Just as I was getting ready to write about a recent case of travel-associated rabies in the UK, a second suspected case has been identified in the UK. They’re not linked and it’s just a co-incidence that the two have been identified in a short period of time, but they highlight the potential risks of rabies during travel.
The first report is about a confirmed case of rabies in a woman in her 50s who was bitten by a dog in India. At last report, she was being treated in hospital, although the prognosis is presumably extremely poor if treatment was started after the onset of disease. Public health officials have investigated people who were in contact with the woman to determine who needs post-exposure treatment.
There’s not much information in the most recent report, beyond the fact that a suspected rabies case was detected in a person in Leeds following a dog bite that occurred abroad. There’s no information yet (at least that I’ve seen) about where the bite occurred, the condition of the patient or whether the person received medical care after the bite.
While travel-associated rabies is very rare, it’s almost always fatal. It’s almost 100% preventable too, and any cases that occur typically reflect a breakdown in knowledge, communication or medical care.
Knowledge/Communication: People need to know about rabies, and be aware that any bite from a mammal in a rabies-endemic area should be investigated as a potential rabies exposure. They need to know about the risk of rabies in areas they visit, and avoid situations that might lead to a bite. Travelers and non-travelers alike need to know to go to a physician after any bite and to ensure that rabies exposure is duly considered. Individuals traveling abroad need to know how to access the healthcare system where they are, communicate the problem and act as their own advocate to make sure things are taken care of properly.
Medical Care: With proper post-exposure treatment, rabies is almost 100% preventable. The problem is getting the treatment in a timely manner. Knowing to go to a doctor is one issue. Getting proper care once there is another, particularly in some countries where access to rabies vaccine may be limited or where the healthcare system is poor. Rabies exposure is a medical urgency, not an emergency (although the more severe the bite and the closer to the head, the more important it is for a prompt response). If someone has had a potential rabies exposure and they aren’t getting proper care, they need to get home (or somewhere else) where they can obtain the appropriate treatment. That doesn’t mean panicking and getting on the first flight out of the country, but it also doesn’t mean waiting until your planned vacation is over. It means getting home in good time, while not freaking out if it takes a day or two.