Rabies: is it a danger in the UK?

Holidaymakers should "be careful around animals" when visiting rabies-affected countries, said the UK Health Security Agency – after a woman from Yorkshire died from the disease after being scratched by an infected puppy in Morocco.

Yvonne Ford had been on holiday to the North African country in February but only became ill two weeks ago. She "didn't think much" of the scratch from the young stray dog at the time, her daughter Robyn Thompson said in a Facebook post. But once she fell ill, she deteriorated rapidly, "losing her ability to walk, talk, sleep and swallow".

There is "no risk" to Ford's family and friends or to the wider public – there is no evidence of rabies being transmitted from human to human, said the UKHSA. But her death is a reminder that everyone should "take animal bites seriously" and "educate those around you", said her daughter.

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What is rabies?

Rabies is a rare but serious infection, spread by mammals such as dogs, cats, bats, raccoons, monkeys and foxes. It can be transmitted to humans through the saliva of an infected animal – usually in a bite or scratch but also from a lick to the eye, nose or mouth or an open wound.

Symptoms usually take between three and 12 weeks to appear, according to the NHS, but they can come much sooner or months, even years, later. Signs of infection include numbness or tingling around the area that's been bitten or scratched, muscle aches, headaches, nausea and fever. As the infection progresses to the central nervous system, symptoms can include muscle spasms that make it difficult to swallow, excessive saliva, double vision, seizures, and extreme irritability. In some cases, patients develop hydrophobia (fear of water), aerophobia (fear of fresh air), hallucinations and paralysis.

By the time symptoms appear, rabies is "almost always fatal". But if you get treatment quickly after being bitten or scratched by an animal with rabies, it "can be very effective" at preventing infection. There are also vaccinations you can have before travelling, if you're heading to a country where rabies is common.

Has anyone survived rabies?

In 2004, US teenager Jeanna Giese "made history" when she became the first person to survive rabies without a vaccination, said the Daily Mail. The 15-year-old was bitten by a bat as she carried it out of her local church in Wisconsin. Three weeks later, suffering from double vision and exhaustion so bad she "couldn't get out of bed", she was diagnosed with rabies.

My parents were told it was a "near-guaranteed death sentence", Giese told The Guardian. But doctors decided to try something that had never been done before, placing her in a coma to suppress her brain function and give her immune system a chance to fight the virus. Miraculously, she made a full recovery. Her treatment, now known as the Milwaukee protocol, has since been used on a number of other rabies patients but results have been mixed and its effectiveness questioned.

How common is rabies?

According to the World Health Organisation, rabies is a "serious public health problem in over 150 countries and territories", mostly in Asia and Africa. Globally, there are an estimated 59,000 human deaths a year from the disease.

The UK is considered to be "rabies-free", according to the government, since the disease has been "eliminated from the terrestrial animal population". Between 2000 and 2024, there were just six reported cases of rabies in the UK, all linked to exposure abroad, said the BBC.

There are, however, "rabies-like viruses" present in some species of bat found in the UK, said The Telegraph. There have been only been four documented cases in Europe of transmission of these viruses to humans from bats; one of those was in Scotland in 2002, when a licensed bat handler died after being bitten.

Costa Rica, Colombia and Turkey are among the countries labelled "high risk" for rabies by the UK government. Visitors are advised to "avoid contact" with animals in these countries and to consider having a course of pre-exposure rabies vaccines before travelling.

What should you do if you're bitten or scratched?

Wash the wound immediately with plenty water, disinfect it with alcohol or a strong antiseptic, and urgently seek medical help and the post-exposure treatment.

If you've already been vaccinated, "simple booster doses after a bite give full protection", said The Telegraph. Treatment is "more complicated" if you haven't been vaccinated: in addition to a rapid course of the vaccine, you'll need an injection of rabies immunoglobulin directly into the wound. However, this medication, which contains antibodies to neutralise the rabies virus, is "scarce and very expensive" and can be "hard to find".

The tragic death of Yvonne Ford highlights "vitally important issues", travel medicine specialist Dr Richard Dawood told the paper. With vaccination and prompt treatment, rabies is "an entirely preventable disease. Any death from rabies in a British traveller is an avoidable tragedy".