A fatal case of imported human rabies has been reported
in England. The patient was bitten by a dog while on holiday in Goa, India.
The diagnosis of rabies was confirmed by the United Kingdom National Reference
Laboratory for Rabies in Weybridge, Surrey .
In February of this year, a German woman died of rabies after spending
four weeks in India in late 2004 , and in May 2004, a man in Bavaria,
Germany died from a rabies infection that he acquired during his five month
stay in India . India reports at least 30 000 human deaths from rabies
per year .
There are risks associated with travel to rabies endemic countries .
Travellers should avoid all unnecessary contact with animals. If bitten
or scratched by a warm blooded animal they should wash the wound with plenty
of soap and water and seek medical attention immediately, even if previously
vaccinated. If they do not seek medical treatment while abroad, they should
seek it when they return to their home country, even if it is some time
after the event. Promptly administered post-exposure prophylaxis is extremely
effective in preventing rabies. For people who have not received any rabies
vaccine prior to a potential exposure, post-exposure prophylaxis consists
of a dose of vaccine as soon as possible after the bite followed by four
further doses 3, 7,14 and 30 days later. If the person has been previously
vaccinated, fewer doses of vaccine are required. Human rabies immunoglobulin
may also be given if the exposure is considered to be high risk.
Travel agents need to stress the importance of obtaining travel health
advice well before holidays or trips overseas to ensure that the risks of
all travel associated illness, not just rabies, have been explained.
In the United Kingdom, while rabies vaccine is not routinely advised for
all travellers, pre-exposure immunisation is recommended for those living
in or travelling for more than one month to rabies enzootic areas, unless
there is reliable access to prompt, safe medical services; those travelling
for less than one month in rabies enzootic areas but who may be exposed
to rabies because of their travel activities; and those who have limited
access to post-exposure medical services.