Taking the Bite Out of Vaccination

With the right knowledge and technology, prevalence of rabies need not stop you from visiting some of the most interesting and wonderful places in the world. But please exercise caution, and in the event you or someone in your party is bitten, do not leave anything to chance.

Summer is a time for travel; for broadening horizons and spending quality time with loved ones. While for many this means heading off to the nearest beach or national park, an increasing number of us now seek adventure and new experiences further afield in less developed regions of the world. Adventure holidays such as these are of course culturally enriching, life-affirming and economically beneficial for the host country. They can, however, also spell danger if the correct precautions are not taken, with rabies, among other diseases, remaining a potent threat in many parts of the world.

Human rabies cases in the US may be few and far between, and even more rare in Europe, but they are on the rise in many parts of the developing world. In total, around 55,000 people die each year from rabies, the majority having contracted the disease from a dog bite. Most of the deaths occur in India and sub-Saharan Africa, although parts of South East Asia and Latin America continue to be prone to the disease.

In the interests of increasing awareness of the dangers of the world's most fatal disease - but certainly not wanting to discourage travel to rabies-prone areas - it is worth examining the conditions that contribute to the ongoing threat of rabies to human health.

One reason is the fact that free-roaming dog populations are on the rise in certain countries where rabies has historically been high. In some cities in India, for example, where there are an estimated 30 million stray dogs, publicly funded programmes to sterilise dog populations cannot keep up with the growth in population.

Another problem is awareness. Most victims of rabies are children, as lack of education prevents them from having the knowledge to treat stray animals cautiously. In the US, an estimated 45% of all families own dogs, but it is important for kids travelling abroad to be made aware that the animals they may meet on holiday may not be vaccinated and could therefore represent a danger to life. The same goes for adults as tragically, many die after failing to seek immediate treatment.

Last is adequate access to healthcare. Rabies is entirely preventable even after a bite so long as medication is administered before the disease reaches the central nervous system, but sadly many people die of rabies because they either do not have access to post-exposure prophylaxis or they cannot afford the multiple injections needed after a bite.

So what to do when travelling to places where rabies is present. First thing is to ensure your children and other members of your family know that if they are bitten or scratched by an animal, that they immediately tell you. Safe and effective rabies vaccines are available and can protect anyone exposed to rabies even after they have been bitten. In some cases, when families are traveling to remote regions, vaccines may not be readily available. In this case, consider getting your family vaccinated before you travel to add extra protection against rabies.

If anyone is bitten or scratched by an animal during their travel to a rabies endemic country, the first thing to do is wash the wound for fifteen minutes with soap and water then seek medical advice. Vaccines are available in every city and most local clinics, although less easy to find in the more remote areas.

With the right knowledge and technology, prevalence of rabies need not stop you from visiting some of the most interesting and wonderful places in the world. But please exercise caution, and in the event you or someone in your party is bitten, do not leave anything to chance.

The author is Chief Executive Officer at the Global Alliance for Rabies Control

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