Rabies while traveling: when is it wise to get vaccinated?

How high is the risk of rabies while traveling?

Rabies is an infectious disease caused by the rabies virus. The virus can be transmitted through a bite or scratch from an infected animal. A lick on an open wound or mucous membrane can also pose a risk.

Most infections result from contact with dogs, but other mammals can also transmit the virus, such as cats, monkeys, and bats.

The risk varies greatly depending on the destination. The way you travel also plays a role. Someone staying in a city for two weeks faces a different risk than someone traveling through a high-risk area for months or spending a lot of time in remote locations.

Rabies is rare among Dutch travelers. Nevertheless, we take the disease seriously. Once someone develops symptoms of rabies, treatment is no longer possible and the disease is fatal. After possible contact with an infected animal, it is therefore important to take immediate action.

Why do we discuss rabies during a travel consultation?

An important part of protecting yourself against rabies is actually very simple: don’t touch any animals while you’re traveling.

That sounds easier than it sometimes turns out to be.

A dog near your lodging seems friendly. A cat comes and sits next to you while you’re eating. Monkeys are running around at a tourist attraction. Children see a puppy and want to pet it.

It’s precisely in these kinds of everyday situations that contact with animals occurs.

That’s why, during a travel consultation, we discuss not only vaccination but also what you can do yourself to reduce the risk: don’t pet dogs or cats, don’t feed or touch monkeys, and leave bats alone.

When might a rabies vaccination be advisable?

Not every traveler to a country where rabies is present needs to get vaccinated in advance.

Whether vaccination is advisable for you depends on various factors. For example, vaccination may be more relevant if:

• you’re staying in a high-risk area for an extended period;
• you frequently travel to countries where rabies is present;
• you cycle a lot or engage in other activities that put you in closer contact with animals;
• you’re traveling with young children;
• you’re visiting remote areas during your trip;
• adequate medical care is not always readily available;
• your work or activities bring you into frequent contact with animals.

That doesn’t automatically mean you need a rabies vaccine. During a travel consultation, we’ll look at the big picture and discuss the pros and cons of vaccination.

Why get vaccinated if you still need treatment after a bite?

This is an important question.

Getting a rabies vaccination before you leave doesn’t mean you don’t have to do anything after a bite or scratch. Even if you’ve been vaccinated, you must take immediate action after possible exposure to rabies.

The main difference lies in the follow-up treatment.

If you’ve been fully vaccinated beforehand, treatment after a possible exposure is simpler. You’ll still need additional rabies vaccinations, but you won’t need rabies antibodies, also known as MARIG.

If you have not been vaccinated beforehand, more extensive treatment is required. You will need multiple vaccinations and, in certain cases of exposure, MARIG as well. It is precisely these antibodies that are not equally readily available everywhere in the world.

For some travelers, this is an important reason to get vaccinated before departure.

Read more about the vaccine, the vaccination schedule, and post-exposure treatment on our page about the rabies vaccine.

Traveling with children requires a different approach

I didn’t get vaccinated against rabies myself until about ten years after my first long-distance trip.

When I had children and started traveling with them, I began to view the risk differently. Children are curious and are more likely to interact with animals. A dog, cat, or monkey can seem especially fun and interesting to them.

In addition, children don’t always tell you if an animal has scratched or bitten them. A small scratch might not be immediately noticeable.

That doesn’t mean every child traveling to a high-risk area needs to be vaccinated. Traveling with children is, however, a factor we take into account when weighing the risks.

Prevention remains important

Even if you’ve been vaccinated, it’s still wise to avoid contact with animals as much as possible.

A few practical rules:

• Don’t pet dogs or cats, even if they seem tame.
• Don’t feed monkeys or try to touch them.
• Don’t let children play with unfamiliar animals.
• Never touch bats.
• Avoid attractions where direct contact with wild animals is part of the experience.

An animal doesn’t have to look sick to pose a risk.

If you’re bitten, scratched, or licked: What should you do?

What if you’re bitten or scratched by an animal while traveling? Or what if an animal licks an open wound or mucous membrane? Take immediate action.

Rinse the wound thoroughly with plenty of water and soap for at least fifteen minutes, then disinfect it with 70% alcohol or iodine.

Next, contact your travel insurance provider or health insurance provider’s emergency number immediately and seek medical attention. Do this even if you were vaccinated against rabies before your trip.

The treatment you need depends, among other things, on how you came into contact with the animal and whether you were fully vaccinated beforehand.

A dog bite in Thailand

We regularly receive questions from travelers who have come into contact with an animal during their trip.

For example, we received a call from a traveler who had been bitten by a dog in Thailand. He had not been vaccinated against rabies before departure and went to a hospital there. He began a course of rabies vaccinations at the hospital.

Later, uncertainty arose as to whether his follow-up treatment had been administered strictly according to the required schedule. Understandably, this caused a great deal of concern.

A situation like this illustrates why we discuss rabies before departure. Not because every traveler needs to get vaccinated, but because it’s important to know what the risk is and what to do if you do come into contact with a potentially infected animal.

Rabies vaccination: a personal decision

The risk of contracting rabies while traveling is usually low. However, the consequences can be severe if you do not receive the proper treatment in time after coming into contact with a potentially infected animal.

That’s why, when providing travel advice, we don’t just consider the likelihood of being bitten or scratched. We also take into account your destination, the duration of your trip, your planned activities, who you’re traveling with, and how easily you can access medical care while you’re there.

Based on this information, we’ll discuss whether a rabies vaccination is advisable for your trip.

Would you like to know if vaccination is right for your trip? Make an appointment for personalized travel advice. During the consultation, we’ll discuss your travel plans and the appropriate protection for your trip.

Marchel Ratering, registered travel nurse and director of Vaccinatiecentrum.nl