Rabies

Rabies is a virus carried in the saliva of infected mammals — most often dogs, but also cats, monkeys and bats — and passed on by a bite, a scratch or a lick on broken skin. It attacks the nervous system and once symptoms appear it is almost always fatal. It is present in most of Asia, Africa and Latin America, and causes around sixty thousand deaths a year. It is entirely preventable.

Why vaccinate before you go

Anyone bitten in a risk area needs urgent treatment, whether vaccinated or not. The difference is what that treatment involves. Someone who has had the pre-travel course needs two further doses of vaccine, which most clinics can give. Someone who has not needs rabies immunoglobulin as well — which is expensive, in short supply, and often simply unavailable outside major cities. The vaccine buys you time and options.

Who should have it

• Travellers to rural or remote areas where medical care is more than a day away.
• Anyone staying a month or more in a risk country.
• Runners, cyclists, trekkers and anyone likely to be around animals — including children, who are bitten more often and less likely to say so.
• Volunteers, vets and people working with animals.

The vaccine

Three injections at days 0, 7 and 21 to 28. Where time is short the third dose can be brought forward to day 21. The vaccine is suitable from birth. If you stay at risk — through your work, for instance — a booster at one year is recommended and then every three to five years; for everyone else a booster is worth considering ten years on.

If you are bitten or scratched

Wash the wound with soap and running water for several minutes, apply iodine or alcohol, cover it, and get medical help the same day. Tell them whether you have had the vaccine.

Not sure whether you need this one? Book the travel consultation instead and the pharmacist will go through your trip with you.