Why should we still be wary of rabies? Update from the Clermont-Ferrand University Hospital travel prevention service

Rabies, this dreadful disease, considered eradicated in mainland France since 2001, was talked regarding once more in the summer of 2019, with a report to the Limoges University Hospital. Thanks to post-mortem analyses, the National Reference Center for Rabies confirmed in the fall of 2020 that the victim had contracted the disease following having been in contact with European bats which lodged in his attic.

The disease still exists in Europe

In Clermont-Ferrand, Professor Jean Beytout, attached to the anti-rabies center of the infectious diseases department

explains that the hexagonal territory, even considered free of rabies, is not immune to an occasional vector.

The disease still exists in Eastern Europe, and it starts in Germany and Switzerland

In Switzerland, yet declared free, the virus also persists in bats: on June 30, 2022, the Swiss Rabies Center detected it on a bat?!

Watch out for popular winter destinations

But the main risk of transmission to humans is rather linked to travel to many countries where the virus is still transmitted by terrestrial mammals. This is particularly the case for Tanzania, a destination for which the CHU’s “traveller” consultation is very popular this winter.

Reservoirs also exist in populations of foxes further east in Europe, wolves in Iran, skunks in North America, monkeys in many Asian countries, etc.

The virus is also active in overseas France, notably in Guyana and probably also in the Caribbean.

The risk is not zero in France

The fact is that only four people have contracted rabies in Europe since 1985. But the risk cannot be excluded with an infected bat being attacked by a domestic animal and biting it back. It suffices, then, that said animal bites a person, licks his eyes or his mucous membranes, for there to be a risk of transmission.

Deadly disease: what to do

For those who are not vaccinated, “rabies is a 100% fatal disease”, recalls the infectiologist. “Once you’ve been bitten, is it a race once morest time?! The virus progresses through the nerves to the central nervous system and to the brain. » Daily. The teeth and claws of animals are soiled by bacteria or viruses which can cause infections. Those of cats can deposit germs deeply while the skin seems barely injured. “We particularly fear tetanus, the spores of which persist in the soil that soils the wounds”.
2022 Updated Immunization Schedule Cleaning must be systematic, and consist of washing under a constant jet of antiseptic. Then be followed by antibiotic treatment if necessary. In prevention, the tetanus vaccination, compulsory for infants, will be updated at 6, 12, 25, 45, 65 years, then every ten years. Check your vaccination schedule or get an update in secondsici

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The neurological damage that defines the disease can take from a few days to several weeks: a very variable incubation period during which it is absolutely necessary to practice several injections of rabies vaccine. This is why the professor pleads for early vaccination. “Each injection makes it possible to increase the chances in the event of exposure, or at least to accelerate the good reactivity with the treatment”.

The approach does not stop there

In the event of a bite, in France and abroad, regardless of the conflict situation with the environment of the suspected animal: “It is absolutely necessary to know where the animal lives, if it has an owner and to take its coordinates , find out if the animal has veterinary care, if it has traveled to a country where rabies is present, if its behavior has recently changed…”, insists the doctor.

The most important thing is to be able to monitor the animal. This can above all be reassuring: “If he is alive and healthy following two weeks, it means that he was not rabid when he bit and he cannot have transmitted rabies. »

Clermont University Hospital, infectious and tropical pathologies department of Dr Christine Jacomet, on the Montpied site.
Rabies case at the Limoges University Hospital: “A bat cannot transmit the virus to humans if we follow a few good practices”
Anne-Bourges

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