Sadly, Africa is full of stray dogs and wherever your adventures take you, you're likely to see malnourished, mange-ridden animals living rough on the streets. For dog lovers, the temptation to feed and pet these sorry souls is huge. However, there is a risk of rabies throughout the continent, so the safest course is to avoid contact unless you're sure the dog isn't infected. Of course, dogs aren't the only animals to carry the disease. All mammals can get rabies and some wild African animals including bats, mongeese, jackals and foxes are common carriers.
What is Rabies?
Rabies is a virus that is transmitted to humans through the saliva of an infected animal, i.e. via a bite or scratch. There are two different forms of the disease – furious rabies and paralytic rabies (see below for separate symptoms). Rabies is found all over the world, in more than 150 countries and on every continent except Antarctica. However, 95% of rabies-related deaths occur in Africa and Asia, with a total of 60,000 people dying from the disease every year. Rabies can be effectively treated if it is caught in time. However, once clinical symptoms set in, the disease is uniformly fatal.
Rabies symptoms do not develop immediately after exposure. Typically, there is an incubation period of between two and three months (although in some cases, symptoms may appear as soon as a week after the bite or may be delayed by up to a year). The length of incubation depends on the position and severity of the bite. At first, victims will experience flu-like symptoms including fever, headaches, weakness and discomfort. This is swiftly followed by a burning or tickling sensation around the wound site.
Once the virus spreads to the central nervous system, the brain and spinal cord become inflamed and death is imminent. This is known as the clinical stage and there are fewer than 20 documented survivors. The two forms of rabies have different clinical symptoms. Sufferers of furious rabies may experience hyperactivity, agitation, anxiety and fear of water (hydrophobia). Death occurs in a matter of days as a result of cardio-respiratory arrest. Paralytic rabies victims experience gradual muscle paralysis, which results in a coma and eventually, death.
The best way to avoid contracting rabies while traveling is to avoid contact with potentially rabid animals. Animals with rabies may behave in a number of ways, depending on which form they have. Those with furious rabies are overly aggressive, have an excess of saliva and may try to bite anyone that comes near them. Paralytic rabies results in animals that are timid, depressed and/or lethargic, and often makes wild animals behave as if they are tame. Some animals may display no symptoms at all.
Because it's impossible be certain whether an animal has rabies, the safest course is to avoid contact with any stray, pet or wild animal unless you know for sure that they are not infected. 99% of global rabies cases in humans are caused by dog bites, so be especially wary around dogs. If you're traveling with kids, bear in mind that nearly half of rabies cases occur in children aged 15 or younger. This is because they are more likely to play with infected animals and may not think to report minor wounds to an adult.
What to Do if You Are Bitten
If you are bitten by any mammal during your travels, seek immediate medical attention whether or not the animal shows symptoms of rabies. You will be given a course of the rabies vaccine, which will prevent the disease from spreading to your central nervous system. If given in time, this vaccine is 100% effective. Depending on a number of factors (including the severity of the bite, whether it was provoked, if the animal is known to have rabies or to have been vaccinated against it) you may also be given a shot of rabies immunoglobulin.
Because it is very difficult to diagnose rabies before the onset of clinical symptoms, you should always seek treatment even if you believe the chances of infection are slim. If you wait until serious symptoms develop, it may be too late. While waiting to receive treatment, make sure to clean the wound thoroughly with soap and water. Immediate cleansing has been proven to significantly reduce the likelihood of infection.
Pre-Exposure Rabies Vaccination
Rabies vaccinations are also available as a preventative measure. Pre-exposure vaccination is recommended for anyone traveling to a known rabies area, especially if you are going to be in contact with stray or wild animals or in a remote region where medical aid is difficult to get to quickly. Examples include people going on safari and those who will be involved in veterinary or conservation work. Talk to your doctor well in advance about getting a rabies vaccination, as it must be administered in three doses over a period of up to four weeks.
Remember that getting a pre-exposure vaccination does not preclude you from having to seek medical attention if you get bitten. You should still follow the same steps listed above. However, those that have already received the rabies vaccination have longer to get to hospital before clinical symptoms set in, and will respond more quickly to treatment. You will need fewer doses of the post-exposure vaccine and you will not need rabies immunoglobulin, which is expensive and sometimes difficult to procure.