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Rabies

By Dr. Mark Wise

Rabies is a very low risk for short term travelers. My usual advice is "don't play with dogs and other moving animals".

Rabies is is a viral infection of the central nervous system, which when contracted by humans is thought to be 100% fatal in the absence of proper pre- or post exposure vaccination. It is transmitted by the bite, scratch or rarely a lick from infected animals, most commonly dogs. Cats, bats and monkeys may also be infectious. In many countries of the world, stray dogs, many of whom may have rabies, are a tremendous problem. Not all dogs behave like Old Yeller (if you remember the Disney movie from the 1950s). Rather, they may be docile, and rather pathetic looking. Just the kind of animal youd love to pet! Dont!

Pre-exposure vaccination, which consists of 3 injections over 30 days (days 0 - 7 - 30), is only recommended for those at the highest risk. This may include those with occupational exposure (veterinarians, spelunkers), or others who by nature of the location and duration of their travels might be exposed. Children, who are reputed not to have the same common sense as adults, may be at greater risk. Pre-exposure vaccination does not preclude the need for further injections after a potentially rabid bite.

If such a bite occurs, it is imperative that the bite be thoroughly cleansed with soap and water. If one has received pre-exposure vaccination, then there is still a need for 2 further injections (on days 0 and 3) of vaccine after exposure. For the person who has not previously been vaccinated, it is necessary to receive HRIG (Human Rabies Immune Globulin) as quickly as possible. This provides some immediate protection. As well, immunization with the rabies vaccine on days 0,3,7,14 and 28 should be started. Human rabies immune globulin (HRIG) is sometimes exceedingly expensive, and/or difficult to find in some of the more remote parts of the world. It is not exactly cheap back home either!

© Copyright 2000 Dr. Mark Wise


Dr. Mark Wise is the director of The Travel Clinic (TM)) in Thornhill, Ontario, Canada and the Medical Director of The Travel Wise (TM) Clinic in Scarborough, Ontario, Canada. He is a family physician with training from the London School of Tropical Medicine in Tropical Diseases. He is a parent himself and often see potential adoptive parents in his clinic. Dr. Wise gives lectures and writes articles on the subject of travel medicine, for both medical and non-medical groups.

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