Travellers to rabies-enzootic regions are recommended to have a risk assessment to guide vaccination decision-making, and all travellers should avoid exposure to rabies virus and other lyssaviruses
People who will be travelling to, or living in, rabies-enzootic areas should have a risk assessment by a health professional that considers their likelihood of interacting with animals and access to emergency medical attention in that location. This is needed to guide the decision to give rabies vaccine as pre-exposure prophylaxis.
People likely to be exposed to potentially rabid terrestrial animals in rabies-enzootic areas should receive pre-exposure prophylaxis.
To reduce their risk of exposure to rabies virus and other lyssaviruses, advise travellers to rabies-enzootic regions as follows:
- Avoid close contact with wild and domestic animals — this is especially important for children.14-16
- Avoid contact with stray dogs or cats. Be vigilant when walking, running or cycling.
- Do not allow young children to feed, pat or play with animals. Young children’s height makes bites to the face and head more likely. Bites in these locations increase the risk of developing rabies and reduce the time to onset of disease. Parents travelling with children to rabies-enzootic areas should consider pre-exposure prophylaxis for younger children.
- Do not carry food, and do not feed or pat monkeys, even in popular areas around temples or markets where travellers may be encouraged to interact with monkeys. In particular, do not focus on monkeys carrying their young, as they may feel threatened and bite suddenly.
- Avoid contact with bats anywhere in the world, including Australia. Only people who are appropriately vaccinated and trained should handle bats. If bats must be handled, follow safety precautions, such as wearing protective gloves and clothing.
- Know what to do if an animal bites or scratches16-20 — travellers should be educated about first aid treatment for rabies exposures, regardless of whether they have received the vaccine.
Note that bites have occurred in travellers who did not initiate any contact with animals, including people taking photos of an animal.13
For pre-exposure prophylaxis schedules, see People who work with bats, laboratory workers who work with live lyssaviruses and some people who travel to rabies-enzootic areas are recommended to receive rabies vaccine as pre-exposure prophylaxis.