Rabies: an update for nurses in general practice
Abstract
Practice nurses have an important role to play in raising the profile of rabies as a travel-related hazard. Hilary Simons, Rachael Fletcher and Katherine Russell give an update for nurses working in this area of practice
Many thousands of human deaths are attributed to rabies infection globally each year; once the symptoms of rabies occur, death is almost always inevitable. Rabies is a zoonosis—a disease of animals that can be transmitted to humans—and can occur in all warm-blooded animals. Rabies remains a neglected disease that impacts most on impoverished and disadvantaged populations living in rabies endemic regions, who may have limited or no access to good healthcare facilities and safe rabies vaccine products. Practice nurses are well placed to raise travellers' awareness of the risk of rabies at a destination, and provide guidance on pre-travel vaccination and post-exposure treatment.
Rabies virus causes an acute viral encephalitis. Many thousands of human deaths are attributed to rabies infection globally each year; once the symptoms of rabies occur, death is almost always inevitable.
Rabies is a zoonosis—that is a disease of animals that can be transmitted to humans—and can occur in all warm-blooded animals. Transmission of rabies to humans from dogs accounts for more than 99% of human rabies deaths annually (World Health Organization, 2018a).
Rabies remains a neglected disease that impacts most on impoverished and disadvantaged populations living in rabies endemic regions, who may have limited or no access to good healthcare facilities and safe rabies vaccine products.
Effective pre-exposure rabies vaccine and post-exposure rabies treatment products are available in most high-income countries, including the UK. However, deaths from rabies in un-vaccinated travellers still occasionally occur.
Provision of travel health services can be complex and health professionals should ensure that they are working within their level of competence (Royal College of Nursing, 2018). Practice nurses are well placed to raise travellers' awareness of the risk of rabies at a destination and within a specific travel itinerary. It is important to offer clear advice about avoiding contact with animals, management of bites, scratches and mucous membrane exposures from animals, as well as guidance on pre-travel rabies vaccination and post-travel treatment in the event of a rabies-prone exposure.
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