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Dogs in Belgium officially rabies-free, contact with bats remains dangerous

On World Rabies Day ITM calls attention to a forgotten disease that makes 60,000 victims worldwide every year.
Since July 2017, the Institute of Tropical Medicine (ITM) is the national anti-rabies centre in Belgium. In the past three months 46 patients who were scratched of bitten by a possibly infected animal came to the ITM policlinic. In most cases, Belgian travelers came into contact with dogs, monkeys or other animals in risk countries in Africa or Asia, but six patients suffered scratch and biting wounds by Belgian bats. Belgium has been officially rabies-free since 2001, but contact with bats entails a small risk.

Dr. Patrick Soentjes, physician-in-chief at ITM: “Better safe than sorry. Rabies can be completely prevented, but thousands of people are killed every year in developing countries. In Belgium, the risk is limited to contact with bats. Fortunately, this is exceptional, but it does happen occasionally. Travelers traveling to Africa and Asia can be vaccinated preventively. Rapid intervention after a bite is also vital."

A deadly but almost forgotten disease

Rabies is a fatal disease.  It is the result of an infection with the rabies virus, usually by a bite of a rabies-infected animal such as a dog. The disease claims more than 60,000 human lives every year, especially young children in Africa and Asia. Belgium has been rabies-free since 2001 after an extensive vaccination campaign among the fox population. There is a small chance of contracting rabies in our country when coming into contact with bats, however.

The rabies virus occurs especially in dogs, bats, foxes and cats. Travelers can get it through a bite, scratch or lick of an infected animal. Once symptoms develop, the disease is always fatal. Persons who have been in contact with an infected animal have to be treated as soon as possible.

Vaccination before and after a risk contact

Since the beginning of July 2017, ITM is the only center in Belgium that can administer the active antibodies (rabies immunoglobines), after a risk assessment by a doctor. In addition, any doctor may ask  ITM to make an assessment of the risk that his patient has run. In contrast with most vaccinations, immunoglobulins are administrated after exposure to the virus.

Preventive vaccination offers partial protection against infection. ITM advises the vaccination treatment for people going on adventurous travels to Africa and Asia, or who frequently travel to these locations. The vaccine bolsters the immune system, but after a risky bite additional vaccination treatment is necessary, albeit to a lesser degree.

Protecting oneself against rabies is quite an undertaking. It takes three doses on three different days (day 1, day 7 and day 28). ITM researches promising shorter schemes of one week or even a day. Shortened vaccination schemes would be a cheaper solution that can also be applied in developing countries, where the disease causes the largest number of casualties.

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