Rabies Vaccine: Essential Protection for Travel and High-Risk Situations

Rabies: A Deadly Virus Spread by Mammals

Rabies is a life-threatening virus primarily transmitted to humans through bites or scratches from infected animals. The virus, present in the saliva of these animals, attacks the nervous system, leading to brain inflammation. Rabies is nearly 100% fatal once symptoms appear, making prevention crucial. Globally, rabies remains a serious health threat, causing thousands of deaths each year.

Which Animals Can Transmit Rabies?

Only mammals can carry the rabies virus. Dogs are the leading source of human rabies deaths worldwide, responsible for up to 99% of transmissions. Other wild animals that commonly spread rabies include raccoons, skunks, and foxes.

Bats are another major carrier. Any physical contact with a bat is considered high-risk and requires immediate medical attention. A bat scratch or bite can be difficult to detect, especially since encounters often happen at night or while sleeping.

In addition, non-human primates like monkeys, particularly macaques in tourist areas of Asia, frequently cause injuries that require rabies treatment. These animals are common around temples and can be aggressive. To stay safe, avoid eye contact with monkeys and keep food and personal items out of sight.

Global Rabies Risk: Where the Virus is Most Common

Rabies exists on every continent except Antarctica, with over 95% of human deaths occurring in Asia and Africa. It is also present in parts of Latin America. The CDC provides an online tool to assess the rabies risk in any country.

In the U.S., rabies deaths are rare, largely due to the absence of canine rabies. However, rabies is still present in wildlife, including bats, raccoons, skunks, and foxes, even in Arizona.

Rabies Vaccine: Pre-Exposure and Post-Exposure Protection

The rabies vaccine is an inactivated vaccine given in a series of injections to protect against the virus. It is used both as a preventive measure (Pre-Exposure Prophylaxis or PrEP) and after a potential exposure (Post-Exposure Prophylaxis or PEP).

• Pre-exposure prophylaxis: Usually given as two doses, 7 days apart.
• Post-exposure treatment: The schedule depends on prior vaccination and how the wound was treated initially.

Why is Rabies Pre-Exposure Vaccination Important for Travelers?

Any animal bite or scratch is considered a potential rabies exposure and a medical emergency. For individuals without prior vaccination, immediate treatment with rabies immunoglobulin (RIG) is required. Unfortunately, RIG is often unavailable in many parts of the world, potentially requiring medical evacuation to a facility that offers it.

For travelers to rabies-endemic areas, getting vaccinated provides peace of mind and reduces the urgency of seeking immediate treatment if bitten. No deaths have been reported among people who received pre-exposure prophylaxis.

High-Risk Groups for Rabies Vaccination

Certain individuals are at a higher risk of contracting rabies and should consider pre-exposure vaccination:

• Children visiting areas where rabies is a risk: They make up 40% of those bitten by rabid animals, often on the head or face, increasing the risk.
• Visiting Friends and Relatives (VFRs): VFR travelers often stay in areas with higher rabies risks and may not take the same precautions as other travelers.
• Long-term travelers: Particularly missionaries and others staying in rabies-endemic regions.
• Outdoor enthusiasts: Cyclists and hikers are more likely to encounter dogs or wild animals.
• Animal workers: Veterinarians and animal volunteers should be vaccinated.
• Bat-exposed travelers: Cavers and those likely to encounter bats are at high risk.

 Rabies Vaccine Side Effects

The rabies vaccine is generally well-tolerated, with mild pain or redness at the injection site being the most common side effect. Newer formulations have minimized adverse reactions.

Is the Rabies Vaccine Safe for Children?

Yes, the rabies vaccine is safe for children and infants, especially those at high risk of exposure, such as those traveling to rabies-endemic areas.

Rabies Prevention Tips

• Avoid contact with unfamiliar animals to prevent rabies.
• Get vaccinated against rabies, especially when traveling to high-risk regions.
• Immediately clean any bite wounds with soap and water to reduce the risk of infection. Seek medical help right away, even if you’ve been vaccinated.

In the Phoenix area, contact the Maricopa County Department of Public Health at 602-747-7500 (available 24/7) for suspected rabies exposure. An epidemiologist will assess your situation and recommend treatment.

Where to Find Rabies Vaccination Providers

Rabies vaccines and RIG are available at select U.S. hospitals, and treatment in an emergency department can be costly. At TravelBug Health, we always have the rabies vaccine in stock for both pre-exposure and post-exposure prophylaxis. However, we do not currently carry RIG.

When traveling, you can use the International Society of Travel Medicine (ISTM) online clinic finder to locate travel medicine clinics worldwide, many of which stock rabies vaccines and RIG.