Rabies risk varies depending on where you are travelling and what activities are planned while abroad. The World Health Organisation (WHO) maintains maps of rabies-endemic countries, and The UK Health Protection Agency (HPA) maintains a list of rabies risk in land dwelling animals by country. Generally, the risk is highest in developing countries across Asia (including Bali and Timor-Leste), Africa and Central and South America; however, animals in developed countries have the potential to be infected and spread rabies.

Regardless of your destination, you should take the following measures to reduce your and your family’s risk of contracting rabies:

• Talk to your doctor about pre-travel rabies vaccination at least 1 month before departure (to allow enough time to receive a full vaccine course if required). Your doctor may recommend being vaccinated depending on the places you are planning to visit, your likelihood of interacting with animals, your access to emergency medical attention while abroad, and your personal health circumstances.
• Avoid contact with all wild and domestic animals (especially dogs, cats, bats and monkeys), and even if previously vaccinated, take precautions to avoid being bitten, scratched or exposed to their saliva through your nose, eyes or mouth.
• Do not allow children to feed, pat or play with animals; their height makes them particularly vulnerable to high-risk bites to the face, head and neck
• Avoid contact with stray dogs and cats, and remain vigilant when walking, running, cycling, riding scooters, or other activities that may provoke an animal to attack
• Do not carry food while outdoors and do not feed, pat or play with animals, even in popular tourist areas where travellers may be encouraged to interact with these animals.

What should I do if bitten, scratched or exposed to a potentially rabid animal?

Even if previously vaccinated, if you are bitten or scratched by a bat anywhere or by a land dwelling mammal overseas, you should:

• immediately wash the wound thoroughly with soap and water for at least fifteen minutes - proper cleansing of the wound reduces the risk of infection
• apply an antiseptic with anti-virus action such as povidone-iodine, iodine tincture, aqueous iodine solution or alcohol (ethanol) after washing
• seek medical attention as soon as possible to care for the wound and to assess whether you are at risk of infection and require preventive treatment.

If you are at risk of infection, you may require treatment consisting of a combination of rabies immunoglobulin and rabies vaccine. If you have not been vaccinated previously, you will require an injection of rabies immunoglobulin as soon as possible and a series of either four or five rabies vaccine injections over one month. If you have been vaccinated before with a full course of vaccination, you will require two further doses of vaccine.

If exposure occurs while abroad, wherever possible you should seek treatment as soon as possible in that country. Rabies immunoglobulin may be difficult to obtain in some countries but vaccine is usually available.

If you do receive treatment while abroad, you should ask for a post-exposure prophylaxis (PEP) certificate, and obtain the following details (preferably in English), including the:

• contact details for the clinic attended (telephone and email address)
• batch and source of immunoglobulin (RIG) used (note: equine RIG rather than human RIG may be used in some countries)
• volume of RIG administered
• type of vaccine used
• vaccine batch number
• the number of vials used
• route of vaccine administration
• date(s) of RIG and/or vaccine administration.

Upon returning to Australia, you should see a doctor to reassess the risk and complete the course of treatment where required. In NSW, your local public health unit will work with your doctor to assess your risk, and where indicated, will arrange for rabies vaccines and immunoglobulin to be delivered to your GP or hospital.

If the animal or bat can be observed or tested without placing other people at risk, health authorities may decide to delay your treatment for a short period of time. If it is found that the animal is not a rabies risk, the course of vaccinations will not be required and can be ceased.

How is it treated?

There is no available treatment for rabies once symptoms have started.

Further information

• NSW Health Rabies and Australian bat lyssavirus fact sheet
• NSW Health Staying safe and healthy overseas
• Translated information on rabies
• ​Smart Traveller Australia