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How much does time outdoors increase your risk of rabies exposure?

90% of animal rabies cases in the U.S. occur in wildlife.1

Bats have caused 62 out of 89 (70%) human rabies cases in the U.S. since 1960.2 Contact with wildlife such as skunks, raccoons, and foxes also pose a potential risk.3

Bats are especially concerning because most types have very small teeth, leaving marks that disappear quickly. If a bat has landed on you while sleeping or if you waken to a bat near you, seek medical advice immediately.4 Generally speaking, never handle bats!

Is rabies in your state?

Here’s where in the U.S. you’re more likely to encounter rabid animals in the wild5:

Graphic illustration of a bat suspended

Bats

Every state but HI

Graphic illustration of a skunk

Skunks

Parts of AZ, CA, KY, NC, NM, TN, TX, VA, and the Midwest

Graphic illustration of a raccoon

Raccoons

Southern and eastern states

Graphic illustration of a fox

Foxes

AK, AZ, NM, TX

Graphic illustration of a mongoose

Mongoose

Puerto Rico

Which states report the most rabies?6

The number of rabid animals reported in the U.S. increased by 11% from 2017 (4,454) to 2018 (4,951). The states shown here accounted for almost half of all those reports.

  • Silhouette of the state of Colorado Colorado
  • Silhouette of the state of New York New York
  • Silhouette of the state of North Carolina North Carolina
  • Silhouette of the state of Pennsylvania Pennsylvania
  • Silhouette of the state of Texas Texas
  • Silhouette of the state of Virginia Virginia
Graphic illustration of a woman taking a selfie with foxes at a remote camping site

Hobbies and activities associated with a higher risk of rabies exposure7

While contracting rabies during everyday outside activities is rare, exposures can still happen. It’s important to be aware of your surroundings and teach children to do the same.

Of people worldwide who are bitten by suspected rabid animals, 40% are children.8

Children are at greater risk of rabies exposure because they8:

While visiting state or national parks, the best way to avoid exposure is to watch wildlife from a safe distance and keep pets leashed or well supervised. It’s important to teach children to avoid contact with stray animals and always report to a park authority when animals are acting strangely.9 Be cautious of animals who show signs of fearfulness, aggression, staggering, paralysis, seizures, or drooling more than normal. Others may act shy or timid, even uncharacteristically tame. All are possible symptoms of rabies.10

A bite or scratch from a stray animal is a bad way to end a vacation.

Rabies is known to exist on every continent except Antarctica. Overseas travel, especially to Southeast Asia, India, and North Africa, increases the risk of rabies exposure.11 No matter where your travels take you, it’s important to be aware of rabies risk and avoid contact with12:

If your travel plans include extensive stays in higher-risk areas, outdoor activities in remote rural areas, or caves that may lead to direct contact with bats, you may want to consider pre-exposure rabies vaccination.13

Receiving rabies vaccination before you are exposed does not eliminate the need for additional treatment if you are bitten. But it can offer a level of protection, particularly against unrecognized exposures or when post-exposure therapy is delayed. Pre-exposure vaccination primes your immune response so treatment after exposure can be effective more quickly. It also reduces the number of vaccinations and simplifies treatment.7

Graphic illustration of a family at a vacation cabin with bats flying nearby

Should your family be vaccinated against rabies?

Widespread domestic canine vaccine programs in the U.S. have virtually eliminated transmission of rabies by dogs. And oral anti-rabies vaccination bait is helping reduce spread among wildlife.14

But camping, certain outdoor exploration, and overseas travel to high-risk areas, all increase the risk of rabies exposure.13

Taking the step of having your family vaccinated against rabies as a precautionary measure can add peace of mind while traveling.

Those at highest risk of contact with a potentially rabid animal are advised by the Centers for Disease Control and Prevention (CDC) to consider pre-exposure rabies vaccination.7 Talk to your doctor about potential risks for rabies and ask if pre-exposure vaccination is right for you.

Where to go for help when you’re traveling

If you’re traveling to a remote area, you may have less access to quality healthcare, including rabies treatment.

If you suspect you or your family have been exposed to rabies while traveling, it’s important to immediately wash any wound for at least 15 minutes using soap and water.15

Seek help at the nearest medical facility and explain the circumstances around your possible rabies exposure. If you have been exposed, you may need to undergo a series of rabies doses. You may also receive human rabies immune globulin (HRIG) if you have not been previously vaccinated. Waiting for symptoms to appear will be too late. If you’re in any doubt, get medical attention right away.

References
  1. Blanton JD, et al. J Am Vet Med Assoc. 2012;241(6):712-722. doi:10.2460/javma.241.6.712 https://avmajournals.avma.org/view/journals/javma/241/6/javma.241.6.712.xml
  2. Pieracci EG, et al. MMWR Morb Mortal Wkly Rep. 2019;68(23):524-528. doi:10.15585/mmwr.mm6823e1 https://www.cdc.gov/mmwr/volumes/68/wr/mm6823e1.htm
  3. Rupprecht CE, et al. Lancet Infect Dis. 2002;2(6):327-343. doi:10.1016/s1473-3099(02)00287-6 https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(02)00287-6/fulltext
  4. Centers for Disease Control and Prevention. Coming in contact with bats. Accessed April 19, 2021. https://www.cdc.gov/rabies/bats/contact/
  5. Centers for Disease Control and Prevention. Wild animals. Accessed April 30, 2021. https://www.cdc.gov/rabies/location/usa/surveillance/wild_animals.html
  6. Ma X, et al. J Am Vet Med Assoc. 2020;256(2):195-208. doi:10.2460/javma.256.2.195 https://avmajournals.avma.org/view/journals/javma/256/2/javma.256.2.195.xml
  7. Centers for Disease Control and Prevention. Preexposure vaccinations. Accessed April 14, 2021. https://www.cdc.gov/rabies/specific_groups/travelers/pre-exposure_vaccinations.html
  8. World Health Organization. Rabies: key facts. Accessed April 14, 2021. https://www.who.int/en/news-room/fact-sheets/detail/rabies
  9. National Park Service. Biological Resources Division. Rabies. Accessed April 19, 2021. https://www.nps.gov/orgs/1103/rabies.htm
  10. American Veterinary Medical Association. Rabies and your pet. Accessed April 14, 2021. https://www.avma.org/resources/public-health/rabies-and-your-pet
  11. World Health Organization. Epidemiology and burden of disease. Accessed April 15, 2021. https://www.who.int/teams/control-of-neglected-tropical-diseases/rabies/epidemiology-and-burden
  12. World Health Organization. Expert Consultation on Rabies: Third Report. WHO Technical Report Series; 2018. Accessed April 21, 2021. https://apps.who.int/iris/bitstream/handle/10665/272364/9789241210218-eng.pdf?sequence=1&isAllowed=y
  13. Centers for Disease Control and Prevention. Rabies. Accessed April 14, 2021. https://wwwnc.cdc.gov/travel/diseases/rabies
  14. Cliquet F, et al. Vet Res. 2018;49(1):61. doi:10.1186/s13567-018-0554-6 https://veterinaryresearch.biomedcentral.com/articles/10.1186/s13567-018-0554-6
  15. Centers for Disease Control and Prevention. When to seek care. Accessed April 14, 2021. https://www.cdc.gov/rabies/exposure/index.html

Important Safety Information

  • People with a history of severe allergic reaction (e.g., anaphylaxis) to RabAvert or any of its ingredients should not receive RabAvert…

Indication

RabAvert is a vaccine approved for all age groups to help prevent rabies infection both before and after a suspected exposure.

…for protection before a potential exposure (PrEP) to the rabies virus. They should receive a different rabies vaccine if a suitable product is available. However, because rabies is almost always fatal if left untreated, the protection provided with RabAvert after a potential exposure (PEP) to the rabies virus outweighs the risks associated with a severe allergic reaction.

  • The ingredients of RabAvert, which could in rare cases, cause allergic reactions in some people, include egg and chicken proteins, processed bovine (cow) gelatin and trace amounts of neomycin, chlortetracycline, and amphotericin B. Let your healthcare professional know if you have had any issues, including allergic reactions, with any of these ingredients or with vaccines in general.
  • Severe, potentially life-threatening allergic reaction, swelling of the brain and spinal cord; loss of movement or sensation due to nerve damage, such as inflammation of the brain or temporary loss of movement; Guillain-Barré Syndrome; inflammation of spinal cord; inflamed nerves of the eye; and multiple sclerosis have in very rare cases been reported.
  • RabAvert should be injected into muscle only. RabAvert injected into a vein may cause a reaction throughout the body, including shock.
  • Fainting can occur when injectable vaccines are used, including RabAvert. Your healthcare provider should put procedures in place to avoid falling injury and to restore blood flow to the brain after fainting.
  • Patients with a weakened immune system due to illness or the use of certain medications or treatments (such as radiation therapy, antimalarials, and corticosteroids) may have issues developing immunity. If such a patient is receiving RabAvert, then the healthcare professional may measure immune response through blood testing. Vaccination with RabAvert for protection before a potential exposure (PrEP) to the rabies virus should be delayed in anyone who is sick or recovering from an illness.
  • RabAvert contains albumin which is a protein found in human blood that carries an extremely remote risk for transmission of viral diseases, including Creutzfeldt-Jakob disease (CJD), a rare brain disorder. No cases of transmission of viral diseases or CJD have ever been identified for albumin.
  • Persons who have not been previously vaccinated against rabies will receive Human Rabies Immune Globulin (HRIG). HRIG should not be administered to persons who have been previously vaccinated as it may counteract the effect of the rabies vaccine. Let your healthcare provider know if you were previously vaccinated for rabies as you may not need HRIG.
  • Only use RabAvert while pregnant or breastfeeding if clearly needed. RabAvert was not studied in pregnant or lactating women so it is not known if RabAvert can cause any harm to the fetus, have any effect on ability to get pregnant, or whether it is passed through breast milk to infants (but many drugs are excreted in human milk).
  • There is no information on how RabAvert works when given at the same time as other vaccines.  
  • The most common side effects in clinical trials were reactions at the injection site, such as reddening, hardening, and pain; flu-like symptoms, such as lack of energy, tiredness, fever, headache, muscle pain, and feeling of discomfort; joint pain; dizziness; swelling of lymph nodes; upset stomach; and rash.
  • Vaccination before a potential exposure (PrEP) to the rabies virus does not remove the need for additional therapy after a suspected or known rabies exposure.
  • Seek the advice of a healthcare professional to help assess your specific level of risk if you are traveling to areas of high risk of rabies exposure; in frequent contact with the rabies virus or rabid animals, such as on the job; and/or are active outdoors and could encounter animals with rabies in the wild.
  • If you are exposed to a potentially rabid animal, seek medical attention right away before you have symptoms. Once symptoms are present, the rabies infection has spread through the body and survival is unlikely.

Uses for RabAvert

RabAvert is a vaccine approved for all age groups to help prevent rabies infection both before and after a suspected exposure. 

Patients should always ask their healthcare professionals for medical advice about the appropriate use of vaccines and adverse events. To report SUSPECTED ADVERSE REACTIONS, contact Bavarian Nordic at 1-844-4BAVARIAN or the US Department of Health and Human Services by either
visiting www.vaers.hhs.gov/reportevent.html or calling 1-800-822-7967.

Please see full Prescribing Information