Rabies is a rare but very serious infection of the brain and nerves. It's usually caught from the bite or scratch of an infected animal, most often a dog.
Rabies is found throughout the world, particularly in Asia, Africa, and Central and South America. Cases in Northern Ireland are rare.
They usually result from travel to an area where rabies occurs, and being bitten or scratched by an infected animal, without having been vaccinated.
It's almost always fatal once symptoms appear, but treatment before this happens is very effective. There's also a vaccine for people at risk of being infected.
You should consider getting vaccinated against rabies if:
- you're travelling to an area where rabies is common and you plan to stay for a month or more, or there's unlikely to be quick access to medical care
- you're travelling to an area where rabies is common and you plan to do activities that could put you at increased risk of exposure to animals with rabies – such as running or cycling
Visit your GP or a travel clinic if you think you may need the vaccine. It's sometimes free, but most people have to pay.
Even if you've been vaccinated, you should still take precautions to avoid coming into contact with rabies if you're travelling in an area where rabies is found.
You should get medical advice straight away if you've been bitten or scratched.
A few people may need the rabies vaccine because they could come into contact with rabies through their work. If you think this applies to you, speak to your occupational health department.
How to avoid being bitten or scratched
All mammals (including monkeys) can carry rabies, but it's most common in:
They can spread the infection if they bite or scratch you or, in rare cases, if they lick an open wound or their saliva gets into your mouth or eyes. Rabies isn't spread through unbroken skin or between people.
While travelling in an area where rabies is a risk:
- avoid contact with animals – some infected animals may behave strangely, but sometimes there may be no obvious signs they're infected
- avoid touching any dead animals
If you're travelling with a child, make sure they're aware of the dangers, and that they should tell you if they've been bitten, scratched or licked by an animal.
Check them for any wounds if they come into contact with an animal.
For information about areas where rabies is a risk, see:
What to do if you've been bitten or scratched
If you've been bitten or scratched by an animal in an area with a risk of rabies:
- immediately clean the wound with running water and soap for several minutes
- disinfect the wound with an alcohol- or iodine-based disinfectant and apply a simple dressing, if possible
- go to the nearest medical centre, hospital or GP surgery as soon as possible and explain that you've been bitten or scratched
If this happens while you're abroad, get local medical help immediately. Don't wait until you've returned to Northern Ireland.
If you've already returned to Northern Ireland without getting medical advice, it's still a good idea to get help – even if it's been several weeks since you were bitten or scratched.
It's unlikely you've been infected, but it's best to be safe. Post-exposure treatment is nearly 100 per cent effective if it's begun before any symptoms of rabies appear.
Treatment after a bite or scratch
If you've been bitten, scratched or licked by an animal that might have rabies, you may need specialist medical treatment to stop you getting rabies. This is called post-exposure treatment.
Post-exposure treatment involves:
- cleaning and disinfecting the wound
- a course of the rabies vaccine – you'll need to have 5 doses over a month if you haven't been vaccinated before, or 2 doses a few days apart if you have
- in some cases, a medicine called immunoglobulin given into and around the wound – this provides immediate but short-term protection if there's a significant chance you've been infected
Treatment should be started as soon as possible, ideally within a few hours of being bitten or scratched.
But it's often safe to delay treatment until the next day if the vaccine and/or immunoglobulin need to be specially ordered in by your doctor.
Symptoms of rabies
Without treatment, the symptoms of rabies will usually develop after 3 to 12 weeks, although they can start sooner or much later than this.
The first symptoms can include:
- a high temperature (fever) of 38C (100.4F) or above
- a headache
- feeling anxious or generally unwell
- in some cases, discomfort at the site of the bite
Other symptoms appear a few days later, such as:
- confusion or aggressive behaviour
- seeing or hearing things (hallucinations)
- producing lots of saliva or frothing at the mouth
- muscle spasms
- difficulty swallowing and breathing
- inability to move (paralysis)
Once symptoms appear, rabies is almost always fatal. In these cases, treatment will focus on making the person as comfortable as possible.
More useful links
The information on this page has been adapted from original content from the NHS website.
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