Rabies is a viral disease of the central nervous system that is virtually always fatal once symptoms appear. It is caused by viruses of the genus Lyssavirus (family Rhabdoviridae).
How infection occurs: most often by the bite of a sick animal; scratches or contamination of damaged skin with saliva and contact of saliva with mucous membranes (eyes, nose, mouth) can also be dangerous. Infection by inhalation of aerosol in an environment with a large number of bats (e.g., caves) has been rarely described.
Source of pathogen (reservoir): mammals – wild and domestic. Worldwide, dogs are responsible for the vast majority of human infections (WHO states 99%).
Incubation period: most often 1–3 months, but may be shorter (even approx. 10 days) or longer. It usually develops faster after a bite to the face/neck (closer to the CNS).
Who is most at risk: people with frequent contact with animals (e.g., veterinarians, shelter workers, foresters), travelers to endemic countries, and also people having contact with bats (e.g., cavers). Children are particularly vulnerable to bites.
2. Symptoms of rabies
In the beginning, symptoms are non-specific, which makes diagnosis difficult:
fever, headache, irritability, malaise,
disturbing tingling/pricking/burning at the site of the wound (after a bite or scratch).
Next, the neurological phase appears (often within a few days of initial symptoms), e.g.:
agitation, anxiety, insomnia,
hydrophobia (fear of water), difficulty swallowing, drooling,
photophobia, convulsions,
or paralytic form (progressive paralysis).
Complications and prognosis: after the onset of clinical symptoms, the disease almost always ends in death (usually as a result of respiratory failure).
When to urgently see a doctor:
always after a bite/scratch by an unknown animal or after saliva contact with mucous membranes, especially in risk countries,
immediately after exposure to a bat (even if the wound is small or not visible).
3. Where does rabies occur?
It is a disease with almost global range, but the risk varies greatly between regions.
Highest risk for humans: mainly Asia and Africa (WHO estimates about 59,000 deaths annually, and most cases concern these continents).
Frequent risk countries (examples): including India and parts of South/Southeast Asia and many African countries; risk may also concern parts of Latin America (depending on the region and access to post-exposure prophylaxis).
Europe/Poland: cases in humans are rare, but outbreaks in animals can occur (e.g., a GIW announcement reported outbreaks in Poland in 2025).
This information is most important for people going to exotic destinations, places with difficult access to medical care, and planning activities like trekking, field work, contact with animals, caves.
4. How to protect yourself against rabies?
A. General prevention
Do not touch or feed stray or wild animals (even "tame" ones).
Teach children the rule: we do not approach, pet, or pick up.
Avoid places where bats may be; in caves and grottos exercise particular caution.
If injury occurs: immediately wash the wound with soap and water for a long time, and then report to a doctor as soon as possible (medical qualification determines further proceedings).
B. Vaccination
Type of vaccine: the rabies vaccine is inactivated ("dead") – it cannot cause the disease.
For whom recommended (pre-exposure):
people from occupational risk groups (e.g., veterinarians, shelter workers, foresters),
people having contact with bats (e.g., cavers),
travelers to high-risk regions, especially when:
they plan a long stay, expeditions into the field,
they travel with children,
they will be in places with limited access to immunoglobulin and vaccinations after exposure.
Pre-exposure vaccination schedule (PrEP):
an increasingly used and recommended schedule is 2 doses: day 0 and 7.
in some situations, a 3-dose schedule is still found: 0, 7, 21/28 (depending on recommendations and preparation).
Booster doses and duration of protection:
with constant risk: antibiotic level control or a booster dose is used within a specific time window (depending on risk category and recommendations).
Important note: even after pre-exposure vaccination, after potential infection, you still need to see a doctor – usually 2 booster doses are then given (days 0 and 3), but without immunoglobulin.
5. Summary
Rabies is a disease that is best prevented, because after the onset of symptoms it is virtually always fatal. It is particularly worth considering vaccination if you are going to high-risk countries (especially in Asia and Africa), plan an active trip into the field, contact with animals, or expeditions to caves. It is safest to start vaccination at least a few weeks before departure, so as to manage to take the full schedule (minimum 0 and 7 days), and after every bite or contact with a bat act immediately and report to a doctor.