Rabies

What is rabies?

Rabies is an infection that affects your brain and central nervous system. It’s caused by a type of virus called a lyssavirus. You can get rabies from a bite or scratch from an infected animal.

In very rare cases, rabies can also be contracted from an organ transplant.

Rabies in humans is almost always fatal (causes death), but prompt treatment can stop the infection from developing.

Australia is one of the few countries in the world that does not have rabies. However, Australian bats carry other viruses in the lyssavirus family including Australian bat lyssavirus, which is closely related to rabies.

What are the symptoms of rabies?

Rabies symptoms usually first appear 2 to 3 months after being exposed to the virus. But they can appear anywhere from a week to a year after exposure. Symptoms include:

• fever
• hydrophobia (fear of water)
• aerophobia (fear of air)
• a choking feeling

Other symptoms of rabies in humans can include:

• hypertension (high blood pressure)
• too much saliva in your mouth
• tachycardia (your heart beats faster than normal)
• hyperthermia (high body temperature)

Once symptoms appear, there is no treatment for rabies. The illness progresses rapidly causing paralysis, delirium, convulsions and death, usually within a week or 2.

What causes rabies?

Rabies is caused by infection with the rabies virus. You can catch the virus from infected animals through:

• bites and scratches
• their saliva via your eyes, mouth, nose or broken skin

Overseas, rabies occurs in many animals including:

• dogs
• bats
• monkeys
• foxes
• raccoons
• skunks
• jackals
• mongooses

More than 9 out 10 cases of rabies in humans are caused by bites from infected dogs.

Animals in Australia do not have rabies. However, Australian bat lyssavirus is found in Australian bats. It can be transmitted from bats to humans via a bite or scratch from an infected bat.

While it’s very rare, you should assume that any bat in Australia could potentially carry the virus.

When should I see a doctor?

If you are overseas and are bitten or scratched by an animal you should:

• immediately wash the wound thoroughly with soap and water for 15 minutes
• after washing, apply an iodine containing medicine or anti-viral medicine
• do not cover the wound
• get medical attention as soon as possible — even if you’ve had the rabies vaccine

If you are bitten or scratched by a bat in Australia, you should:

• immediately wash the wound thoroughly with soap and water for 15 minutes
• after washing, apply an iodine containing medicine or anti-viral medicine
• do not cover the wound
• get medical attention as soon as possible

How is rabies diagnosed?

Your doctor will talk to you about what happened and whether you have any symptoms. Your doctor may:

• test your saliva
• do blood tests
• take a biopsy (a small sample of skin) from the back of your neck
• test your spinal fluid with a lumbar puncture

How is rabies treated?

Treatment for rabies should start straight away, even if your diagnosis is not confirmed. This is called post-exposure prophylaxis (PEP) and is done to prevent infection from developing.

If you have been exposed to the rabies virus, your doctor will give you post-exposure rabies vaccine. Some people will also be given antibodies called human rabies immunoglobulin. These can help you fight the infection.

A series of rabies vaccinations must then be given over time, usually over 2 weeks.

If you receive treatment abroad, ask for a post-exposure prophylaxis (PEP) certificate. This should list:

• what immunoglobulin was used
• how much was used
• the vaccine batch number
• the route it was given
• the dates it was given
• the contact details of the clinic you attended

Show this information to your doctor as soon as you return to Australia. You may need more treatment in Australia.

Can rabies be prevented?

Rabies can be avoided through vaccination.

It’s also important to stay away from animals when travelling in areas where rabies occurs.

Reducing risk of rabies

There are ways to reduce your risk of exposure to rabies when in a country with rabies:

• Avoid close contact with all animals — this is especially important for children.
• Avoid contact with stray dogs or cats.
• Do not allow children to feed, pat or play with animals.
• Do not carry food, and do not feed or pat monkeys. Try not to focus on monkeys carrying their young, as they may feel threatened and bite suddenly.
• Avoid contact with bats anywhere in the world, including Australia.
• Know what to do if you are bitten or scratched by an animal.

Follow these steps even if you have received the rabies vaccine.

Speak to your doctor if you are travelling to a country where there is a rabies virus risk. You may benefit from vaccination.

Rabies vaccine

Vaccination is your best protection against rabies. The vaccine can be given before exposure to rabies. This is called pre-exposure prophylaxis (PrEP). This table tells you more about the rabies vaccine.

Complications of rabies

Rabies is almost always fatal, once symptoms appear.