What is rabies?

Rabies is an infection that affects your brain and central nervous system. It's caused by a type of virus called a lyssavirus. You get rabies from a bite or scratch from an infected animal.

In rare cases, you can get rabies from an organ transplant.

Rabies in humans is almost always fatal (causes death). Prompt treatment can stop the infection from developing.

Australia is one of the few countries in the world that does not have rabies. However, Australian bats carry viruses that are related to rabies including Australian bat lyssavirus.

Can rabies be prevented with a vaccine?

Yes, vaccination prevents (stops) you from getting rabies.

Speak with your doctor if you are travelling to a country that has rabies. You may benefit from the vaccine.

Rabies vaccine

Vaccination is your best protection against rabies. There are 2 rabies vaccines available in Australia.

Pre-exposure prophylaxis (PrEP) is when you get the vaccine before contact with the rabies virus.

Post-exposure prophylaxis (PEP) is when you get the vaccine after contact with the rabies virus.

This table tells you more about the rabies vaccine.

Find out more about the rabies vaccines that are available in Australia.

What are the symptoms of rabies?

Rabies symptoms may start with:

• fever
• sore throat
• vomiting
• headaches

This may be followed by:

• a changed mental state, agitation or hyperactivity
• tremors
• hydrophobia (fear of water)
• aerophobia (fear of air)
• dysphagia (difficulty swallowing)
• too much saliva in your mouth
• enlarged pupils

Rabies symptoms usually appear 2 to 3 months after contact with the virus. But they can appear anywhere from one week to one year after exposure.

Once symptoms of rabies appear, there is no treatment to cure rabies.

What causes rabies?

The rabies virus, and bat lyssavirus both cause the clinical syndrome that is rabies. You can catch the virus from infected animals through:

• bites and scratches that break your skin
• contact with the virus via your eyes, mouth or nose

Many animals in overseas countries carry rabies including:

• dogs
• bats
• monkeys
• foxes
• raccoons
• skunks
• jackals
• mongooses

More than 9 in 10 cases of rabies in humans are due to bites from dogs.

Who is most at risk of rabies?

You have an increased chance of rabies if you have contact with mammals in a country where rabies often occurs.

Animals in Australia do not have the rabies virus. However, Australian bats may have Australian bat lyssavirus (ABLV) which also causes rabies.

ABLV is passed from bats to humans via a bite or scratch. People who handle bats in Australia are at risk of ABLV infection.

While it's very rare, you should assume that all bats in Australia carry the virus.

When should I see my doctor?

If an animal that may have rabies scratches or bites you, go to hospital straight away. This includes scratches and bites from bats. You still need to see a doctor even if you have had the rabies vaccine.

See your doctor or visit a travel medicine clinic before travelling overseas. They will decide whether you need the rabies vaccine. They will consider things like:

• where you are going
• how likely you are to be near animals
• what emergency medical care is nearby

How is rabies diagnosed?

Your doctor will talk to you about what happened and whether you have any symptoms. Your doctor may:

• test your saliva
• do blood tests
• take a biopsy (a small sample of skin) from the back of your neck
• test your spinal fluid with a lumbar puncture

Rabies is a notifiable disease. This means that any cases of rabies must be reported to the local health authorities.

How is rabies treated?

If an animal that may have rabies scratches or bites you, go to hospital straight away. This includes scratches and bites from bats. You still need to see a doctor even if you have had the rabies vaccine.

If you have been exposed, treatment for rabies should start straight away, even before a diagnosis. This is because rabies almost always causes death once symptoms appear.

This is called post-exposure prophylaxis (PEP) and stops the infection from developing.

First-aid after an animal bite or scratch when overseas

If you get an animal bite or scratch when overseas, you should:

• wash the wound with soap and water for 15 minutes straight away
• after washing, use an iodine-containing medicine or anti-viral medicine
• do not cover the wound
• see a doctor as soon as you can — even if you've had the rabies vaccine

First-aid after a bat scratch or bite in Australia

If you get a bat bite or scratch in Australia, you should:

• wash the wound with soap and water for 15 minutes straight away
• after washing, use an iodine-containing medicine or anti-viral medicine
• do not cover the wound
• see a doctor as soon as you can

Medicines for rabies — post-exposure prophylaxis (PEP)

If you have had contact with the rabies virus, your doctor will give you post-exposure prophylaxis (PEP).

If you are unvaccinated (have not had the rabies vaccine), you will need:

• an injection of human rabies immunoglobulin as soon as possible
• 4 or 5 rabies vaccine injections over 1 month

The human rabies immunoglobulin (HRIG) helps you fight the infection, while your immune system responds to the rabies vaccine.

If you've had a full course of rabies vaccination, you will need 2 more doses of vaccine.

The number of vaccine doses you need will depend on:

• how you came into contact with the virus
• the animal involved
• your immune status
• whether you've already been vaccinated against rabies

Treatment abroad

If you get treatment abroad, ask for a post-exposure prophylaxis (PEP) certificate. This should list:

• the type of immunoglobulin used
• the dose (how much) used
• the vaccine batch number
• how it was given
• the dates you were treated
• contact details of the clinic you attended

Show this information to your doctor as soon as you get back to Australia. You may need more treatment in Australia.

What are the complications of rabies?

Rabies is almost always fatal once symptoms appear. The illness will progress quickly causing:

• paralysis
• delirium
• convulsions
• death — within 1 to 2 weeks of getting symptoms

Can rabies be prevented?

Rabies can be prevented through vaccination. PrEP vaccination occurs before exposure to the virus. PEP vaccination happens after exposure to the rabies virus.

It's also important to stay away from animals when travelling in areas where rabies occurs.

Lowering my risk of rabies

There are ways to lower your risk of contact with the virus when in a country with rabies.

• Do not get close to animals — this is especially important for children.
• Do not touch stray dogs or cats.
• Do not allow children to feed, pat or play with animals.
• Do not carry food, and do not feed or pat monkeys. Try not to look at monkeys that have babies, as they may feel threatened and bite suddenly.
• Do not touch bats anywhere in the world, including Australia.
• Know what to do if you get an animal bite or scratch.

Follow these steps even if you have had the rabies vaccine.

Resources and support

Find out more about rabies on the World Health Organization website.

Find a guide to rabies and bat lyssavirus infection in English and other languages.

If you need to know more about rabies or need advice on what to do next, call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.