Rabies

What is rabies?

Rabies is a fatal, yet preventable, viral disease that infects the central nervous system. Singapore has been rabies-free since 1953.

How is rabies transmitted?

Rabies is commonly spread through the saliva of infected animals (commonly dogs), via bites or scratches, or direct contact with the mucosa (e.g. eyes, mouth or open wounds).

What are the symptoms of rabies?

Persons infected with rabies may initially develop non-specific symptoms including:

• Fever

• Tiredness

• Cough

• Sore throat

• Loss of appetite

• Abdominal pain

• Nausea and vomiting

• Diarrhoea

• Pain or numbness at the wound site

Symptoms may progress in severity, and the infected person might subsequently experience the following:

• Unusually fast heart rate

• High blood pressure

• Throat spasms

• Extreme or irrational fear of water and drafts

• Paralysis and coma

The death rate for rabies is virtually 100%.

What are the risk factors?

Animal bites (most commonly mammals such as dogs or bats) in a rabies-endemic country.

How is rabies treated?

There is no specific treatment for symptomatic rabies in humans and only supportive care.

If you have been scratched or bitten by an animal in a rabies-endemic country, consult a doctor immediately on whether you need to start rabies post-exposure prophylaxis.

How to prevent rabies?

When travelling to rabies-endemic countries, you are encouraged to adopt these health precautions:

• Rabies vaccination is available in Singapore. Discuss pre-exposure rabies vaccination with your doctor 4 to 6 weeks prior to travelling. Note that even with pre-exposure vaccination, post-exposure treatment is still required if bitten or scratched.

• Avoid feeding or touching animals, especially stray or wild animals.

• Supervise children around animals and instruct them to report any animal bites or scratches immediately.

If scratched or bitten, you should immediately:

• Wash the wound thoroughly with soap and water. If available, use a virus-killing agent such as povidone iodine solution to wash the wound.

• Seek medical attention immediately. Your doctor may offer you rabies post-exposure treatment (prophylaxis), to prevent disease after exposure. Post-exposure prophylaxis is highly effective when administered promptly.  This would consist of a series of rabies vaccines and may include administration of rabies immunoglobulin around the wound if indicated. Your doctor may also provide additional management to prevent other animal bite-related complications (e.g., antibiotics, antivirals, tetanus vaccines).