In this week's British Medical Journal, experts warn travellers to getvaccinated and avoid animals when visiting areas such as Africa, Asia,Latin America, and the Middle East, where rabies is common. They shouldalso seek urgent help if they are bitten or scratched.
Their warning comes after the recent death of a British woman, bitten by a dog during a two week holiday in Goa, India.
Rabies is an acute viral infection of the central nervoussystem. The virus is usually transmitted through a dog bite, andresults in at least 40,000 deaths worldwide every year.
Around 90% of deaths occur in the developing world,particularly in India, where dogs that roam freely are largelyresponsible. Rabies is rare in the UK, where just 12 cases have beenreported since 1977, 11 contracted abroad and one rare case acquiredfrom a bat in the UK.
A team of researchers describe the case of a woman in her late30s who was admitted to hospital with shooting pain in her lower backand left leg. Three and a half months earlier, she had been bitten by apuppy on a lead during a two week holiday in Goa.
It left a slight graze, but she did not seek medical help, andshe had not received a vaccination before travelling. She was diagnosedwith rabies and died after 18 days in hospital.
This case serves as an important reminder of the risk of rabiesfor any traveller to a country where rabies is endemic, even touristson a short visit to a holiday resort, say the authors.
Travellers need to know whether they are visiting a countrywhere rabies is endemic, and that any dog bite must be taken seriously,even an apparently innocuous bite from a pet.
The risk can also be reduced by avoiding contact with animalsthat might be susceptible to rabies, adds Professor Derrick Pounder inan editorial. Ignoring freely roaming dogs and cats may go against theinstincts of animal loving travellers to developing countries, but itis a necessary precaution. Wildlife should be appreciated at a distance.
Paralytic rabies after a two week holiday in India BMJ Volume 331, pp 501-3
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