Explainer: What is rabies and how do you avoid getting it?

A grandmother from South Yorkshire has died from rabies after returning from a holiday in Morocco, where she was scratched by a puppy with the virus.
Yvonne Ford, 59, from Barnsley, visited the North African country in February but . Her family now want to raise awareness about the virus.
What is rabies?
Rabies is a virus transmitted between mammals, nearly always through bites and scratches from an infected animal.
Rabies is always fatal once symptoms appear - even if someone is treated for it - but post-exposure treatment is very effective if given quickly enough.
How rare is it?
Although cases in UK travellers are very rare, rabies is endemic in many parts of the world, including popular holiday destinations such as Morocco, Turkey, India, Thailand, the Philippines and Indonesia.
While most developed countries are considered safe, the government says there is a risk from rabies in foxes in some European countries.
Since 1946, 26 cases have been reported in the UK. The most recent incident involved a person in 2018. The only domestic case was in Scotland in 2002 when a person was bitten by a bat.
There are around 59,000 cases of rabies globally each year, but there have been no incidents of human-to-human transmission.
How do you get infected?
Rabies is usually transmitted to humans through the bite or scratch of an infected animal, most often dogs, but also cats and bats.
Even a minor scratch can pose a risk, but there is also a risk of transmission where the animal has licked the eyes, nose or mouth, or a wound.
What if you are bitten, scratched or licked?
Immediate medical help is essential.
Anyone who is bitten, scratched or licked by an animal abroad should wash the site with plenty of soap and water and contact a doctor or medical centre.
The NHS says the same applies for people who are bitten or scratched by a bat in the UK.
Treatment, called post-exposure prophylaxis (PEP), includes a course of rabies vaccinations and, in some cases, rabies immunoglobulin.
What are the symptoms?
Once a person begins showing signs and symptoms of rabies, the disease is nearly always fatal.
Initially, people with the virus may exhibit flu-like symptoms, which develop into a fever, headache, nausea, vomiting, agitation, anxiety, difficulty swallowing and excessive saliva.
Spasms of the muscles used for swallowing make it difficult for the patient to drink and people can suffer hallucinations and paralysis.
The incubation period between being infected and showing symptoms is typically between 3 and 12 weeks, but can it can be as soon as a few days and can take many months.
How do you avoid rabies?
It is possible to get the vaccination before travelling abroad, but anyone who is bitten, scratched or licked is still advised to seek help even if they have had a course of jabs.
The NHS says the rabies vaccine is recommended for anyone travelling to a part of the world where rabies is more common, especially if they're going somewhere where it may be hard to get medical help quickly; they might come into contact with infected animals (for example by doing lots of outdoor activities like cycling or running), or they're staying for over a month.
But the rabies vaccine for travel is not available on the NHS meaning it will require a visit to a travel health clinic or pharmacy with travel health services.
Dr Chris Smith, clinical associate professor at the London School of Hygiene & Tropical Medicine (LSHTM), said that while treatments are "highly effective when started early", prevention is better.
"Avoid contact with animals abroad; if bitten or scratched, seek medical care immediately - don't wait for symptoms to appear," he said.

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Apply anti-itch cream If your rash is itchy, taking over-the-counter antihistamines or using topical corticosteroids may provide relief. You can also try using witch hazel towelettes or an itch-reducing lotion. Stay hydrated Don't let yourself get dehydrated. Drinking water and other fluids may help alleviate and prevent EIV. Elevate your feet It may be hard to rest while you're out and about on vacation, but try to build in rest breaks with your legs elevated whenever possible. You may be able to do this while someone holds your place in ride lines and during snack or meal breaks. Ducking into air-conditioned kiosks or restrooms with seated areas can also help. Check guest services Disney and other theme parks typically have first aid stations throughout the facility. They may stock anti-itch cooling gel to use on your skin. You can also gear up with some ahead of time. Soak your feet When the day is done, treat yourself to a cooling oatmeal bath. 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Massage your legs That same small study suggests manual lymphatic drainage massage could be of benefit as well. This gentle massaging technique is geared toward draining lymph (fluid) out of the legs and increasing blood flow in both deep and superficial leg veins. Here's how to do it. Drink water and go light on salt Drink lots of fluids and avoid eating salty food. This will help prevent the swelling associated with EIV. Wear moisture-wicking clothing If it's hot and sunny, protect your legs from sun exposure by covering them with light-colored fabric or sunscreen. If it's humid, try wearing moisture-wicking socks for added comfort. Covering your skin will help prevent further irritation. What does Disney rash look like? Here are some photos of Disney rash (exercise-induced vasculitis). What else could it be? In addition to EIV, here are some other rashes and skin irritations that may occur while you're on vacation: Heat rash (prickly heat). Heat rash can affect adults or children. It occurs in hot, humid weather and results from skin-on-skin or fabric-on-skin chafing. Urticaria. This condition is earmarked by hives brought about by raised body temperature. It can occur if you exercise strenuously or sweat profusely. Sunburn and sun poisoning. Too much sun exposure can cause sunburn or sun poisoning to occur. Also known as sun allergy, this condition can result in a painful, itchy red rash and blisters. You can avoid it by using sunscreen or covering your skin with UV-protective fabric. Contact dermatitis (allergy). While on vacation, you might be exposed to environmental irritants you're sensitive to or allergic to. These can include hotel soaps and shampoos and the detergent used to wash your bedding. When to contact a doctor Disney rash generally clears up independently, but you might need to see a doctor for more severe cases. A doctor can help you manage Disney rash if it: is very Itchy or painful lasts longer than 2 weeks returns with other forms of exercise A doctor might run tests to confirm that Disney rash is causing your symptoms. You'll likely be tested for allergies and other skin conditions with similar symptoms. After Disney rash is diagnosed, you could be prescribed an antihistamine or a topical corticosteroid cream to help manage your rash. Tips for staying cool and comfortable while on vacation Disney rash may not be the only tourist-related malady you experience while on vacation. Here are some other vacation-related conditions and their fixes. Preventing aching feet and legs People claim to clock in anywhere from 5 to 11 miles per day at theme parks like Disney. That amount of walking is bound to take its toll on feet and legs. Wearing well-fitting, comfortable shoes is a good way to ensure that your feet can handle the challenge. Make sure you choose footwear that allows your feet to breathe and provides ample support. Choose footwear that's appropriate for hiking in hot weather, and your feet, legs, and back will all be in better shape at the end of the day. Flip-flops and flimsy sandals may not be your best bet. But they're handy to keep with you for a quick change at the very end of the day. Avoiding sunburn Wear sunscreen, whether the sun is bright or you're walking around on a cloudy or hazy day. A hat and sunglasses can help protect your face and eyes. Also, consider opting for light-colored sun-protective clothing. If you do get a sunburn, treat it with home remedies, such as aloe vera, oatmeal baths, or cool compresses. If your sunburn is blistered or severe, check in with your hotel doctor or stop by a theme park first aid station for treatment. Staying cool It can be hard to escape from heat and humidity at a theme park, but there are ways to stay cool on the go. Consider the following: Carry a battery-operated or paper handheld fan. You can also find battery-operated fans that attach to strollers or can clip onto wheelchairs. Use a personal, handheld water mister on your face, wrists, and the back of your neck for an instant cooldown. Keep drinks in a small cooler with an ice pack or frozen bottle of water. Wear a cooling bandana with activated polymers around your forehead or neck. Wear a cooling vest. These usually use evaporative cooling or come with a cold-pack system. Wear moisture-wicking fabrics to keep skin comfortable and dry. The most important thing is to drink plenty of water or other hydrating drinks. They can be cold or not. Staying hydrated helps your body do what it does best to keep you cool: sweat. Takeaway It may be vacation, but a day at a theme park can be grueling, even if you're in excellent physical condition. At the end of the day, try to build in some quiet time when you can rest and recharge. 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Medscape

6 hours ago

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