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A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Fri 19 De 2008
Source: Health Protection Agency Report, Vol. 2, No. 51 [edited]
Case of imported rabies in the UK
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A case of imported human rabies has been identified in Northern
Ireland. The diagnosis was confirmed by tests on samples sent to the
United Kingdom National Reference Laboratory for Rabies at the
Veterinary Laboratory Agency, Weybridge, Surrey. The patient had
worked as a volunteer with animals in South Africa for short periods
during the past 2 years, and had close contact with various animals
including dogs. Rabies is endemic in South Africa where bites from
infected dogs are the main source of rabies in humans.
In the last 10 years there have been 3 previous cases of imported
human rabies in the UK. Although an estimated 55 000 cases of
classical rabies occur worldwide each year, there has never been a
virologically confirmed case of natural human to human transmission
of rabies. Despite the lack of evidence for human to human
transmission, some people who have been exposed to the secretions of
a patient with rabies may be offered post-exposure immunisation,
purely as a precautionary measure.
If bitten, scratched, or licked by a warm blooded animal in a
rabies-endemic country, people should wash the wound or site of
exposure (e.g., mucous membrane) with plenty of soap and water and
seek medical advice without delay, even if previously vaccinated. If
they do not seek medical treatment while abroad, they should still
seek it when they come home, even if some time after the event.
Following exposure an individual risk assessment should be undertaken
to determine the need for post-exposure prophylaxis (PEP) with rabies
vaccine and/or immunoglobulin. PEP is highly effective in preventing
rabies if given promptly and there have been no cases of rabies in
the UK in people who have received rabies post exposure prophylaxis.
Travellers should always be advised to seek travel health advice well
in advance of their visit overseas to ensure that the risks of all
travel associated illness, not just rabies, have been explained.
Although rabies vaccine is not routinely advised for all travellers,
pre-exposure immunisation is recommended for those:
- working abroad (e.g., veterinary staff or zoologists) who by the
nature of their work are at risk of contact with rabid animals;
- living in or travelling for more than one month to rabies-enzootic
areas unless there is reliable access to prompt, safe medical care;
- travelling for less than one month to enzootic areas but who may
be exposed to rabies because of their travel activities;
- those who would have limited access to post-exposure medical care.
This advice should be specifically brought to the attention of those
planning to do voluntary work with animals in rabies-endemic areas.
Further information on rabies prevention for the traveller is
available from the National Travel Health Network and Centre at:
information on rabies is available in chapter 27 of the Green Book [1].
Reference:
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(1) DH. Immunisation against infectious disease ("the Green Book").
Available at:
posted in the interest of the traveling public; by Walter M Woolf, V.M.D. .. Principal Owner & Managing Director - Air Animal Pet Movers .. providing relocating pet owners with pet moving logistics and solutions.
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