Rabies Immunisation

What is rabies?

Rabies is a disease caused by a virus. It causes spasms, fear of water, madness, paralysis, and usually death. Symptoms usually start 2-8 weeks after being bitten by an animal carrying the rabies virus. However, symptoms may occur months or even years after a bite from an infected animal. The virus passes through the cut skin and travels (gradually) into the nervous system.

At present, the UK is virtually free of rabies. There had been no reported cases in the UK for over 100 years until 2002 when a man died of rabies in Scotland after been bitten by a bat. As far as we are aware, there have been no cases since, and no cases in the UK for over 100 years caused by bites from other animals. The strict quarantine regulations for imported animals helps to keep rabies out of the UK.

However, rabies is present in most of the rest of the world. Worldwide, there are about 50,000 human cases each year, most commonly in India. Foxes are the main carriers of the disease but dogs, cats, cattle, horses, badgers, deer, racoons, bats and skunks can be affected. A bite from any of these animals from any country outside the UK should be taken very seriously.

• People whose work might bring them in contact with rabid animals such as zoo keepers, quarantine workers, vets, etc.
• Travellers to remote parts of the world where medical treatment might not be available.
• Travellers to parts of the world where rabies is particularly common in animals. Most travellers do not require rabies immunisation. However, get medical help immediately if you are bitten by an animal.
• Health care workers who come in contact with patients with rabies.
• People working with the rabies virus in laboratories.
• Health workers who are at risk when dealing with patients with confirmed rabies.

The vaccine

Three doses of vaccine are usually given. The first injection, a second injection seven days later, and a third injection 28 days after the first injection. The vaccine is very effective - almost 100%. The vaccine stimulates your body to make antibodies against the rabies virus. These antibodies protect you from illness should you become infected with this virus.

Booster doses may be required every 2-3 years for people who continue to be at risk and where medical treatment is not available.

Local redness and swelling at the site of the injection may occur for 1-2 days. Mild fever and muscle aches with nausea (feeling sick) occur rarely and soon pass without leaving any problems. Severe reactions are rare.

There is no absolute reason why anybody at risk of rabies should not be immunised. Like many immunisations, it is usually wise not to have it when pregnant. However, pregnant women should still consider being immunised if the risk of exposure to rabies is high.

If you are bitten by an animal in an 'at risk' country then:

• Wash the wound immediately with running water (and soap if possible) for at least five minutes.
• Seek medical attention as soon as possible even if you have been previously immunised as treatment may be given to reduce to risk of infection to a minimum.

There is an effective anti-serum (antidote). You may also be given a series of immunisations (even if you have been previously immunised).

Further information

Health Advice for Travellers.
All travellers going abroad are advised to get this booklet by the Department of Health. You can get a free copy:

• From main post offices, or
• By writing, phoning, faxing or emailing the Department of Health (allow 10 days to get it).

  Department of Health, PO Box 777, London, SE1 6XH
  Telephone: 08701 555455    Fax: 01623 724524    Email doh@prolog.uk.com

• Or view the content on the web www.dh.gov.uk/PolicyAndGuidance/HealthAdviceForTravellers/fs/en

Immunisation Against Infectious Disease (The Green Book)
www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/GreenBook/fs/en
From the Department of Health. Aimed at health professionals but of interest to all.

Health Information for Overseas Travel (The Yellow Book)
www.archive.official-documents.co.uk/document/doh/hinfo/index.htm
From the Department of Health. Aimed at health professionals but of interest to all.

Information on immunisation
www.immunisation.org.uk
From the NHS aimed at the general public.

Patient UK Travel Health Page
www.patient.co.uk/showdoc/38/
Has a comprehensive list of links to UK websites on travel health.

© EMIS and PIP 2005   Updated: August 2005