After a British woman, Yvonne Ford, 59, sadly died from rabies following a trip to Morocco where she was scratched by a dog, an alert has been shared by the UK Health Security Agency (UKHSA) to remind holiday goers to stay safe.
UKHSA also sought to reassure those worried that rabies could become an issue here in the UK.
In a new blog post responding to the news, UKHSA said while "the individual was diagnosed in Yorkshire and the Humber, there is no risk to the wider public in relation to this case".
As a precautionary response, it added, "health workers and close contacts are being assessed and offered vaccination when necessary".
But what actually is rabies and the risk of catching it while abroad? What symptoms should we be aware of? And what treatment options are there rabies?
What is the level of rabies risk in the UK?
Given the tragic death of a woman in Yorkshire and the Humber in relation to rabies (a neurotropic virus) and the fact we're just emerging from a pandemic, it's understandable that people might be concerned. But, says superintendent pharmacist, Abbas Kanani MRPharmS, of Chemist Click, the risk of contracting rabies in the UK is extremely low. "The UKHSA report that there is no risk in animals and low risk in bats."
Dr. Bruno Silvester Lopes, lecturer in microbiology and epidemiology at Teesside University, adds that, "The UK is classified as rabies-free in terrestrial animals, meaning that the risk of rabies here is very low. The only reservoir of rabies-like viruses is in some species of bats, but human cases from bats are exceedingly rare."
Which popular holiday destinations pose a rabies risk?
"There are a number of countries where the risk of rabies is particularly high. High-risk Asian countries include India, Thailand, Indonesia (Bali), Vietnam, Philippines and China," Dr Lopes notes. "Rabies is also a risk in Africa, and in particular countries such as Morocco, Egypt, Kenya, Tanzania and South Africa. People should also consider the risk of rabies when travelling to Brazil, Mexico, Peru, Turkey, Romania and Serbia.
"These countries often have a large population of free-roaming dogs and less consistent access to post-exposure treatment."
Always check the travel advice on the government website prior to visiting a new country and be mindful of interactions with animals. You can also look into getting a vaccination and speak with your GP about this.
Elsewhere, the UK government has a list of other high risk rabies countries, some of which include:
- Argentina
- Armenia
- Bali
- Bangladesh
- Borneo
- Brazil
- Cambodia
- Central African Republic
- China
- Egypt
- Ghana
- India
- Indonesia
- Israel
- Korea (North and South)
- Laos
- Lithuania
- Mexico
- Nepal
- Peru
- Poland
- Romania
- Sri Lanka
- Thailand
- Vietnam
Canada and the USA are both listed as low risk but "foxes, skunks and racoons are high risk".
How is rabies transmitted and how can we keep safe?
"The main route for the transmission of rabies is by bites or scratches from infected mammals, particularly dogs, which make up over 99% of human cases worldwide," says Dr Lopes, who adds that cats and monkeys can also transmit rabies.
"People can also contract rabies through other routes including licks on broken skin or mucous membranes such as the eyes or mouth, by dogs or very rarely, by bat bites."
In order to keep safe, the number one piece of advice is to avoid contact with animals – in particular stray dogs, cats, and monkeys – no matter how cute, friendly or clean they may appear.
Dr Lopes adds it's also best not to "feed or pet animals, even in tourist areas" and that it's "highly recommended to get a pre-exposure rabies vaccine if you are travelling to high-risk areas for long periods, visiting remote regions with limited medical access or working with animals".
What should you do if you're bitten by a stray dog?
If you're bitten or scratched by a dog in a high risk country, it's always best to act quickly, says Dr Lopes, and get the wound cleaned before seeking medical help.
"If bitten or scratched, immediately wash the wound with soap and water for at least 15 minutes and seek urgent medical attention for post-exposure prophylaxis (PEP) even if you are vaccinated," he says.
What are the symptoms of rabies?
Symptoms of rabies can vary from one person to another and may not appear immediately. In the case of Yvonne Ford, it is reported that it took several months for her symptoms (which included a headache which later led on to her being unable to walk, talk, sleep or swallow) to manifest.
Ford passed away in June but visited Morocco back in February.
Kanani says signs to be aware of include:
- Numbness or tingling at the site of being bitten or scratched
- Increased anxiety or energy levels
- Hallucinations
- Problems with swallowing or breathing
- Paralysis
"Symptoms usually take some time to appear, typically between 3 to 12 weeks of infection," he details. "Once these symptoms are present, it is likely to be fatal."
How do you treat rabies?
Unfortunately, rabies cannot be treated once it reaches the central nervous system and symptoms begin, says Kanani explains. "People who have not had the rabies vaccine or have a compromised immune system may also be given a medicine called rabies immunoglobulin," he continues.
"Ford's case is rare because rabies is preventable when the correct provisions are followed. However, the survival rate once rabies symptoms are present is practically non-existent."
Dr Lopes adds, "Before rabies symptoms start, post-exposure prophylaxis PEP treatment is advised, as well as thorough wound cleaning for at least 15 minutes. In some cases, rabies immunoglobulin is required or rabies vaccination, which involves a course of four doses."
Speaking about the very sad case of Yvonne Ford, Dr Lopes highlights "the recent death we have heard about in the news this week is a rare occurrence. Human rabies cases are very rare in the UK, and any death is typically due to infection acquired abroad.
"This tends to happen when a person is bitten while travelling but does not seek prompt PEP, they do not realise the seriousness of the risk and there is limited access to care in remote areas."
This article is not intended to be a substitute for professional medical advice or diagnosis. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
Jennifer Savin is Cosmopolitan UK's multiple award-winning Features Editor, who was crowned Digital Journalist of the Year for her work tackling the issues most important to young women. She regularly covers breaking news, cultural trends, health, the royals and more, using her esteemed connections to access the best experts along the way. She's grilled everyone from high-profile politicians to A-list celebrities, and has sensitively interviewed hundreds of people about their real life stories. In addition to this, Jennifer is widely known for her own undercover investigations and campaign work, which includes successfully petitioning the government for change around topics like abortion rights and image-based sexual abuse. Jennifer is also a published author, documentary consultant (helping to create BBC’s Deepfake Porn: Could You Be Next?) and a patron for Y.E.S. (a youth services charity). Alongside Cosmopolitan, Jennifer has written for The Times, Women’s Health, ELLE and numerous other publications, appeared on podcasts, and spoken on (and hosted) panels for the Women of the World Festival, the University of Manchester and more. In her spare time, Jennifer is a big fan of lipstick, leopard print and over-ordering at dinner. Follow Jennifer on Instagram, X or LinkedIn.
