Introduction

Rabies is a very serious viral infection that targets the brain and nervous system.You can catch rabiesif you are bitten by an infected animal and haven't been vaccinated.

It's almost always fatal once symptoms develop, but can be prevented if treatment is given promptly after exposure.

In the UK, rabiesis not found in the animal population (with the exception of bats) andinfections are almost always picked up during travel abroad.

When to seek medical help

Seek immediate medical advice if you're worried that you or your child may have been bitten, scratched or licked by an animal while abroad, or if you're bitten or scratched by a bat in any country, including the UK.

Althoughrabies is unlikely, you should also seek immediate medical help if you're bitten or scratched by a pet that has travelled abroad and has an uncertain vaccination history.

If you've been bitten or scratched, you should:

• wash the wound thoroughly with soap and water under a running tap for 15 minutes
• applyantiseptic or alcohol to clean the wound
• leave the wound open
• go to the nearest hospital or medical centre and explain thatyou've been bitten

If the incident happens abroad, you should seek local medical help and not wait until you have returned to the UK.

How rabies spreads

Rabies can be spread to humans from infected animals through a bite, scratch or lick to broken skin, the mouthor the eye. You may also be at risk if an animal spits in your face. In very rare cases, rabies can be spread during an organ transplant.

Once it enters the body, the rabies virus multiplies before spreading into nerve endings. It then travels to the spinal cord and brain (the central nervous system). Once the virus is in the central nervous system, it multiplies rapidly andspreads to the salivary glands, lungs, kidneys and other organs.

Animals that carry rabies

All mammals, including monkeys,can carry the rabies virus, but the following species are more commonly infected:

• dogs
• bats
• raccoons
• foxes
• jackals
• cats
• mongooses

What are the symptoms?

It can take a while for symptoms to develop, but when they do the condition is almost always fatal.

Symptoms in humans can include:

• a high temperature (fever)
• an irrational fear of water (hydrophobia)
• sensitivity to light (photophobia)
• fear of drafts of air (aerophobia)
• confusion or aggressive behaviour

This is known as post-exposure treatment.

It's important this is done before you develop symptoms. Once symptoms develop, the infection cannot be treated and it's almost always fatal.

Post-exposure treatment (preventing rabies)

Post-exposure treatment usually involves administering a course of the rabies vaccine, with or without rabies immunoglobulin,in an attempt to prevent the infection spreading to the brain and nervous system. If started promptly, post-exposure treatment is very effective.

However, if rabies infection reaches a stage where it causes symptoms, it's almost always fatal.In these cases, treatment will usually focus on making you as comfortable as possible.

Rabies can only be diagnosed once you have developed the disease and get symptoms. Various tests, including a skin Biopsy , saliva tests or blood tests , can be used to make the diagnosis.

Routine (pre-exposure) vaccination is usually only recommended if you regularly work with potentially infected animals orare travelling to a part of the world known to have high levels of rabies and limited medical care.

A course of rabies vaccine can also prevent rabies from developing after a potential exposure, provided it is started promptly. Before you travel, you should seek advice about whether you need a rabies vaccination.For more information, visit the Travel Health Pro website .

Examine your children regularly for cuts and scratchesafter contact with any animal and ask how they got them. Make sure they know that being bitten orlickedby an animal may be dangerous and they need to tell you about it.

It's rare for bat rabies viruses to infect other animals, and the risk of human infection is thought to be low. Nevertheless, if you find an injured bat or a bat that needs to be moved, don't touch it. Call the Bat Conservation Trust helpline on 0345 1300 228 for advice.

Quarantine and the Pet Travel Scheme (PETS)

To keep countries rabies-free, it's important there are strict public health measures to control stray animals such as foxes.

The movement of potentially infected animals across borders into uninfected regions is controlled by strictly enforcing quarantine regulations. Animals that don't have a licence shouldn't be brought into the UK.

The Pet Travel Scheme is a system that allows pet dogs, cats and ferrets from certain countries to enter the UK without going into quarantine as long as they have been vaccinated. It also means people in the UK can take their dogs, cats and ferrets to other European Union (EU) countries and return with them to the UK.

More information can be found on the GOV.UK website .

How common is human rabies?

There are an estimated 60,000 deaths from human rabies each year worldwide. Most cases occur in the developing world, particularly in Africa and Asia.

Asa result of strict UK quarantine lawsregarding transporting animals, as well asthe introduction of the Pet Travel Scheme, the UK has been rabies-free since the beginning of the 20th century, with the exception of a rabies-like virus in a single species of bat.

There have been no cases of human rabies acquired in the UK since 1902, apart from a case of rabies acquired in a bat-handler from an infected bat in 2002. The last recorded case of rabies in the UK was in 2012.The patient, who died, contracted the disease after beingbitten by a dog in India.