Katerina I were enjoying a beautiful afternoon on a Central American beach, swimming and body surfing the day away. As the sun dipped below the horizon, we finished up with a trip for dinner. In the small town near the restaurant, a man had a pet monkey that he was allowing the tourists to take pictures with for a few bucks. Who doesn’t like monkeys? Of course we went to get a picture with the spider monkey on our shoulder.
Unfortunately, the cute little monkey got excited and bit Katerina on the hand. In that instant, many thoughts flashed through my mind — first and foremost: rabies. After a very close inspection of the wound and a thorough cleaning with soap and water, we saw that the skin was not broken. This, combined with a detailed questioning of the monkey’s handler, made me feel much better about the situation.
Some basic knowledge of rabies, including treatment and prevention, is necessary for any traveler who might come into contact with animals. Rabies is a viral disease carried by warm blooded animals. This is primarily a neurological illness that effects the brain. In North America, bats, raccoons, and skunks are most common carriers. Dogs and cats from all corners of the world are also potential carriers.
Transmitted through saliva, often during a bite, the virus ascends the nerves to the brain. Thus, a bite on the leg will take longer to show effects than, say, a bite to the face. The CDC states that exposure to urine, feces or blood of an infected animal does not constitute an exposure. But an infected animal that licks an open wound can transmit the virus. Symptoms of rabies in humans includes weakness, agitation, fever, headache, and itching at the location of the bite are the most common. A few days later, hyperactivity and hallucinations can occur.
Rabies is a killer, literally. There has been at least one case of a person who had documented rabies and survived, without pre or post exposure treatment. Fortunately, there is an effective treatment if given in time. There’s even a vaccine!
If you’re bitten from an unknown animal, a good, aggressive cleansing with soap and water is first. The next step is to obtain the rabies “shots.” This is a combination of HRIG (Human Rabies Immune Globulin) and HDCV (Human Diploid Cell Vaccine). The first is given as soon as possible after the bite, while the latter is given five times over 30 days.
For those at high risk, such as animal handlers, a vaccine exists. A three shot series, given over 28 days, the pre-exposure vaccine still means you need more injections if bitten. A person who has received the rabies vaccine still requires two addition injections if bitten.
There can be a few problems if bitten in a remote or developing area. Some locations use rabies anti-serum made from duck or horse product, which can cause severe reactions in humans. Of course, this is better than no rabies treatment, but riskier than Human Rabies Immune Globulin. In the event of a bite or exposure in a developing area, notify your consulate and ask where you can get HRIG. Some consulates even stock it, themselves. The International Society of Travel Medicine may also be of help locating a clinic.
Having a game plan is key. Bites often occur unexpectedly and in unprovoked circumstances. This is also an unfortunate complication of a curious child who is raised to not be scared of other animals. If bitten, especially by an unknown animal…seek help immediately.
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