What Is Rabies?
A fatal viral disease transmitted through the saliva of infected mammals, almost always through bites or scratches.
Pathogen: Rabies virus (Lyssavirus genus, Rhabdoviridae family)
Type: Virus
Transmission
Bite, scratch, or saliva contact with mucous membranes from an infected mammal. Dogs are responsible for up to 99% of human cases globally. Bats, monkeys, cats, and other mammals can also transmit the virus.
Vector: No arthropod vector. Direct mammal-to-human transmission via bites, scratches, or saliva on broken skin or mucous membranes.
Symptoms
Initial symptoms include fever, pain or tingling at the bite site, headache, and malaise. Progresses to either furious rabies (hyperactivity, hydrophobia, aerophobia, agitation) or paralytic rabies (ascending paralysis). Both forms progress to coma and death.
Incubation period: 21 – 90 days
Usually 1-3 months but can range from days to over a year depending on bite location (shorter for head/neck bites), wound severity, and viral load. Once symptoms appear, rabies is almost invariably fatal.
Timeline: Prodromal symptoms last 2-10 days. Neurological phase lasts 2-7 days. Death typically occurs within 2 weeks of symptom onset. Once clinical rabies develops, survival is essentially zero.
Case fatality rate: Virtually 100% once symptoms appear. Fewer than 20 people have ever survived clinical rabies.
Diagnosis & Treatment
Diagnosis: Diagnosis in humans is typically clinical once symptoms appear. Laboratory confirmation via direct fluorescent antibody (DFA) test on skin biopsy (nuchal), saliva PCR, or serum/CSF antibody testing. Diagnosis is often confirmed post-mortem.
Treatment: No treatment once symptoms develop. Post-exposure prophylaxis (PEP) is highly effective if started promptly: thorough wound washing, rabies immunoglobulin (RIG) infiltrated around the wound, and a course of rabies vaccine. PEP must begin as soon as possible after exposure.
Prevention
- Pre-exposure vaccination (3 doses, recommended for travellers to high-risk areas)
- Avoid contact with stray dogs, monkeys, bats, and other mammals
- Do not feed or pat unfamiliar animals
- Teach children to avoid animals
- Carry a plan for accessing post-exposure prophylaxis at your destination
- Know the location of the nearest facility that stocks rabies immunoglobulin
💉 Vaccine Available
A vaccine is available for Rabies. View the Rabies vaccine guide for details on schedule, cost, and availability in Australia.
Post-Exposure
Immediately wash the wound thoroughly with soap and running water for at least 15 minutes. Apply antiseptic (povidone-iodine or alcohol). Seek medical attention urgently for post-exposure prophylaxis (PEP). If pre-vaccinated, you need 2 booster doses. If unvaccinated, you need rabies immunoglobulin (which may not be available locally) plus 4-5 vaccine doses.
Long-Term Effects
There are no chronic sequelae — rabies is either prevented by timely PEP or is fatal. The rare survivors have had severe permanent neurological disability.
📋 Rabies is a nationally notifiable disease in Australia. Australia is considered rabies-free, though Australian bat lyssavirus (ABLV), a closely related virus, is present in Australian bats.
Frequently Asked Questions
Do I need the rabies vaccine for Southeast Asia?
Pre-exposure rabies vaccination is strongly recommended for travellers to Southeast Asia, particularly if you plan to visit rural areas, will be travelling for more than a month, or may have difficulty accessing medical care within 24 hours. Countries like Indonesia, Vietnam, Cambodia, Thailand, and the Philippines all have high rates of canine rabies. Monkey bites in tourist areas (e.g., Ubud Monkey Forest in Bali) are also a common exposure.
What should I do if I'm bitten by a dog overseas?
Immediately wash the wound with soap and running water for at least 15 minutes — this alone significantly reduces risk. Then apply antiseptic (iodine or alcohol). Seek medical attention the same day for post-exposure prophylaxis (PEP). If you were pre-vaccinated, you need 2 booster doses. If unvaccinated, you need rabies immunoglobulin (RIG) plus a full vaccine course. RIG is often unavailable in developing countries, which is a key reason to get pre-vaccinated before travel.
How much does the rabies vaccine cost in Australia?
The pre-exposure rabies vaccine course (3 doses on days 0, 7, and 21-28) typically costs $300-400 in total at Australian travel clinics, including consultation fees. While this is a significant cost, post-exposure treatment overseas (if available) can cost $1,000-3,000 or more, and rabies immunoglobulin is often unavailable in rural areas of endemic countries.
Can you get rabies from a monkey scratch in Bali?
Yes. Any bite or scratch from a mammal in a rabies-endemic area should be treated as a potential rabies exposure. Monkey scratches are a common exposure at places like the Ubud Monkey Forest. Even minor scratches should be washed thoroughly and assessed by a doctor for PEP. Bali has confirmed dog rabies and monkeys can also carry the virus.
How long after a bite can you get rabies treatment?
Post-exposure prophylaxis (PEP) should be started as soon as possible — ideally the same day. However, PEP can be effective even weeks after exposure, as the incubation period is typically 1-3 months. There is no time limit after which PEP should not be given. If you were bitten overseas and did not receive PEP, seek medical attention as soon as you return to Australia, even if weeks have passed.
Is rabies always fatal?
Once symptoms of rabies appear, the disease is almost invariably fatal. Fewer than 20 people have ever survived clinical rabies, and most survivors had severe permanent disability. However, rabies is almost entirely preventable with timely post-exposure prophylaxis (PEP) after a bite. The key is to seek treatment before symptoms develop.
Do I need rabies immunoglobulin if I was pre-vaccinated?
No. If you completed a pre-exposure rabies vaccination course, you do not need rabies immunoglobulin (RIG) after an exposure — only 2 booster vaccine doses (on days 0 and 3). This is a major advantage of pre-vaccination, as RIG is expensive, often unavailable in developing countries, and must be infiltrated around the wound.
Which animals carry rabies?
Any mammal can carry rabies. Globally, domestic dogs are responsible for up to 99% of human rabies deaths. Other animals that commonly transmit rabies include cats, monkeys, bats, foxes, and raccoons. In Australia, the closely related Australian bat lyssavirus (ABLV) is found in bats. Avoid contact with all unfamiliar animals when travelling in endemic countries.
Sources & References
Last updated: April 2026