Rabies vaccination is becoming increasingly accepted by travelers and represents a not inconsiderable expense in travel medicine counseling. Here, the traveler’s fears of the frequency of the disease are in the foreground.

High-quality medical advice, especially in this sensitive area, should of course, like all our medical activities, be based on factual arguments and also take into account the individual feelings of the patient or traveler.

The following considerations should be communicated in order to arrive at an optimal travel vaccination outcome together with the patient:

  • Rabies is common in almost all tropical regions and is known as urban rabies. This means that transmission to humans occurs predominantly through dogs and rarely through bats.
  • Infection of German travelers with rabies is an exceptionally rare event. We average one introduction every one to two years.
  • The disease of rabies is absolutely fatal.
  • Contact with dogs on the trip is not so rare. Travel medicine specialists speak of up to 10% probability. The probability certainly depends on the type, duration and destination of the trip.

If this is how the traveler envisions contact with an animal that may be carrying rabies, they must decide the following alternatives for themselves:

  • A. He does nothing at all and says to himself: “it will be nothing”.
  • B. He immediately tries to get a postexposure vaccination.
  • C. is prophylactically vaccinated.
  • Point A is quite possible due to the rarity of the actual disease, but in the case of an absolutely fatal disease, the traveler will hardly bear this with the necessary composure. It is also not particularly pleasant to watch every approaching dog with suspicious eyes.
  • Point B is possible in principle, but often difficult to implement in practice. The efficacy of postexposure vaccination is not 100% documented. The vaccine, especially the passive one, is not available everywhere. The application of a hyperimmunoglobulin is very painful and has no side effects. No one actually knows exactly how quickly such postexposure vaccination must be given, ideally as quickly as possible in the first two days. After the first 3 vaccinations have to be given within a week, this is usually followed by a stay at the place of vaccination.
  • Point C Preventive vaccination consists of three vaccinations that are very well tolerated. To be considered is the expenditure of time, 3 pinpricks and the cost. The cost of travel vaccinations is currently covered by many health insurance plans. To be on the safe side, after contact with a likely infected animal, get 2 more active vaccinations. Passive vaccination may be omitted. If this revaccination is not possible or not desired, one can feel very safe, since no rabies case of a vaccinated person has become known yet.

With this information, the physician can also guide the traveler ethically clean on the path for or against prophylactic rabies vaccination in travel medicine.