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1. Should I be concerned about rabies when I travel outside the United States?

Yes. Rabies and the rabies-like viruses can occur in animals anywhere in the world. In most countries, the risk of rabies in an encounter with an animal and the precautions necessary to prevent rabies are the same as they are in the United States. When traveling, it is always prudent to avoid approaching any wild or domestic animal.

The developing countries in Africa, Asia, and Latin America have additional problems in that dog rabies is common there and preventive treatment for human rabies may be difficult to obtain. The importance of rabid dogs in these countries, where tens of thousands of people die of the disease each year, cannot be overstated. Unlike programs in developed countries, dog rabies vaccination programs in developing countries have not always been successful.

Rates of post-exposure prophylaxis in some developing countries are about 10 times higher than in the United States, and rates of human rabies are sometimes 100 times higher. Before traveling abroad, consult a health care provider, travel clinic, or health department about your risk of exposure to rabies and how to handle an exposure should it arise.

2. Should I receive rabies pre-exposure vaccination before traveling to other countries?

In most countries, the risk of rabies and the precautions for preventing rabies are the same as they are in the United States. However, in some developing countries in Africa, Asia, and Latin America, dog rabies may be common and preventive treatment for rabies may be difficult to obtain. If you are traveling to a rabies-endemic country, you should consult your health care provider about the possibility of receiving pre-exposure vaccination against rabies. Pre-exposure vaccination is suggested if:

• Your planned activity will bring you into contact with wild or domestic animals (for example, biologists, veterinarians, or agriculture specialists working with animals).
• You will be visiting remote areas where medical care is difficult to obtain or may be delayed (for example, hiking through remote villages where dogs are common).
• Your stay is longer than 1 month in an area where dog rabies is common (the longer you stay, the greater the chance of an encounter with an animal).

3. If I get pre-exposure vaccination before I travel, am I protected if I am bitten?

No. Pre-exposure prophylaxis is given for several reasons:

• First, although pre-exposure vaccination does not eliminate the need for additional therapy after a rabies exposure, it simplifies therapy by eliminating the need for human rabies immune globulin (HRIG) and decreasing the number of doses needed; a point of particular importance for persons at high risk of being exposed to rabies in areas where immunizing products may not be readily available.
• Second, it may protect persons whose post-exposure therapy might be delayed.
• Finally, it may provide partial protection to persons with unapparent exposures to rabies.