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What nurses need to know: Rabies

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Rabies is often carried by animals such as raccoons, bats and stray dogs

What is it?

Rabies is a potentially fatal infection which affects the brain and nerves. It’s commonly contracted from

contact with an infected animal, most often a dog, although animals such as bats and raccoons are also know to carry the infection.

Rabies is found throughout the world, particularly in Asia, Africa and Central and South America. It is not found in the UK except in a small population of wild bats.

The rabies virus is found in the saliva of an infected animal. The virus is transmitted to humans by a bite or scratch, or when saliva from an infected animal comes into contact with broken skin

The condition is almost invariably fatal once symptoms appear, but treatment before this point can be very effective. There is also a vaccine for people at risk of being exposed to rabies.

Rabies In the UK

In the UK, the last case of rabies in a terrestrial animal was observed in 1922. The last recorded cases of animal rabies outside of quarantine occurred in 1969 and 1970 when two imported dogs died soon after completing six months quarantine.

According to NATHNC, since then, nearly all cases of rabies in the UK have occurred in quarantined animals or in people who were infected abroad. The exception was human rabies in a bat handler infected with the condition in Scotland in 2002. The last reported case of rabies in a bat in Great Britain was in 2014.

There were 25 human deaths in the UK from imported rabies between 1902 and 2005, all but one of which resulted from a dog bite. Approximately 64% of deaths (16 of 25) were following a bite that occurred on the Indian Sub-Continent. Since 2000, five imported cases have been reported

Information for nurses

Practice nurses are extremely unlikely to see a case of rabies present in their surgery. However, nurses should be aware of the risks to travellers to areas where rabies is present. They should advise patients to:

  • Avoid contact with animals. The patient should also be informed that infected animals may behave strangely, but sometimes there may be no obvious signs that they are infected
  • Avoid touching any dead animals
  • Additionally, if the patient is travelling with a child or children, nurses should make sure that the parent or guardian informs the child on the dangers. In particular, the child should know that they should tell someone if they’ve been bitten, scratched or licked by an animal. They should also be checked for any wounds if they come into contact with an animal.

Treatment involves cleaning and disinfecting the wound, and a course of the rabies vaccine. In some cases, a medication called rabies immunoglobulin will be given into and around the wound. This provides immediate but short-term protection if there’s a significant chance you’ve been infected.

For more information, visit:
www.nhs.uk/conditions/rabies

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