In 2002, more than 10 million people from Germany traveled to rabies risk areas. The risk of contracting the disease is underestimated by many travelers – mostly due to a lack of information. In a survey of 1,200 travelers, more than 95 percent were not protected against rabies. Preventive vaccination against rabies, along with other travel vaccinations such as hepatitis A or typhoid fever, has so far played only a minor role. And this, although a rabies disease, once it has broken out, always leads to death!
Every year, about 60,000 people worldwide die from rabies
Especially in popular travel countries with constantly increasing numbers of vacationers, such as lndia, Thailand, Brazil, Indonesia, Tanzania, Mexico, Dominican Republic or even in Turkey, rabies is widespread. Dogs are the most common carriers of rabies; in South America and Asia, stray dogs cause about 90% of all rabies cases. However, other animals such as cattle, sheep, and poultry can also transmit rabies.
The causative agent of rabies – a virus – is excreted in saliva, which in dogs may already contain virus before the onset of the disease. A large part of the deaths is in Asia. Very few vacationers are aware of the risk of infection to which they are exposed.
The treacherous thing is that once the disease has broken out, there is no medical treatment, it always leads to death. The only life-saving measure is the immediate vaccination after a rabies-suspicious animal contact! Therefore, every traveler should inform himself about the risk of rabies infection and about a possible preventive vaccination before his trip.
Suspected rabies – what to do?
Rabies can be prevented – even shortly after infection – by vaccination, but is fatal once the typical signs of the disease (convulsions, photophobia and aversion to water) have appeared. The best protection against rabies is to prevent an animal bite or contact with saliva. Who nevertheless had contact with a rabies-suspicious animal, must immediately visit a physician or better immediately a hospital – even if a vaccination was already made before!
That means: If an infection is suspected, a postexposure treatment must be started as soon as possible (vaccination after contact with a rabid animal). Vacationers without complete preventive rabies protection then require five vaccinations and possibly an additional rabies immunoglobulin (immunoglobulins are proteins that can ward off the rabies pathogen). In contrast, travelers with a complete basic immunization only need two booster vaccinations.
Know the risk and prevent with vaccination
The problem: In many travel countries, the supply of a rabies vaccine is not guaranteed – acquiring the vaccine is not only difficult, but not possible at all. In Germany, on the other hand, a well-tolerated and effective vaccine is available to travelers. Preventive rabies vaccination, which has already been carried out in Germany, can provide the necessary time until postexposure treatment can be initiated in the event of a case. The basic immunization consists of three vaccinations in the upper arm on days 0, 7, 21 or 28. The vaccine is well tolerated and is effective for about 3 years. A booster vaccination after one year can extend immunity to about 5 years.
Preventive rabies vaccination is a reasonable measure; however, the vaccination is quite expensive. Therefore, the individual risk situation should always be taken into account (e.g. long-term or active vacationers in areas with high rabies risk). In any case, vaccination is recommended when treatment options after infection are poor or nonexistent.
