Rabies 

Percutaneous

Bite or scratch from an infected animal, including bats, foxes, monkeys and other free-roaming animals.
Dogs are the source of the vast majority of human rabies death.
Transmission can also occur when infectious material, usually saliva, comes into direct contact with human mucosa or fresh skin wounds.

55,000 deaths  (vast majority occurring in rural areas of Africa and Asia) worldwide annually (estimated)

Symptoms

Fever, wound site pain, unusual tingling, pricking or burning sensation around the wound site.
 

Severe case

Inflammation of the brain and spinal cord, hyperactivity, hydrophobia, loss of consciousness, death.
 

Prevention

●Precautions against rabies, including avoiding animal bites and receiving vaccinations (pre-exposure, for travelers to endemic areas), should be considered.
-Pre-exposure immunization does not eliminate the need for careful wound management and post-exposure immunization
●Avoiding risk situations for animals bites
Thorough wound cleaning initiated as soon as possible after exposure.
●Vaccination and immunoglobulin (post-exposure, for all exposed people)
-It is important to consider the destination, the purpose and the duration of the trip as well as the patient’s access to healthcare and th availability of rabies biologics.
-For post-exposure vaccination to work, it is essential that medical expertise be available on an urgent basis

 

Vaccine

Pre-exposure prophylaxis is recommended for anyone who will be at continuous, frequent, or increased risk of exposure to the rabies virus. This includes  travel to the highest-prevalence countries and travelers who belong to one of the following groups:

• Long-term travelers or expatriates going to a risk country

• Short-duration travelers at high risk for exposure during travel, such as those who are very likely to come in contact with animals and where immediate access to appropriate medical care, including rabies vaccine and human rabies immunoglobulin, may be limited

• Individuals with potential occupational exposure

• Individuals with cumulative exposure due to frequent trips to endemic areas