Rabies

Rabies

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Changed on: 14.01.2019
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About 55,000 to 60,000 humans are infected with the rabies virus every year, according to figures provided by the World Health Organisation (WHO). In most cases, dogs were identified as the transmitters. Almost half of the people bitten by dogs suspected of rabies are children under the age of 15.

Austria was declared free of terrestrial rabies in 2008. Rabies was last diagnosed in Austria in 2004 and 2006, both times in a fox. However, further examinations showed that the infection was caused by a vaccination virus that was ingested by a young animal. Prior to this, there was an animal rabies outbreak in 2002, which was caused by the immigration of foxes from Slovenia.

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About 55,000 to 60,000 humans are infected with the rabies virus every year, according to figures provided by the World Health Organisation (WHO). In most cases, dogs were identified as the transmitters. Almost half of the people bitten by dogs suspected of rabies are children under the age of 15.

Austria was declared free of terrestrial rabies in 2008. Rabies was last diagnosed in Austria in 2004 and 2006, both times in a fox. However, further examinations showed that the infection was caused by a vaccination virus that was ingested by a young animal. Prior to this, there was an animal rabies outbreak in 2002, which was caused by the immigration of foxes from Slovenia.

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Transmission

The virus is transmitted via the saliva of infected animals, in most cases through a bite. However, there are rare cases in which the pathogen enters the body through mucous membranes and abrasions, if there is direct contact with saliva. Dogs and cats usually discharge rabies viruses via their saliva when the disease is in its final phase. It is unlikely that the animal will display normal behaviour at this stage.

Contact with the blood, urine or faeces of an infected animal or just touching or stroking infected animals does not pose an infection risk.

Some cases of human-to-human transmission were published. The primary cause in such cases were transplants. Additionally, there were reports of individual cases where the virus was transmitted from one person to the other via a bite. Infections resulting from caring for rabies patients have not been observed to date.

Dogs represent the biggest risk in transmitting the pathogen to humans – the majority (ca. 99 %) of human infections are caused by dog bites. Cats are also important vehicles. However, transmission of the virus via rodents, leporine animals or primates is considered a very low infection risk.

The theory that exposure to bats in their living environment (caves with large bat populations) may present a relevant risk for a possible airborne transmission is still controversial. The mere presence of a bat in the same room is not enough to transmit the pathogen, although direct contact with bats does present an infection risk.

Bats infected with rabies are often found lying on the ground. They show abnormal behaviour, attack items close to them, have problems orienting themselves and show signs of paralysis. Such bats change their typical habits, become active in daylight and can be found in places they would not normally be seen.

Symptoms

Most rabies cases end terminally within 14 days of infection. The time between the bite and the first visible symptom depends where the victim was bitten. The further the bite is away from the central nervous system, the longer it takes for the first symptoms to appear. We differentiate between furious (excitative) rabies and dumb (paralytic) rabies, depending on whether the clinical presentation is dominated by a phase of hyperactivity or only by signs of paralysis.

The disease progresses in three classic stages:

Prodromal Phase

Humans: unspecific symptoms, such as signs of an influenza-like infection, aches, itching or parasthesia (neuropathic pains, e.g. tingling or burning sensations) around the area of the bite.


Animals: lethargy, fever, nausea, loss of appetite, vomiting, hydrophobia

Excitative phase

Humans: about 80% of patients develop this classic form of rabies (“furious rabies”). It is characterised by episodes of confusion, severe agitation and aggressiveness, alternating with periods of full consciousness. Additionally, fever, increased salivation, perspiration, widened pupils and goose bumps have also been described as symptoms. Cramps are rare, but may occur at a more progressed stage of the disease. The majority of patients develop hydrophobia, the most characteristic symptom of rabies. The disease will finally cause pareses, coma and multiple organ failure.

Animals: phases of severe agitation, hyperactivity, aggressiveness, salivation

Paralytic phase

Humans: in the paralytic form of rabies (“dumb rabies”, ca. 20 % of all cases) symptoms are the early onset of paresis and, later, pain, sensitivity disorders and vegetative dystonia. Hydrophobia is a less common symptom in this form, but may still occur. Eventually, the disease ends fatally through the complete paralysis of the respiratory muscles.

Animals: paralysis, sensitivity disorders, coma.

Surveillance

Surveillance

Rabies has declined rapidly in Western and Central Europe, thanks to intensive control measures. Austria was able switch to a random surveillance programme to effectively control the rabies-free status of the Austrian fox population, as a result of the overall favourable disease situation in Europe.

The new Austrian surveillance programme is based on an EFSA study, which recommends the passive surveillance of rabies in rabies-free countries. Only so-called indicator animals – i.e. animals that have been found dead or foxes, raccoon dogs and raccoons, as well as all wild animals suspected of rabies that have been killed in road accidents (confirmation by the local veterinarian officer required) – have been examined for rabies since 2013. See also “Information leaflet for hunters”. 

Immunisation

A pre-exposure prophylaxis is recommended for veterinarian staff (incl. veterinary students), taxidermists, animal keepers, pet shop owners and staff and epidemic hygiene staff, as well as staff at the appropriate laboratories and vaccine producers, according to the Austrian vaccination plan. Hunters only need rabies prophylaxis if they work near the borders to rabies-endemic regions (there were none in Austria as of 2014) and for hunting trips to rabies-endemic regions abroad. Pre-exposure prophylaxis is also recommended for bat researchers and professional, as well as hobby, speleologists and for travellers to rabies-endemic regions.

All individuals travelling into regions in which rabies is endemic should be informed of the risks of rabies infection and the possibility of a pre-exposure vaccination, as well as the treatment possibilities with post-exposure prophylaxis. However, our own behaviour can also help avoid infection, in addition to immunisation. Contact with pets, such as cats and dogs, as well as wild animals and bats, should be avoided in rabies-endemic regions.

Rabies Immunisation for Pets

Anti-rabies inoculations have become even more important since the introduction of the EU pet passport. The EU pet passport is a uniform pet document in English and the language of the relevant country issued for cats, dogs and ferrets. It replaces all former border formalities with regards to EU Member States and facilitates travel with pets inside the EU. The EU pet passport, which is valid for entering and leaving a country, must contain the anti-rabies inoculation and precise identification of the animal (tattoo or microchip).

AGES also determines the rabies vaccination titre for pets for travelling abroad in line with the regulations of the destination countries in question.

Important information for pet owners: change in regulations for travelling with pets as of 29th December, 2014.


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