People who come into contact with wild or domestic mammals, including bats, in a rabies endemic country are at increased risk of rabies infection. This factsheet provides advice on how to reduce your risk of infection when travelling.
Rabies risk varies depending on where you are travelling and what activities are planned while abroad. The World Health Organisation (WHO) maintains maps of rabies-endemic countries, and The UK Health Protection Agency (HPA) maintains a list of rabies risk in land dwelling animals by country. Generally, the risk is highest in developing countries across Asia (including Bali), Africa and Central and South America; however, animals in developed countries have the potential to be infected and spread rabies.
Regardless of your destination, you should take the following measures to reduce your and your family’s risk of contracting rabies:
Even if previously vaccinated, if you are bitten or scratched by a bat anywhere or by a land dwelling mammal overseas, you should:
If you are at risk of infection, you may require treatment consisting of a combination of rabies immunoglobulin and rabies vaccine. If you have not been vaccinated previously, you will require an injection of rabies immunoglobulin as soon as possible and a series of either four or five rabies vaccine injections over one month. If you have been vaccinated before with a full course of vaccination, you will require two further doses of vaccine.
If exposure occurs while abroad, wherever possible you should seek treatment as soon as possible in that country. Rabies immunoglobulin may be difficult to obtain in some countries but vaccine is usually available.
If you do receive treatment while abroad, you should ask for a post-exposure prophylaxis (PEP) certificate, and obtain the following details (preferably in English), including the:
Upon returning to Australia, you should see a doctor to reassess the risk and complete the course of treatment where required. In NSW, your local public health unit will work with your doctor to assess your risk, and where indicated, will arrange for rabies vaccines and immunoglobulin to be delivered to your GP or hospital.
If the animal or bat can be observed or tested without placing other people at risk, health authorities may decide to delay your treatment for a short period of time. If it
is found that the animal is not a rabies risk, the course of vaccinations will not be required and can be ceased.
There is no available treatment for rabies once symptoms have started.