaccines have been given. Rabies immunoglobulin injection may also be advised.

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Vaccination options

2 licensed vaccines available in the UK.

Level of protection: ~ 99-100% Travellers must seek prompt medical advice is bitten/scratches as post exposure vaccines may be necessary.

Protection duration: Most travellers will not require a booster.

 

How is it given: 3 injections usually @ 0, 7 and 28 days. An accelerated schedule can be used if necessary: 4 injections @ 0, 3 and 7 days, with a 4th dose at 12 months.

Ideally start: 4 weeks before travel.

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Did you know?

  • Although it is rare in travellers, anyone who has possibly been exposed to rabies should seek medical advice urgently, even if they received pre-exposure vaccines.
  • Children are at particular risk from rabies as they are less likely to avoid animals.
  • Even animals that look to be well could be carrying the rabies virus.

Clinical Oversight By:

Professor David Ross

Professor David Ross OStJ

Medical Director, MASTA

PhD MSc MBBS MRCGP FRCPCH FFPH FFTM RCPS(Glasg.) FRCP(Glasg.)

GMC No. 3115417

Professor David Ross OStJ is the Medical Director of MASTA and has been associated with MASTA since 2005. He served 41 years in the Army, including over 10 years as senior advisor on public health to the UK Surgeon General. In 2012 he was appointed the Parkes Professor of Preventive Medicine, in 2014 an Honorary Queen’s Physician and in 2023 an Officer in the Order of St John.

Professor David Ross

Professor David Ross OStJ

Medical Director, MASTA

PhD MSc MBBS MRCGP FRCPCH FFPH FFTM RCPS(Glasg.) FRCP(Glasg.)

GMC No. 3115417

Professor David Ross is the Medical Director at MASTA and has been associated with the company since 2005. He was commissioned into the Royal Army Medical Corps in 1983 and graduated in medicine from St Bartholomew’s Hospital, London in 1986. In 2012 he was appointed the Parkes Professor of Preventive Medicine, in 2014 an Honorary Queen’s Physician and in 2023 an Officer in the Order of St John. He was the senior advisor on public health from 2012–2023 to the UK Surgeon General. He retired from the Army in October 2024, after 41 years active service.

Professor David Ross was Director of Education, Honorary Secretary, and Vice Dean before becoming Dean of the Faculty of Travel Medicine, Royal College of Physicians & Surgeons (Glasgow) in October 2024. Recent travel medicine research interests have included malaria prevention and tuberculosis screening. He was Chief Examiner of the Diploma of Medicine in Conflict & Catastrophes at the Society of Apothecaries until 2024, is Chair of the Final UK MFPH and an Examiner at the UK Faculty of Public Health.

The last few years of his military working life were dominated by supporting the international and national public health response to COVID-19, where he managed many large COVID outbreaks both overseas and in the UK. David also led research into risk factors for mental ill health in the UK Army and for this was awarded a PhD by the University of Glasgow in 2024.