Public Health Agency of Canada
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Rabies
October 2009
Rabies
What is Rabies?
Rabies is a viral infection that is transmitted to humans through close contact with the saliva of an infected animal, most often by a bite or scratch, or by licks on broken skin or mucous membranes, such as the eyes, nose or mouth. Worldwide, dog bites are responsible for most human cases of rabies.
Cause
A virus of the Rhabdoviridae family
Risk to Travellers
Risk varies depending on location, purpose and duration of trip, as well as lifestyle, activities, and access to medical care.
Travellers who engage in activities which place them in close contact with animals, such as cave exploration, camping, hiking, or cycling in areas where rabies is found, may be considered high risk.
Travellers who work in close contact with animals, such as veterinarians, animal control or wildlife workers, or laboratory workers are at high risk.
Children are also considered at high risk because they often play with animals and are less likely to report bites or scratches. Bites in children are usually higher on the trunk or face and are often more severe.
Severity
Once symptoms appear, rabies is almost always fatal.
Prevention
Take personal precautions to avoid animal bites and avoid contact with bats.
Get vaccinated.
Treatment
There is no specific treatment for rabies.
Thoroughly cleansing the wound or bite site immediately after exposure can help prevent the onset of rabies.
Shots given after exposure to the virus (called post-exposure prophylaxis) can be effective at preventing disease, as long as they are received promptly after exposure, and the appropriate product is administered using the appropriate technique.
Seek medical attention as soon as possible after being bitten or scratched by an animal, or having close contact with a bat. Post-exposure prophylaxis is available worldwide however it is often difficult to obtain.
Symptoms
- Can take 20 to 60 days to appear, although this may vary considerably from several days to several years.
- Early symptoms are flu-like, including headache, malaise, fever, and fatigue. There may be discomfort or pain at the exposure site (i.e. bite).
- Symptoms progress quickly as the central nervous system is attacked, and the illness generally presents in one of two ways:
- "Furious rabies" is more common, and is characterised by anxiety and psychological disturbances (confusion, agitation, delirium, rage, hallucinations, and hydrophobia).
- "Dumb rabies" occurs in approximately 20% of patients and presents with paralysis.
- In both "furious" and "dumb" rabies, death usually occurs within seven days due to breathing failure caused by paralysis of the respiratory system.
Transmission
- Rabies is spread when virus from the saliva of an infected animal enters the nervous system of the victim through a bite, scratch, broken skin, or the mucous membranes (eyes, nose, mouth). Worldwide, this often occurs through a dog bite or scratch.
- Virus is also present in the nervous system tissue of an infected animal, which presents a risk to people who examine dead animals and tissues (e.g., veterinarians and laboratory workers).
- Rabies can occur in any warm-blooded animal, domestic and wild.
- Dogs are the main carriers of the disease in Asia and Africa. Foxes, skunks, raccoons, bats and livestock may be other common carries in Canada and the United States.
- About 30 to 60% of the victims of dog bites are children under the age of 15.
Where is Rabies a Concern?
- Rabies occurs worldwide, although most human deaths occur in Asia and Africa.
- In more recent years, bat rabies has become a public health concern in the Americas and the Caribbean.
A map of the areas 
where rabies transmission occurs is available from the World Health Organization.
Related Travel Health Notices
Recommendations to Travellers
1. Take personal precautions to avoid animal bites and avoid contact with bats;
Travellers should consider all stray animals to be infected with rabies and should therefore;
- Not attempt to pick up, pet, or handle unfamiliar animals (including bats).
- Not attract or approach wild or stray animals.
- Cavers, or spelunkers, should not handle bats.
2. Get vaccinated
Travellers should consult with a health care provider to discuss the benefits of getting vaccinated.
- Rabies vaccine should be offered to people at potentially high risk of contact with rabid animals.
- Pre-travel immunization should be offered to travellers going to areas where rabies is endemic and there is poor access to medical care.
- Vaccine should be offered to children who are too young to understand either the need to avoid animals or to report contact with animals.
3. If bitten or scratched or licked on broken skin or mucous membranes, by an animal;
- Immediately clean the wound thoroughly by washing and flushing with soap and water for a minimum of 15 minutes.
- Immediately seek medical assistance to assess risk and discuss treatment options.
- When you return to Canada, see your health care provider and tell them about your exposure and any shots you may have received.
Don't Forget …
- Consult a doctor, nurse or health care provider or visit a travel health clinic at least six weeks before you travel.
- What to do if you get sick when you are travelling.
- What to do if you get sick after you return to Canada.
- Know what vaccines you need and when to get them.
Other Related Information
Public Health Agency of Canada – Vaccine Preventable Diseases: Rabies
World Health Organization –
Rabies Fact Sheet
World Health Organization – Global Rabies Map
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