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Read moreNHS Choices - Introduction
(18/02/2015)
Rabies is a very serious viral infection that targets the brain and nervous system. You can catch rabies if you are bitten by an infected animal and haven't been vaccinated.
It's almost always fatal unless treated very early.
In the UK, rabies has largely been eliminated from the animal population and infections 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 infected by an animal while abroad.
Although rabies is almost non-existent in the UK, you should also seek immediate medical help if you're bitten or scratched by a bat or a pet without a known 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
- apply antiseptic or alcohol to clean the wound
- leave the wound open
- go to the nearest hospital or medical centre and explain that you've been bitten
How rabies spreads
Rabies can spread to humans from infected animals through a bite, a scratch, or a lick to broken skin or 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 and spreads to the salivary glands, lungs, kidneys and other organs.
Animals that carry rabies
All mammals can carry the rabies virus, but the following species are more commonly infected:
- dogs
- bats
- raccoons
- foxes
- jackals
- cats
- mongooses
- monkeys
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:
- tingling and itchiness at the site of infection
- high temperature (fever)
- an irrational fear of water (hydrophobia)
- sensitivity to light (photophobia)
- fear of drafts of air (aerophobia)
- aggressive behaviour
An animal with rabies may also have some of these symptoms, although some symptoms – such as hydrophobia – only occur in humans.
Read more about the symptoms of rabies.
Treating rabies
If there is a high risk that you have rabies in its early stages (soon after exposure, before you have any symptoms), you'll be given a course of treatment known as post-exposure prophylaxis.
This usually involves cleaning the site of contamination and administering a course of the rabies vaccine, in an attempt to prevent the infection spreading to the brain and nervous system. In most cases, post-exposure prophylaxis is effective.
If rabies 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.
There are currently no tests to identify rabies before it reaches a fatal stage. A diagnosis is based on the likelihood that you have the infection – for example, whether you've visited somewhere with high rates of the disease and if you may have been bitten by a potentially infected animal.
Various tests, including a skin biopsy, saliva tests or blood tests, can be used to diagnose rabies in its later stages.
Read more about treating rabies.
Vaccination
A number of vaccines can be used to prevent a rabies infection developing.
Routine vaccination is usually only recommended if you regularly work with potentially infected animals or are travelling to a part of the world known to have high levels of rabies and limited medical care.
Public Health England provides a detailed list of countries that have rabies on the GOV.UK website.
Most people going on a standard holiday (as opposed to trekking or living and working in rural areas) won't need a rabies vaccine.
Read more about the rabies vaccination.
Avoiding rabies
When travelling in countries that aren't rabies-free, don't touch unknown animals and educate your children about the dangers of petting them. Examine your children regularly for cuts and scratches following contact with any animal, and ask how they got them. Make sure they know that being bitten by an animal is dangerous and they need to tell you about it.
Quarantine and the Pet Travel Scheme (PETS)
To keep countries rabies-free, it's important that 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 (PETS) 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 that people in the UK can take their dogs, cats and ferrets to other European Union (EU) countries and return with them to the UK.
How common is rabies?
There are an estimated 55,000 deaths from rabies each year worldwide. Most cases occur in the developing world, particularly in Africa and Asia.
As a result of strict UK quarantine laws in regards to transporting animals, as well as the introduction of the PETS, 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.
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 0845 1300 228 for advice.
The last recorded case of rabies in the UK was in May 2012. The patient, who died, contracted the disease after being bitten by a dog in India.